Crohn’s Disease and Comorbidities: Types, Treatment, and Management

Crohn’s disease is an inflammatory bowel disease often associated with symptoms such as diarrhea, abdominal cramps, fatigue, and fever.

Crohn’s disease ranges in severity and can be managed with lifestyle changes, medications, and, sometimes, surgery. As is often the case with many chronic inflammatory conditions, comorbidities and Crohn’s disease often go hand in hand.

Read on to learn which conditions are commonly seen along with Crohn’s disease.

Crohn’s disease is a chronic condition that causes inflammation, specifically in your small and large intestine. The areas where you experience inflammation with Crohn’s disease are what make the condition different from other inflammatory bowel disorders, such as ulcerative colitis or microscopic colitis.

An estimated 1 million Americans have Crohn’s disease. The intestinal inflammation can raise the risk of health complications, such as ulcers, intestinal obstruction, abscesses, and fistulas.

Sometimes, people with Crohn’s disease experience other medical conditions that may be related in some way to Crohn’s. While not everyone with Crohn’s disease will experience the complications outlined below, these do tend to develop more often in people who have Crohn’s.

Comorbidities are medical conditions that occur simultaneously. People with Crohn’s disease tend to experience certain medical conditions. It’s important for doctors to know about these possible comorbidities so they can screen for them.

These are some of the conditions that tend to occur more frequently with Crohn’s disease:

  • Ankylosing spondylitis: Ankylosing spondylitis is a condition that causes arthritis to develop in the spine. The condition can cause pain, stiffness, and immobility in the spine as well as the shoulders, hips, heels, or knees.
  • Colorectal cancer: Crohn’s disease causes significant inflammation in your gastrointestinal tract, which could increase your risk for colorectal cancer. The risks are increased if Crohn’s disease mainly affects your colon, while the risk is not increased if Crohn’s disease mainly affects your small intestine.
  • Iron-deficiency anemia: People with Crohn’s disease experience higher rates of iron-deficiency anemia compared to other inflammatory bowel diseases. The lack of iron that causes anemia or low blood counts can lead to symptoms such as shortness of breath, fast heart rate, chest pain, stomach pain, and nausea. Doctors think chronic inflammation associated with Crohn’s disease may increase the risk for iron-deficiency anemia.
  • Migraine headaches: People with Crohn’s disease tend to experience migraine headaches at higher rates than those who don’t have Crohn’s. Migraine headaches can cause severe headaches that may affect your quality of life.
  • Psoriatic arthritis: An estimated 3.9 percent of people who have Crohn’s disease also experienced psoriatic arthritis, as seen in one study of more than 10,000 Crohn’s disease patients. Psoriatic arthritis causes symptoms such as swollen joints and itchy, scaly patches on the skin.
  • Osteoporosis: According to researchpeople with inflammatory bowel disease who’ve been prescribed a steroid regimen may have an increased risk of developing osteoporosis.
  • Primary sclerosing cholangitis: Primary sclerosing cholangitis is a condition that causes scarring to the bile ductswhich can potentially cause liver damage. This condition can commonly co-occur with Crohn’s disease as well as other autoimmune disorders such as celiac disease and thyroid diseases.
  • Rheumatoid arthritis: Rheumatoid arthritis is an autoimmune disorder that causes inflammation and pain in your joints. Like Crohn’s diseasethe condition causes episodes of exacerbation (worsening) and remission.

The goals for treating Crohn’s disease are to minimize flare-ups and symptoms whenever possible. Fortunately, there are quite a few types of medications that can help.

When prescribing Crohn’s disease medications, it’s important for your doctor to take into consideration any co-morbidities you may have. This is important because some medications for Crohn’s disease may worsen other conditions.

Examples of Crohn’s disease medications include the following:

  • Biologic therapies: Biologic therapies can affect your immune system’s response that causes Crohn’s disease. However, the medication can worsen conditions such as heart failure, chronic obstructive pulmonary disease, and cancer.
  • Corticosteroids: Corticosteroids are medications prescribed to reduce inflammation. They can be helpful in treating acute flares in autoimmune conditions, such as ankylosing spondylitis and rheumatoid arthritis. These medications are not intended for long-term use. Steroids can also increase the rate of bone mass loss, and may not be a good fit if you have osteoporosis.
  • Immunomodulators: Immunomodulators are medications that may reduce immune system activity which, in turn, may ease severe Crohn’s disease reactions. However, these conditions can cause low white blood cell counts. This side effect may be dangerous if you have colorectal cancer or other conditions where you need a strong immune system.

Medications aren’t the only methods that are used to treat Crohn’s disease. Often, diet changes that reduce the demands on the bowels can significantly help manage Crohn’s symptoms. Surgical options are also sometimes needed.

Crohn’s disease symptoms vary in severity. Having Crohn’s disease also isn’t a guarantee that you’ll have comorbidities.

The key is to try and live well with Crohn’s disease. This can include making lifestyle changes that support your physical and mental health.

Examples of these changes include:

  • eating a diet that involves several small meals instead of a few larger meals
  • using a food journal that can help you identify whether some foods make your symptoms worse
  • talking to your doctor about taking an iron supplement or increasing iron-containing foods in your diet, including fortified foods such as cereals and breads
  • seeing a therapist if you experience anxiety and depression related to Crohn’s disease
  • talking to your doctor about needed screenings for comorbidities, such as a colonoscopy for colorectal cancer
  • finding outlets that help you relieve stress, such as meditating, exercising, journaling, or other activities you enjoy

You can also ask your doctor or gastroenterologist if support groups are available in your area. Talking to others who also have Crohn’s disease can help you learn more about effective coping strategies.

Crohn’s disease is an inflammatory bowel disorder that causes inflammation in your large or small intestine. It may increase your risk for other conditions, too.

If you’ve been diagnosed with Crohn’s disease, talk with your doctor about your risks for these comorbidities and if you require additional screenings or treatments.

Knowing if you have any other conditions can help your doctor prescribe the treatment that’s best suited to you.

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