Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes chronic inflammation in the digestive system, leading to symptoms like abdominal pain, diarrhoea, and fatigue.
While traditional therapies such as medication and lifestyle changes are often used to manage Crohn’s, some patients with treatment resistant symptoms are exploring medical cannabis for their associated symptoms, including pain and nausea.
First described by Dr. Burill Crohn in 1932, Crohn’s disease is an autoimmune condition where the immune cells of the body incorrectly attack the cells within the gut. However, the exact cause of Crohn’s disease is unknown. Research into Crohn’s is ongoing but as yet, a comprehensive cause for the disease is yet to be discovered.
Some evidence suggests that Crohn’s has a genetic component. It is thought that Crohn’s disease may occur following exposure to an event, such as a stomach bug, however, this is not proven at this point.
Crohn’s disease typically starts between 15-40 years, however, between 50-60 years of age there is another rise in incidence.
Smoking is believed to exasperate symptoms and smokers are actually more than twice as likely to develop Crohn’s disease. Whilst associations have been suggested for specific diets and Crohn’s disease, these are largely unproven or have weak associations.
Symptoms usually start in childhood or early adulthood and include:
Crohn’s disease symptoms in females and males tend to be the same, and the disease is equally likely to affect men as women in Western countries. However, Crohn’s disease tends to be higher in males in Asian populations. Symptoms may be continuous or come and go weekly or monthly. When people experience a recurrence of active inflammation, these are called flare-ups.
One may also experience extraintestinal manifestations of Crohn’s disease. These symptoms may present themselves before gastrointestinal symptoms become apparent. Extraintestinal manifestations may include:
No, there are not different types of Crohn’s disease, however, there are different names to describe where the inflammation is located in the gastrointestinal tract. They are:
As it shares symptoms with other bowel conditions, Crohn’s can be hard to diagnose in some individuals.
As such, unless an emergency admission is required, a GP will usually complete a thorough assessment where they will ask about:
A physical examination may also take place whereby the GP may feel and examine the stomach and/or take a blood sample. Additionally, a stool sample will often be requested which can be tested for inflammation and infections.
If a GP suspects Crohn’s disease is the reason for symptoms, they will make a referral to a gastroenterologist for tests which can determine whether or not Crohn’s is the cause. These tests may include:
Whilst there is no cure, treatment for Crohn’s disease aims to reduce episodes of active inflammation and to reduce symptoms.
There are different medications to treat Crohn’s disease and sometimes surgery is an option.
Steroids are commonly prescribed for Crohn’s in the first instance to induce remission, and reduce inflammation. They can however have side effects including weight gain, indigestion, sleep disturbance, and increased risk of infections (as they reduce the body’s immunity) and in children, can result in slower growth.
As maintenance therapy, most individuals are prescribed other anti-inflammatory agents known as steroid-sparing agents. Depending on the severity of the disease and whether the condition is resistant to first-line options there are a few different management options. Some patients may require more aggressive immunosuppressive therapies commonly referred to as biological therapies. These target a specific aspect of the immune system to reduce inflammation and as with steroids and other immunosuppressants are started by gastroenterologists.
For people with a Crohn’s diagnosis, it is also important to make changes to their lifestyle. In those who smoke tobacco, one of the most important changes they can make is to stop smoking. No specific diets have been shown to aid in the reduction of inflammation associated with Crohn’s disease, however, some individuals may need to avoid certain foods because of inflammation and scarring in different parts of the gut. Changes to diet should ideally be supported by a trained professional, such as a dietician to reduce the risk of vitamin and mineral deficiencies.
Surgical treatment may be required as an emergency or on an elective basis to treat areas of inflammation that are refractory to best medical therapy or complications such as narrowing of the bowel or the development of fistulae. However, as Crohn’s disease can affect any part of the gastrointestinal tract there is no guarantee that surgery is curative for any individual.
A specialist will discuss all possible treatments with their patient and a suitable Crohn’s treatment plan will be agreed upon together. This can be reviewed further down the line to ensure the best plan for the individual is in place.
It is important to note that medical cannabis does not cure of treat active bowel inflammation and therefore can only be considered to help with managing symptoms that have not responded to first-line therapies. Patients should still receive regular care and medications through their local gastroenterologist if they are prescribed medical cannabis.
View our FAQ’s section and learn more about all the conditions that can be treatable with medical cannabis.
