Managing Crohn’s Disease

What Is Crohn’s Disease?

Crohn’s disease is a chronic condition that affects the digestive tract. Inflammation can occur anywhere along the gastrointestinal (GI) tract.

Crohn’s disease often causes patchy inflammation, which means healthy sections of the bowel can appear between inflamed areas. In ulcerative colitis, inflammation typically begins in the rectum and spreads throughout the colon.

Understanding the GI Tract Impact

Crohn’s disease can affect any part of the gastrointestinal tract — the large and small intestine. However, it most commonly involves the end of the small intestine and the beginning of the large intestine. That location helps explain why symptoms differ from person to person and why some people feel pain on the lower right side of the abdomen.

Crohn’s disease can also cause deeper inflammation than ulcerative colitis. In many cases, inflammation extends through the entire thickness of the bowel wall, not only the inner lining. Over time, this can lead to narrowing, scarring and complications such as fistulas or bowel blockage.

What are Common Crohn’s Disease Symptoms?

Crohn’s disease can show up in patterns, and it helps to know what to look for.

Digestive Signs

Common digestive signs include persistent diarrhea, rectal bleeding and intense abdominal pain. Some people also notice urgency or cramping that interferes with daily life.

Systemic Symptoms

Crohn’s disease can affect the whole body. You may experience unintended weight loss, very low energy and fever. When inflammation affects the small intestine, your body may struggle to absorb nutrients, which can worsen symptoms.

Secondary Issues

Some people develop complications beyond diarrhea and pain. These may include anal fissures (small tears), fistulas (abnormal tunnels that form between tissues) or mouth sores (painful ulcers in the mouth). Over time, narrowing of the intestine may also occur, leading to severe abdominal pain or blockage.

The Flare-Up

A flare is a period when symptoms become more intense after a quieter stretch. During a flare, symptoms of inflammatory bowel disease may worsen quickly. You can experience increased diarrhea, sharp abdominal pain and have low energy that makes daily tasks harder. Many people with Crohn’s describe flares as unpredictable. If Crohn’s is in remission, it means your symptoms improve or disappear for a time.

What Causes Crohn’s Disease?

Researchers do not know the exact cause of Crohn’s disease. Most experts believe it results from immune system changes, genetics and environmental factors.

Immune System Response

In people with Crohn’s disease, the immune system may react to normal bacteria in the digestive tract as if they pose a threat. This abnormal response triggers ongoing inflammation.

Genetics and Risk Factors

Family history increases the risk of disease. If a parent, sibling or child has inflammatory bowel disease, your likelihood of developing Crohn’s disease rises. Genetics may make you more susceptible, although no single gene causes the condition.

Environmental Triggers

Some factors in your environment may affect your risk of Crohn’s disease. Smoking raises the risk of developing Crohn’s disease and can make inflammation worse. Nonsteroidal anti-inflammatory drugs may also trigger flares in some individuals.

How Is Crohn’s Disease Diagnosed?

Crohn’s disease diagnosis usually takes more than one test. Many conditions share similar symptoms, so your physician will rule out infection and other digestive disorders. Diagnostic tools may include:

• Colonoscopy — to examine the colon and the end of the small intestine
• Upper endoscopy — to evaluate the upper gastrointestinal tract
• CT scan or MRI — to assess inflammation in areas a scope cannot reach
• Blood tests — to check for anemia and inflammation
• Stool tests — to rule out infection

These tools help confirm the diagnosis and guide treatment.

Crohn’s Disease Treatment and Management

There are several treatments for Crohn’s disease. Your plan will depend on where the inflammation occurs, how severe the symptoms are and how your body responds over time. Your gastroenterologist will help you choose the right treatment based on your goals and test results.

Medications

Crohn's disease medication often plays a central role in reducing inflammation and helping you reach remission. Depending on your symptoms and disease severity, treatment may include:

• Biologics and biosimilars — These medications target specific parts of the immune system that drive inflammation. Biologics are made from living cells. Biosimilars are highly similar versions of those medications and work in the same way to reduce inflammation.
• Immunomodulators — These medications help calm an overactive immune system, so it causes less inflammation.
• Corticosteroids — These medications can reduce inflammation fast during a severe flare. Because they can cause side effects, physicians use them for short periods when possible.

“Crohn’s disease treatments often change over time,” said Dr. Schulberg. “You know your body best. We combine what you notice with your test results so we can adjust treatment and keep inflammation under control.”

Diet and Lifestyle

Diet does not cause Crohn’s disease, but food choices can affect symptoms, especially during a flare. In some cases, dietary therapy becomes part of treatment.

Options may include:

• Exclusive enteral nutrition (EEN) — a liquid formula diet used for a set period to reduce inflammation, often under close medical guidance
• Specific exclusion diets — structured plans that remove certain foods to reduce symptom triggers and support healing

Your gastroenterologist or dietitian can help you decide whether dietary therapy is appropriate for your situation and how to do it safely.

Surgery

When medication no longer controls inflammation or complications develop, surgery may become necessary. Treatments for Crohn’s disease may include bowel resection, which removes a damaged section of intestine.

Surgery does not cure Crohn’s disease, but it can relieve symptoms, treat narrowing or blockage, and improve your quality of life. After surgery, you will need ongoing follow-up because inflammation can return in other areas of the digestive tract.

Holistic Care

Crohn’s disease can affect more than digestion. Flares, fatigue and diet changes can take a toll over time. Mental health support and stress management can play an important role in long-term success. This may include:

• Counseling or therapy support
• Sleep and routine support
• Stress management skills
• Support groups or community resources

Lifestyle and Prevention

Medicine plays a major role in Crohn’s disease treatment, but daily habits can also affect how often symptoms flare and how you feel over time. Small, realistic changes can support your long-term plan.

Managing Flares

Food does not cause Crohn’s disease, but certain foods can make symptoms worse during a flare. Identifying personal triggers can help you feel more balanced. You may benefit from:

• Eating smaller meals when symptoms increase
• Keeping a simple food and symptom log
• Limiting trigger foods during flares
• Staying hydrated when diarrhea worsens

Smoking Cessation

If you smoke, quitting can be the most important step you take for treating Crohn’s. Smoking can make inflammation harder to control and can lead to more flares and more complications over time. If you want to quit, we can connect you with support that fits your routine.

Nutrition Support

Crohn’s disease can affect how your body absorbs nutrients, especially when the small intestine is involved. A dietitian can help you find foods that feel safe, protect your nutrition and maintain your weight, even when symptoms change.

Long-term Outlook and Follow-up

Crohn’s disease requires lifelong monitoring. Even during remission, you may still have a low level of inflammation. Regular visits with a gastroenterologist will help you track disease activity, make sure your medications are working well for you and prevent complications. Early intervention can reduce the risk of hospitalization and support your long-term health.

If you feel worried right now, schedule a visit with your physician to review your symptoms and your family history. Learn more about Gastroenterology Services at Catholic Health.