Bathroom Troubles Bogging You Down? Crohn’s Disease Could be the Culprit

On a Reddit thread, R, 30, shared her experience of over a few months. She was struggling with severe diarrhoea, with escalating abdominal pains, accompanied by fatigue. Initially attributing these symptoms to high stress levels, she grew alarmed when she started passing bloody stools. What she initially suspected to be appendicitis or irritable bowel syndrome (IBS) turned out to be Crohn's disease.

It might sound alarming, but don’t let that stop you from understanding this complete round-up of its causes, diagnosis, complications, treatments, and how best to manage it.

It is an autoimmune condition that irritates and inflames any part of your digestive tract, right from your mouth to the anus. Usually, it impacts your small and large intestines.

Crohn’s is a type of inflammatory bowel disease (IBD) and it's important to differentiate it from IBS, as Dr Vinay Dhir, a gastroenterologist at SL Raheja Hospital, explains. While IBS entails chronic abdominal pain and changes in bowel movements, IBD involves inflammation across various segments of the gastrointestinal (GI) tract. “IBS manifests as pain in the abdomen with diarrhoea or constipation over a long period. There are no diagnostic tests for IBS as it is a diagnosis of exclusion depending on clinical symptoms,” notes Dr Dhir.

Another type of IBD is ulcerative colitis, a distant cousin of Crohn’s. Ulcerative colitis impacts the large intestine or colon. “Ulcerative colitis presents with ulcers in the colon causing diarrhoea with blood, while Crohn's disease may present with narrowing or strictures, pain, and abdominal distention. There are diagnostic tests to differentiate these two pathologies,” he adds.

Another type of IBD is ulcerative colitis, a distant cousin of Crohn’s. Ulcerative colitis impacts the large intestine or colon. “Ulcerative colitis presents with ulcers in the colon causing diarrhoea with blood, while Crohn's disease may present with narrowing or strictures, pain, and abdominal distention. There are diagnostic tests to differentiate these two pathologies,” he adds.

At present, Crohn’s disease’s causes remain unknown. “First-degree relatives of patients with Crohn's disease are slightly higher at risk for developing the condition. Those whose both parents have Crohn's disease are at considerable risk,” says Dr Dhir.

According to him, certain risk factors also increase the chances of developing Crohn’s, such as “previous appendicectomy (removal of the appendix), a diet low in fibre and high in fat, and a sedentary, stressful life.”

If left untreated, Crohn’s disease can lead to complications such as anal fissures and fistulae, bowel obstruction, malnutrition and increased susceptibility to colon cancer.

Symptoms vary in intensity and can manifest differently for different people. As an autoimmune disease, they can develop over time or suddenly appear, causing a flare-up.

Common symptoms include:

• Abdominal cramps
• Chronic diarrhoea
• Fatigue
• Fever
• Loss of appetite
• Weight loss
• Blood in stools
• Nausea

There are also a few lesser-known symptoms of Crohn’s that manifest outside the gastrointestinal tract. These include:

• Anaemia
• Joint pain and stiffness
• Arthritis 
• Leg ulcers
• Sores inside mouth
• Pain and redness in the eyes
• Inability to walk 
• Skin lesions
• Liver conditions

“Crohn's disease is associated with several skin disorders ranging from acne to more serious problems, including psoriasis,” adds Dr Dhir.

As the symptoms overlap with other gastrointestinal ailments, a diagnosis of Crohn's disease cannot be confirmed using a single test. A medical practitioner may recommend a combination of tests and procedures to conclude a diagnosis.

“Crohn's disease has no known cure, but it can be managed well with treatment to allow a long-term, symptom-free life,” says Dr Dhir.

Crohn’s disease treatment includes medications to reduce the severity of symptoms but cannot cure it completely. In some cases, treatment may also include surgical interventions.

For individuals experiencing severe symptoms, allowing the bowel to rest for a period ranging from a few days to several weeks can offer relief. During this time, one may consume only specific liquids or refrain from eating and drinking entirely.

As Dr Dhir points out, “The patient is symptomatic during the flare-ups, which can be controlled or brought into remission with treatment. Patients can have a long symptom-free period in between flare-ups.”

But for patients, living with Crohn’s disease can be emotionally challenging. “Low energy has removed stability from life, and emotionally it has impacted memory and minimised social life,” reflects Mrs Manoj Singh, who was diagnosed in 2013.

Managing Crohn's disease effectively can significantly enhance your quality of life, allowing you to thrive without discomfort. Adopting dietary modifications and embracing a healthy lifestyle can play a crucial role.

For individuals recently diagnosed with IBD, Singh offers valuable advice, “Maintain a restricted diet, discipline when it comes to meal times, and follow a good work-life balance to get plenty of rest. Strictly follow the diet advised, as cheating can cause more harm. It is a misconception that surgery is the only option to manage Crohn’s.”