Crohn Disease

Is Testing Right for Me? I Have My Test Results

Crohn Disease

Treatment of Crohn Disease

There is no cure for Crohn disease. Treating Crohn disease over a lifetime often takes a combination of medicines and surgery. Diet and stress may need to be controlled to prevent flare-ups of symptoms.

Medicines

The table below lists medicines used most often used to treat Crohn disease. The exact medicines used for any individual person will vary based on their needs. Your doctor might prescribe a medicine not covered here.

Type of Medicine
Purpose
Aminosalicylates (5-ASAs)
Control mild to moderate inflammation

Corticosteroids
(prednisone, methyl predisolone)

Used short term to treat moderate to severe
Crohn disease

Immunomodulators
(azathioprine, 6-mercatopurine)

Help maintain a remission; can help heal
some fistulas

Antibiotics
(metronidazole, ciprofloxacin)

Treat or prevent infections; reduce
inflammation

 Anti-diarrheaTreat diarrhea

 Biologic therapy
(infliximab, adalimumab)

Block TNF, an immune system chemical that increases inflammation


Surgery

Around 70% of people with Crohn disease will need surgery at some point. Surgery is often considered when the medicines stop working well enough or when there are specific problems. Problems that can make surgery necessary include bleeding, infection, narrowing of the intestine, and the development of fistula.

The kind of surgery that is usually done removes an unhealthy part of the intestine and reconnects the healthier parts together. Sometimes, the whole large intestine needs to be removed. In that case, a person may need an ostomy. An ostomy is when the GI tract connects to an opening in the abdomen wall. A bag attaches outside of the body to collect waste. Ostomies can be temporary or permanent, depending on the type of surgery that is done.

Diet and Lifestyle

There isn't a special diet that seems to be best for people with Crohn disease. However, if you have Crohn disease, be sure to:

  • Eat a healthy diet, with the right amount of calories and vitamins. This is important to avoid poor nutrition and weight loss.
  • Avoid any foods that seem to make symptoms worse. These foods seem to vary from person to person. A food diary that tracks what you eat and how you feel may help you to identify these foods.
  • Be aware that there may be a higher chance to have trouble with milk products (lactose intolerance). If this develops, avoid dairy products.
  • Pay attention to water intake. There is a risk of losing too much water if you have diarrhea a lot.
  • Consider limiting raw fruits and vegetables, seeds, nuts, corn and popcorn. These foods can make symptoms worse if there is intestine narrowing or blockage.
  • Find out whether you should take any extra vitamins or minerals.
Next: Resources

To find out if genetic testing might change your medical care, check the box below that best describes you.

I think I might have Crohn disease because I have some of the symptoms, but I haven't seen a doctor yet.

I've been tested for disease, and I definitely have it.

I've been tested for Chron disease, but the results weren't clear. My doctor isn't sure whether I have it.

I'm at-risk for Crohn disease because a close family member has it. I don't have any symptoms of it right now.

I'm at-risk for Crohn disease because I'm Ashkenazi Jewish. I don't have any symptoms of it right now.

I don't have any symptoms or risk factors for Crohn disease, but I'm worried about whether I'll get it.

You told us that you think you might have Crohn disease, but you haven't seen a doctor yet. A genetic test is not the first step to diagnosing Crohn disease. If you have symptoms that could be Crohn disease, it is important for you to see a doctor. The doctor will ask you more about your symptoms, review your family and medical history, and order tests as needed.

You told us that you definitely have Crohn disease based on testing you've had done. Genetic testing may be useful for you. Results of genetic testing may give your doctor information that changes your medical care. Changes in the NOD2/CARD15 gene have been related to types of Crohn disease that:

  • Starts at a younger age
  • Affects the ileum, which is the lower part of the small intestine, just before it joins the large intestine
  • Is more likely to cause a narrowing or blockage of the GI tract. This may make you need surgery more often.

If you have genetic testing and one or more gene changes are found, your doctor may want to treat your symptoms more aggressively. This may mean a different choice of medicine or an earlier surgery.

If you have genetic testing and no gene changes are found, your doctor will continue to treat you based on your symptoms.

Before making a decision about Crohn disease genetic testing, you should consider the benefits, limitations, and possible uses for you. Learn more about the pros and cons of genetic testing for Chron disease.

You told us that you've had testing for Crohn disease that hasn't given you a clear answer. Genetic testing may be useful. Crohn disease and another, related condition called ulcerative colitis are both inflammatory bowel disease (IBD). This means that they can share some features. While other testing can often tell them apart, sometimes it is hard to tell one from the other. People who fall in this uncertain category are sometimes told they have "indeterminate colitis."

  • If you have genetic testing for Crohn disease and a gene change is found, it may "tip the scale" in favor of a diagnosis of Crohn disease.
  • If you have genetic testing for Crohn disease and a gene change is not found, these results probably won't be helpful. Only about 50% of people with Crohn disease have these gene changes, so you can have Crohn disease even if your test results don't find a gene change. Your doctor will continue to treat you based on your symptoms.

Before making a decision about Crohn disease genetic testing, you should consider the benefits, limitations, and possible uses for you. Learn more about the pros and cons of genetic testing for Chron disease.

You told us that you have a higher risk of Crohn disease because of your family history or ethnic group, but you don't have Crohn disease or any symptoms of it. Genetic testing is not likely to be useful for you.

At this time, genetic testing for Crohn disease is used to help confirm a diagnosis of Crohn disease, or to help make treatment decisions. It does not provide useful information for people who are only at risk for the condition. Even if you have a gene change associated with Crohn disease, there is no way to predict whether you'll get it. There isn't anything you can do to prevent it, either.

You can learn about the common symptoms of Crohn disease by reading What Is Crohn Disease?. If you develop any of them, you should see a doctor.

You told us that you are worried about getting Crohn disease even though you don't have any symptoms or risk factors for it. While genetic testing is technically possible for you, it generally isn't recommended. If your results are normal, it doesn't rule out the chance that you could get Crohn disease. If the results find a gene change, there is no way to predict whether you'll get it. There isn't anything you can do to prevent it, either.

You may wish to talk to a doctor who can address your concerns and answer your questions.