10 Questions to Ask Your Doctor About Crohn's Disease
It is one of two diseases of the gastrointestinal tract called Inflammatory Bowel Disease (IBD). The other is ulcerative colitis. Crohn’s disease causes inflammation of the digestive tract. In some people only the last part of the small intestine (ileum) is involved, while in others the large intestine may be affected as well.
An exact cause is not known, but history of the disease does show that if you have a close family member with IBD, you may be at higher risk for Crohn’s. Also, people of European and Jewish descent appear to be at a higher risk. Finally, cigarette smoking has been shown to make Crohn’s disease worse.
There is no one-size-fits-all treatment. Ask your doctor if medication is right for you and which types will work with your medical history and other prescriptions you may take. Medications for Crohn’s include aminosalicylates (5-ASA), corticosteroids, immunomodulators, antibiotics, and biologic therapies. The goal is to alter or suppress the immune system’s inflammatory response, which can relieve some or all symptoms and give the gut a chance to heal.
Your doctor can also recommend lifestyle and diet changes that improve symptoms for many patients. Stress doesn’t cause IBD, but it can make symptoms worse. Lowering your stress can be good for the gut — yoga, gentle exercise, and meditation can help.
Bring a food journal to share with your doctor. This will help you hone in on which foods trigger flares. In general, Crohn’s patients should avoid greasy meals, high fiber foods, roughage, wheat, dairy, caffeine and alcohol. Ask about the Specific Carbohydrate Diet (SCD) or GAPS diet. Your doctor also may refer you to work with a nutritionist.
Yes, in addition to inflammation in the gut, Crohn’s, and some of the medications used to treat it, can cause complications. These include arthritis or joint pain, eczema, malabsorption, malnutrition, osteoporosis, ulcers, strictures, fistulas, fissures, and abscesses. Be sure to discuss any new symptoms or medication side effects with your doctor immediately.
Bring a list of all the terms you don’t understand—strictures, fistulas, fissures, abscesses—and have your doctor clearly define them for you. Only researching these terms online can lead to misinformation or confusion. It’s best to be educated by a medical specialist.
Possibly. According to the Crohn’s and Colitis Foundation of America (CCFA), about two-thirds of people with Crohn’s will require surgery at some point during their lives. This becomes necessary when medications and diet no longer control symptoms. It can also become necessary when fistulas, fissures, or obstructions are present and other treatments have been unsuccessful.
Discuss this with your doctor. Every doctor is different. Some doctors will want to see you periodically until you are in remission. Some physicians have a dedicated nurse who can answer some of your questions and pass along others to the doctor. It is important to set the basis and expectations of your doctor-patient relationship at the beginning of that relationship.
It can take time to get your symptoms under control, but you should be able to participate in most of the activities of everyday life. This may be more difficult when you are having a flare up, but there are many ways to cope. Ask your doctors for contact information for a local support group, or contact your local CCFA chapter.