crohn's disease

Crohn’s Disease: Causes and Treatments

Crohn’s disease is a chronic autoimmune condition of the digestive tract. It affects an estimated half a million Americans. In most cases, it affects the lower part of the small bowel and/or the large intestine.

Crohn’s disease is an inflammatory bowel disease (IBD). It can have a significant impact on the quality of life and cause debilitating pain. Other symptoms include:

  • Chronic diarrhea
  • Bloody stool
  • Abdominal pain
  • Loss of appetite
  • Fatigue
  • Weight loss
  • Fever

Severe cases and flare-ups usually need hospitalization. Individuals with it may experience further complications. These include:

  • Intestinal obstruction
  • Fistulas
  • Abscesses
  • Ulcers
  • Anal fissures
  • Malnutrition
  • Increased risk of colon cancer
  • Inflammation of other organs

The number of Crohn’s disease cases is increasing. Researchers are exploring various risk factors involved in the disease’s development.

In this article, we’ll discuss the causes of Crohn’s disease and treatment options.

crohn's disease - doctor pointing to model of digestive tract

How Do You Get Crohn’s Disease?

The exact reason why people get Crohn’s disease is still unknown. However, immune system dysfunction and genetics are key players in the condition’s development. Several environmental risk factors further increase the risk, too.

Autoimmune Response

With Crohn’s disease, the immune system mistakenly attacks the digestive tract’s tissue. Previous research suggests viruses like Ebstein Barr, cytomegalovirus, and measles can trigger the autoimmune response that leads to the condition. Other bacteria can also trigger the response.


Heredity may also cause Chron’s disease. This is probably because the condition is more common in those who have other family members with it. So far, over 200 genetic variations increase susceptibility to the condition.

The genes NOD2, ATG16L1, IL23R, and IRGM are particularly important. This is because they participate in immune system function. The proteins created by these genes help the immune system detect and communicate with gut bacteria. They’re also involved in autophagy, the body’s natural process to eliminate damaged cells to regenerate new ones.

Age and Ethnicity

Age and ethnicity are also risk factors. Crohn’s disease can develop at any age, but people often develop it before they’re 30 years old. Caucasians, especially Ashkenazi Jewish descendants have a higher risk of the condition.


Smoking cigarettes doubles the risk of developing Crohn’s disease. It could also increase the risk of more severe symptoms and flare-ups. Smokers are also more likely to need surgery. According to one study, 73% of smokers and 39% of non-smokers required one or more surgeries.

Socioeconomic Status

Crohn’s disease is more common in urbanized, well-developed societies with higher socioeconomic status. Researchers believe increased industrialization, environmental pollutants, and sanitization play a role.

Some medications, particularly oral contraceptives and nonsteroidal anti-inflammatory drugs (NSAIDs) may contribute. NSAIDs include ibuprofen, naproxen, and diclofenac.

Dietary Factors

In the past, researchers considered one’s diet caused Crohn’s disease. Now we think only certain dietary habits are risk factors.

Special restrictive diets can actually induce the remission of the condition. Other foods can trigger flare-ups. Some of these foods include:

  • High sugar
  • Fast food
  • Butter
  • Margarine
  • Fatty foods
  • Red meat
  • Coffee
  • Alcohol
  • Corn
  • Dairy products
  • Beans
  • Whole grains
  • Raw fruits
  • Vegetables

Not everyone will react the same way to the same foods. However, food is a common trigger of flare-ups.

It’s also important to note that obesity is an emerging risk factor as well.

Changes in Gut Flora

Gut dysbiosis, or altered gut microbiota, is a key player in the development of Crohn’s disease. Studies found decreased microbial diversity and specific imbalances of certain bacterial strains associate with the condition. The gut flora also experiences changes when Crohn’s is in remission.

crohn's disease - white bottle with spilled pills

Crohn’s Disease Treatment

There are a few treatment options available to those who suffer from Crohn’s disease. These include anti-inflammatory drugs such as corticosteroids like prednisone and oral 5-aminosalicylates.

Commonly used immunosuppression are azathioprine and mercaptopurine. If they don’t offer enough benefits, methotrexate is the next choice.

Biologic agents work by targeting proteins of the immune system. Closely monitor symptoms due to possible serious side effects. For example, natalizumab and vedolizumab target the protein integrins. These drugs stop these proteins from binding to cells of the gut lining.

Ciprofloxacin and metronidazole are two antibiotics that can help manage complications. These include fistulas and abscesses. They can also decrease the number of pathogenic inflammatory gut bacteria.

Other Drugs and Supplements

More available drugs and supplements can provide symptomatic relief for Crohn’s disease. Psyllium powder and loperamide can manage diarrhea. Acetaminophen can also relieve pain.
Multivitamins and minerals help replace missing nutrients. This is important because those with the condition often have nutrient deficiencies.


About half of individuals with the condition may need surgery. This is to remove damaged parts of the intestine. The benefits are usually temporary, so another surgery may take place.

Nutrition Therapy

Nutrition therapy can be useful. Several dietary approaches show benefits for those with Crohn’s disease. Enteral nutrition can reduce inflammation. Low residue low fiber diets relieve intestinal blockages. The Specific Carbohydrate Diet (SCD) also shows benefits when used along with medication.

Alternative Treatments

To fully manage Crohn’s disease, look beyond drugs and short-term dietary changes. A lifestyle change will keep the condition in remission longer.

A healthy lifestyle with a clean diet, regular exercise, improved sleep, and stress management is ideal. It’s also important to avoid smoking and environmental pollutants.

If you suspect you have Crohn’s disease, talk to your doctor to find the best treatment options for you.