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Medical News Today: What are the 5 types of Crohn’s disease?

Crohn’s disease is an inflammatory bowel disease that affects the lower gastrointestinal tract. There are five types of Crohn’s disease, each one impacting a different area of the digestive tract, and some causing unique symptoms.

Doctors have yet to find a cure for Crohn’s disease. However, people can manage their symptoms with a combination of lifestyle changes, medications, and, in some cases, surgery.

Read on to learn more about the different types of Crohn’s disease and their symptoms, including how doctors diagnose and treat the condition.

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Each type of Crohn’s disease causes unique symptoms.

About 201 out of every 100,000 adults have Crohn’s disease, and not everyone experiences the same symptoms.

The disease may cause:

Crohn’s disease can affect any part of the gastrointestinal (GI) tract, from the mouth to the anus. However, the condition usually develops in sections of the lower GI tract, such as the small and large intestines.

Doctors categorize Crohn’s disease into five types based on the location of the inflammation.

The five types of Crohn’s disease include:

  • ileocolitis
  • ileitis
  • gastroduodenal Crohn’s disease
  • jejunoileitis
  • Crohn’s (granulomatous) colitis

Ileocolitis

Ileocolitis is the most common form of Crohn’s disease, according to the Crohn’s and Colitis Foundation of America. It causes inflammation of the lower portion of the small intestine, or ileum, and the large intestine, or colon.

People who have ileocolitis may experience the following symptoms:

  • cramping or pain in the middle or lower abdomen
  • diarrhea
  • weight loss

Ileitis

Ileitis causes inflammation only in the ileum. While Crohn’s disease can cause ileitis, other infections and inflammatory disorders can do so as well.

Ileitis causes similar symptoms as ileocolitis.

People who have ileitis and other forms of Crohn’s may develop gastrointestinal fistulas.

Fistulas are inflammatory channels that create passageways through the walls of the small intestine. Fistulas connect the small intestine to other areas and structures, including into the skin.

Digestive juices can leak through a fistula into the surrounding tissue or other organs. Fistulas can lead to serious health complications, such as severe systemic infection, malnutrition, dehydration, and significant weight loss.

Around 50% of people who have ileitis develop one or more intestinal strictures, which are narrowings of the intestines. Strictures occur when inflammation causes swelling or scarring in the intestinal walls.

Crohn’s colitis

Crohn’s colitis, or granulomatous colitis, causes inflammation only in the large intestine. People who have Crohn’s colitis may develop fistulas, ulcers, and abscesses near the anus.

Symptoms of Crohn’s colitis may occur in other forms of Crohn’s, as well, and often include:

  • diarrhea
  • rectal bleeding
  • bloody stools
  • skin lesions
  • joint pain

Gastroduodenal Crohn’s disease

Gastroduodenal Crohn’s disease affects the stomach, esophagus, and the first part of the small intestine.

Symptoms include:

  • nausea
  • vomiting
  • loss of appetite
  • weight loss

Jejunoileitis

Jejunoileitis causes patches of inflammation in the upper half of the small intestine, or jejunum.

Symptoms can include:

  • abdominal pain or cramps after eating
  • diarrhea

Prolonged inflammation can lead to the formation of fistulas in the jejunum.

Crohn’s disease causes nonspecific symptoms that occur with several other disorders, which can make diagnosing the disease tricky.

Doctors perform physical exams and laboratory tests to confirm whether or not someone has Crohn’s disease. These physical exams and tests can also identify which type of Crohn’s may be present.

Physical exam

During a physical exam, a doctor will assess a person’s overall health by checking their heart rate, blood pressure, and weight. They will also check for signs that may suggest Crohn’s disease, such as:

  • abdominal swelling or bloating
  • abnormal sounds within the digestive tract

A doctor will also review a person’s medical and family histories for any indications that may explain their symptoms.

Laboratory tests

A doctor may perform the following lab tests to rule out other conditions and help diagnose Crohn’s disease:

  • blood tests
  • stool samples
  • CT or MRI scan of the abdomen
  • colonoscopy to check the inside of the colon
  • endoscopy and enteroscopy to check the upper GI tract

Currently, no cure for Crohn’s disease exists. However, doctors can treat symptoms and complications of Crohn’s disease with a combination of medication and surgical procedures.

Medication

Doctors may prescribe different medications and dosages, according to a person’s symptoms.

Common types of drugs doctors use to manage Crohn’s disease include:

Aminosalicylates

Aminosalicylates help regulate inflammation and work well for people who have a recent diagnosis of Crohn’s disease or those who have mild symptoms. Examples of aminosalicylates include:

  • balsalazide
  • mesalamine
  • sulfasalazine

Corticosteroids

Corticosteroids lower immune activity in the body, which decreases any inflammation. However, these medications can leave people vulnerable to infection and cause side effects, such as high blood sugar, high blood pressure, and acne.

Examples of corticosteroids include:

  • hydrocortisone
  • prednisone
  • methylprednisolone

Immunomodulators

Similar to corticosteroids, immunomodulators help control inflammation by reducing immune activity in the body. It may take several weeks or months for immunomodulators to take effect.

Examples of immunomodulators include:

  • cyclosporine
  • methotrexate
  • 6-mercaptopurine (6-MP)

Other medications

Doctors may prescribe other medications to help manage someone’s symptoms or to treat additional complications of Crohn’s disease. These drugs can include:

  • biologics, such as adalimumab and natalizumab
  • antibiotics to prevent or treat infections resulting from fistulas
  • loperamide to treat severe diarrhea

People can take over-the-counter pain relievers that contain acetaminophen, such as Tylenol. However, they should avoid taking nonsteroidal anti-inflammatory drugs (NSAID), such as ibuprofen and aspirin, as these can make symptoms worse.

Surgery

People who have Crohn’s disease often require surgery. One study found that nearly 60% of people with Crohn’s disease had surgery within 20 years of diagnosis.

A doctor may recommend surgery if a person has:

  • fistulas
  • severe intestinal strictures
  • intestinal blockages or obstructions
  • life threatening bleeding

Learn more about Crohn’s surgery here.

An individual should see a doctor if they experience:

  • frequent abdominal pain or cramping
  • bloody stools or rectal bleeding
  • weight loss they cannot explain
  • diarrhea that lasts more than 1 week

There are five types of Crohn’s disease. Crohn’s disease can affect any part of the digestive system, and doctors can identify which part the condition is impacting. They can also determine the type of Crohn’s with physical examinations and diagnostic testing.

People may have different symptoms or develop additional complications, depending on which type of Crohn’s disease they are experiencing. Those who have ileitis or Crohn’s colitis, for example, can develop fistulas and ulcers. On the other hand, people who have gastroduodenal Crohn’s disease may experience more nausea and vomiting.

People living with Crohn’s disease can talk to their doctor or another healthcare provider for more information about the condition and how to manage their symptoms through lifestyle and dietary changes.

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