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Connections: Episode 2

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Crohn's Disease and the Link to Colon Cancer

The number of people diagnosed with Crohn’s disease, especially young people, is on the rise and has been since the 1950s, but the cause is still unknown. Some believe environmental factors and genetics are to blame, while others believe modern food consumption trends may be causing the increase. Since it's Colon Cancer Awareness Month, we’re taking a look at the disease to see how the chronic inflammation caused by Crohn's increases the risk of developing colon cancer.

What is Crohn’s disease?

Crohn’s disease is a chronic inflammatory bowel disease (IBD) that affects approximately 700,000 people in the United States. The disease is named after Dr. Burrill B. Crohn, who first described the disease, along with Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer, in 1932.

Crohn’s is characterized by inflammation and ulcers along the gastrointestinal (GI) tract that can cause severe abdominal pain, diarrhea, fatigue, weight loss and malnutrition. Crohn’s can affect any part of the GI tract, which spans from the mouth to the anus, but most commonly occurs at the end of the small intestine, called the ilium, where it meets the large intestine. Severe forms of Crohn’s can also affect the eyes, skin and joints.

The disease can occur at any age but is most commonly diagnosed between the ages of 15 and 30. Children and teens diagnosed with the disease face different challenges than adults. Since the disease interrupts normal digestive function, younger people may experience stunted growth, weakened bones and even delayed puberty.

Common symptoms

Symptoms caused by Crohn’s disease can range from mild and irritating to painful and debilitating depending on the severity and location of the inflammation. Symptoms most often develop gradually over time. Although rare, symptoms may develop suddenly and dramatically without warning.

Early warning signs of Crohn’s disease include diarrhea, abdominal cramps, bloody stool, fever, fatigue, loss of appetite, weight loss, nausea or vomiting, anemia, feeling like your bowels aren’t empty after bowel movements and feeling a frequent need for bowel movements. As the disease progresses, anal fistulas, ulcers and inflammation of the joints and skin may develop. People may experience periods of severe symptoms followed by periods of no symptoms at all, called remission, that can last for weeks or years.

Due to the chronic inflammation and damage caused by Crohn’s, those with the disease also have a higher risk of developing colon cancer.

Suspected causes of Crohn’s disease

The exact cause of Crohn’s disease is unknown, but there are many theories surrounding possible causes. The most commonly accepted theory is an abnormal reaction in the immune system. Researchers believe the immune system in those with Crohn’s mistakenly attacks foods and good bacteria found in the digestive track as if they were harmful invaders, such as bacteria, viruses or fungi. This causes white blood cells to build up in the lining of the GI tract and triggers inflammation that does not subside, leading to ulcers and pain consistent with Crohn’s. Unfortunately, it’s unclear whether the abnormal immune response causes Crohn’s or is a result of it.

Some also believe that Crohn’s may have ties to genetics. The disease is more common in people who have family members with the disease, so genes may play a role in an individual’s susceptibility. According to the Crohn’s and Colitis Foundation, five to 20 percent of those with Crohn’s have a first-degree relative (parent, child or sibling) with an IBD.

In recent years, researchers have found that Crohn’s is more common in developed countries, leading them to believe environment has an impact on one’s likelihood of developing the disease. A diet high in processed food has been linked to increased chances of developing Crohn’s, as has taking antibiotics and birth control.

Risk factors

In addition to the suspected causes above, the following factors are tied to a higher likelihood of being diagnosed with Crohn’s disease.

Age: Most people are likely to develop Crohn’s at a young age, typically before the age of 30. However, the onset of the disease can occur at any age.

Ethnicity: Caucasians and people of Eastern European Jewish decent have the highest risk. However, an increasing number of African Americans living in the U.S. and the U.K. are being diagnosed with Crohn’s.

Cigarette smoking: Smoking can lead to more severe forms of Crohn’s disease and is one of the most important, controllable factors leading to diagnosis.

Nonsteroidal anti-inflammatory medications: Medications such as ibuprofen, naproxen and aspirin have shown to worsen Crohn’s symptoms by causing inflammation of the bowel. These medications do not cause the disease but can worsen its affects.

Location: Those who live in urban areas or in industrialized countries are more likely to develop Crohn’s disease.

Managing Crohn’s disease

For children, teens and adults with Crohn’s disease, managing life with a chronic condition is a difficult task. For most, the first step in treating Crohn’s is medication to help control symptoms. Your doctor will most likely recommend a combination of prescription and over-the-counter options to alleviate your symptoms, which could include diarrhea, bloating, joint pain, fever and irritation of the skin around the anus.

A change of diet plays a big role in managing Crohn’s at any age. Paying attention to the foods you eat is very important, as Crohn’s negatively impacts your body’s ability to absorb vitamins, nutrients and water. Recommended diet modifications may include eating smaller meals more often, reducing or cutting out greasy or fried foods, avoiding foods that make your symptoms worse, limiting foods high in fiber, avoiding caffeine and taking vitamin or mineral supplements.

There are many resources for people coping with their Crohn’s disease diagnosis. The Crohn’s & Colitis Foundation has excellent information on both IBDs and Crohn’s disease for those searching for ways to incorporate living with Crohn’s into their everyday life.

If you have experienced symptoms of IBD or Crohn’s disease, it’s important to consult a physician as soon as possible for diagnosis and treatment. Find an INTEGRIS location near you and start your journey toward managing Crohn’s disease today.