How can I contact crohns.org.uk?

You may contact crohns.org.uk by sending an e-mail to info@crohns.org.uk

A work colleague has been diagnosed with Crohn’s disease. Could I catch it?

No, Crohn’s disease is not contagious.

Does Crohn’s disease cause a higher risk of miscarriage in pregnancy?

Generally there is no increased risk of miscarriage, however there is an increased risk of disease relapse in the 1st and 2nd trimester and following delivery. If the disease is in remission at conception then the pregnancy should progress relatively trouble free.

I have Crohn’s disease, am I still able to drink alcohol?

Alcohol is only contra-indicated in IBD in patients with CD who are intolerant of yeast – and even thay can often drink spirits without difficulty. Alcohol intake should be limited to 28 units / week for males and 21 units / week for females. Alcohol should not be taken with certain drugs such as metronidazole. Binge drinking must be avoided.

Are there any known herbal remedies taken for Crohn’s disease?

There are curently no herbal remedies for Crohn’s that have been scientifically tested and approved.

Is Crohn’s disease a form of cancer?

No, Crohn’s disease is definitely not a form of cancer.

I think I may have Crohn’s disease. How do I find out?

You should go to your doctor and ask him directly whether you could have Crohn’s and if you should be sent to have the relevant investigations or to see a specialist in IBD. It is important for people with chronic health problems to have a doctor with whom they are comfortable discussing their problems and fears.

I live in the USA, is there someone I can talk to about my Crohn’s?

The Crohn’s and Colitis foundation of America (CCFA) has it’s headquarter at:

386 Park Avenue South, Floor 17
New York, NY 10016-8804
Email:info@ccfa.org Website:www.ccfa.org

How do you conclude when a patient had Crohn’s or Ulcerative Colitis?

Please click on this link ….. to read about investigations which may help your physician to make a diagnosis. Some cases of inflammation in the large bowel show features of both Crohn’s and colitis and it may not always be possible to separate them. Doctors sometimes refer to these cases as ‘Indeterminate Colitis’ and they are usually treated in the same way as Ulcerative Colitis.

How can Crohn’s disease be cured?

Presently no complete cure is available.

What should I do if I am not satisfied with the treatment I have received for my Crohn’s or Coliti

It is not possible nor ethical for us to offer advice on treatment to patients whose cases are not known to us in detail and where we cannot perform examinations and further investigations. You should in the first instance tell your present specialist of your concerns and ask him whether any different treatment is available. If you are still dissatisfied you should ask your GP to refer you for a second opinion from a different specialist.

Can you recommend a specialist who treats IBD?

It is not possible to recommend individual specialists as we cannot keep abreast of frequent staff changes. It is best to take the advice of your General Practioner, who should be well aware of local specialists, their strengths, interests and abilities. A list of hospitals, which provide nutritonal treatment for CD is included in the website.

What is a fistula?

An abnormal connection, usually between two organs, or leading from an internal organ to the body surface, (e.g. between the anus and skin surface - anal fistula).

What is UC?

Ulcerative colitis was first described in 1875 by Wilks and Moxon who were able to separate it from dysentery and infectious diarrhoea.
It is a disease in which there is inflammation of the lining (mucosa) of the large intestine causing diarrhoea and rectal bleeding.

• The rectum is always affected and is called proctitis.
• It may extend further along the left side to the splenic flexure, when it is know as left-sided colitis.
• The whole of the large intestine may be affected and the condition is known as Pancolitis.

The number of people affected by ulcerative colitis is approximately 170 per 100 000 of the population with around 7-12 new cases per 100 000 of the population being reported each year.

It has a worldwide distribution but tends to be more common in the Western Hemisphere.

It can occur at any age but most commonly presents between the ages of 20-60.

Ulcerative colitis is a chronic disease with periods of remission, in which patients are symptom-free, and relapses in which symptoms flare-up. The onset may be gradual or sudden.

Medical treatment is usually successful in keeping most patients in remission until the disease slowly burns itself out. However, occasionally, surgery may be necessary if medical treatment fails, or if the risk of cancer in extensive colitis becomes too great.

What is Crohn’s Disease?

Dalziel first described Crohn’s disease in Scotland in isolated cases in 1913. However, in 1932, Crohn and colleagues named the disease Regional Ileitis. This was later changed to Regional Enteritis when, after further work, it was discovered the disease affected other areas of the gut.

It is a chronic inflammatory disease, which can affect the whole of the alimentary tract (digestive tube) from mouth to anus. The inflammation extends through all layers of the gut wall (transmural) and is characteristically patchy in distribution (skip lesions) with areas of normal tissue between.

The most commonly affected sites are the terminal ileum (the lower part of the small intestine), and the large intestine. It frequently affects the anus.

The disease has several characteristics:

1. The course of the disease is chronic with periods of remission, when patients are symptom-free, and relapses, when symptoms flare up.
2. It has a wide range of symptoms.
3. Complications outside the intestine are common.
4. There is a strong tendency for it to recur after surgery

What should I do if I am not satisfied with the treatment I have received for my Crohn’s or Coliti

It is not possible nor ethical for us to offer advice on treatment to patients whose cases are not known to us in detail and where we cannot perform examinations and further investigations. You should in the first instance tell your present specialist of your concerns and ask him whether any different treatment is available. If you are still dissatisfied you should ask your GP to refer you for a second opinion from a different specialist.

Can you recommend a specialist who treats IBD?

It is not possible to recommend individual specialists as we cannot keep abreast of frequent staff changes. It is best to take the advice of your General Practioner, who should be well aware of local specialists, their strengths, interests and abilities. A list of hospitals, which provide nutritonal treatment for CD is included in the website.

Does Crohn’s disease affect all patients in the same way?

No. As stated, the exact symptoms will vary according to the location of the disease and other factors. Furthermore, Crohn’s disease tends to be broadly split into two categories:

Stenosing Crohn’s disease – when the inflammation of active Crohn’s disease dies down, scar tissue can sometimes remain. If the same area of the GI tract is subjected to multiple episodes of inflammation, the level of scar tissue can build up. Unlike the normal gut wall, scar tissue is not flexible. As such, if high levels of scar tissue accumulate, it can prevent the passage of food through the GI tract and a blockage results. These tight narrowings of the GI tract are referred to as strictures.

Sometimes strictures may respond to dilatation (opening up the narrowing though use of a slowly inflated balloon) although surgical removal of the stricture is sometimes necessary.

Fistulising Crohn’s disease – a fistula occurs when a section of the intestine breaks away and attaches elsewhere. It can re-attach to a more distal section of the gut, the abdominal wall, the bladder or the peri-anal region.

Patients tend to have either fistulising or stenosing Crohn’s disease. An individual patient is likely to have one disease type or the other but not both.

Is there a cure for Crohn’s Disease?

The exact symptoms will depend on a number of factors (disease severity, location of disease, etc) but common symptoms are as follows:

1. Pain
2. Weight loss
3. Diarrhoea
4. Mouth Ulcers
5. Lack of energy
6. Rectal Pain
7. Poor Appetite

Although Crohn’s disease is a disease of the GI tract, symptoms sometimes occur outside the gut:

• Sore eyes
• Joint Pain
• Skin Rashes

How common is crohns disease?

In the UK, Crohn’s disease is thought to affect 1 in 1,000 people. Figures from NACC (National Association of Crohn’s and Colitis) indicate the patient population in the UK is approximately 55,000.

When does Crohn’s disease typically start?

It is unusual for Crohn’s disease to be diagnosed before the age of eight years. Approximately 25% of newly-diagnosed cases of Crohn’s disease are paediatric and peak incidence is between 10 and 20 years of age (Seidman, 1998).

Why is it important to distinguish between Crohn’s disease and UC apart?

The reason why it’s important to tell the difference is that there are important differences in the management of the two disorders. Removing the colon, although too extreme for use in all cases, can effectively cure UC. Surgery does not prevent further relapses in Crohn’s disease and so is avoided unless absolutely necessary.

Of more relevance to us is the difference in response to dietary therapy:

In UC, dietary therapy acts only as a secondary therapy – that is to say, it serves only to help the patient endure their illness and regain lost nutrient stores when they are in remission (i.e. nutrition support only). For the vast majority of cases, it is not thought to have any role in altering the course of the disease

In Crohn’s disease, diet has been shown to work as both a primary therapy and a secondary therapy – that is to say, it can alter the course of the disease in addition to providing nutritional support.

How can Doctors tell crohn’s disease and UC apart?

Sometimes it’s not easy! However, doctors can look at a number of factors:

Location – Crohn’s disease can occur anywhere in the GI tract. UC only occurs in the colon. Disease outside the colon therefore rules out UC

Skip lesions – if active disease is found in the colon, it could be UC or it could be Crohn’s disease of the colon (Crohn’s colitis). To distinguish between the two, doctors may look at the nature of damage to the gut wall (UC only affects the inner lining) and check for skip lesions (only found in Crohn’s disease).