A clear guide for Valley Gastroenterology patients.
What is Crohn’s disease?
Crohn’s disease is a chronic inflammatory condition of the digestive tract. It can affect any part from mouth to anus, most commonly the terminal ileum and colon. Inflammation may be patchy and can extend through the bowel wall, which is why complications like strictures (narrowing) and fistulas (abnormal connections) can occur.
Common symptoms
Abdominal pain/cramping, often right‑lower abdomen
Chronic diarrhea, urgency, sometimes blood or mucus
Unintended weight loss, fatigue, low appetite
Fever during flares; perianal pain, drainage, or swelling
Red‑flag symptoms — call us promptly
Severe abdominal pain, persistent vomiting, signs of obstruction (bloating, no gas/stool)
High fever, shaking chills, rectal abscess drainage or severe perianal pain
Black/tarry stools or heavy rectal bleeding
If severe pain, fainting, or signs of shock occur, call 911 or go to the nearest ER.
How Crohn’s is diagnosed
History, exam, and labs: blood counts, iron studies, CRP/ESR; stool tests (e.g., fecal calprotectin) to detect inflammation
Colonoscopy with ileoscopy & biopsies: confirms inflammation pattern and rules out infection
Cross‑sectional imaging:MR enterography (preferred) or CT enterography to assess small bowel, strictures, fistulas, or abscess
Additional testing as needed (capsule endoscopy; avoid if stricture suspected without patency testing)
Treatment goals
Induce remission (get inflammation under control)
Maintain remission (prevent flares and complications)
Promote mucosal healing, growth in adolescents, good nutrition, and quality of life
Treatment options (personalized)
During flares / to induce remission
Corticosteroids (short term): prednisone or budesonide; not for long‑term maintenance
Antibiotics in select cases (e.g., perianal disease, abscess after source control)
Immunomodulators (thiopurines, methotrexate) in select cases or with biologics
Therapy choice depends on disease location, behavior (inflammatory vs. stricturing/fistulizing), prior response, and patient preferences
Perianal/fistulizing disease
Often needs a combined approach: seton placement by colorectal surgery + anti‑TNF or other biologics
Nutrition
Correct iron/B12/vitamin D deficiencies
Low‑residue diet during stricturing flares; individualized plans with a dietitian
Exclusive enteral nutrition may be considered in special situations
Surgery
For strictures, fistulas/abscesses, or when medical therapy fails. Goal is bowel preservation and symptom relief; medicines continue to prevent recurrence.
Monitoring & preventive care
Regular follow‑up to track symptoms, labs, and fecal calprotectin
Drug safety monitoring (labs, TB/hepatitis screening before biologics)
Vaccinations: keep up‑to‑date (influenza, COVID‑19, pneumococcal, hepatitis A/B, HPV, shingles as appropriate). Avoid live vaccines while on certain immunosuppressants—ask us.
Colon cancer surveillance: if Crohn’s affects much of the colon for >8 years, colonoscopy at recommended intervals
Smoking cessation: smoking worsens Crohn’s and increases flares and surgeries
Pregnancy & family planning
Most patients can have healthy pregnancies. Aim for disease remission before conception; many medications are compatible with pregnancy. Discuss plans with your GI team and OB/GYN.
Living well with Crohn’s
Follow your treatment plan and do not stop meds without guidance
Manage stress, prioritize sleep, and stay active as tolerated
Keep a simple flare diary (symptoms, triggers, medication adherence)
Alaska‑specific note
We offer telehealth for routine follow‑ups and coordinate local labs/imaging. Weather or road issues? We’ll reschedule without penalty and help minimize travel.
Next steps
If you have ongoing abdominal pain, diarrhea, weight loss, or perianal symptoms, schedule a visit for evaluation. We’ll tailor testing and create a stepwise treatment plan.