Living with Crohn's Disease - Nancy Branberg
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Living with Crohn’s Disease

What is Crohn’s Disease?

Many have heard the term, but most people don’t even know what it is. It’s a chronic inflammatory bowel disease that causes inflammation in the digestive tract. Unlike ulcerative colitis, which primarily affects the inner lining of the colon, Crohn’s disease can impact any part of the digestive system. However, it most commonly targets the small intestine (ileum), the large intestine (colon), and quite often the junction between the two.

This inflammation disrupts the normal function of the digestive system, leading to a variety of unpleasant symptoms. The inflammation caused by Crohn’s disease can also affect deeper layers of the bowel wall. 

In severe cases, this can lead to complications like blockages or malabsorption of nutrients. The inflamed tissue can narrow the passage within the intestines, and this in turn makes it difficult to pass stool.

Crohn’s disease is also characterized by periods of relapse (flare-ups) with active inflammation and intervening periods of remission when symptoms subside. The disease course can be unpredictable, and the severity of symptoms can vary greatly from person to person.

diagram illustration of crohn's disease

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What are the Symptoms and Causes of Crohn’s Disease?

Crohn’s disease is characterized by periods of relapse and remission. Symptoms during a flare-up can include:

  • Abdominal pain and cramping
  • Diarrhea, urgent or bloody
  • Fatigue
  • Weight loss
  • Fever
  • Mouth sores

The exact cause of Crohn’s disease remains a mystery, but researchers are piecing together a complex puzzle with several key players.

Autoimmune Response Gone Awry: In a healthy immune system, white blood cells fight off invaders like bacteria and viruses. In Crohn’s disease, the immune system mistakenly identifies healthy gut tissue as a threat, triggering chronic inflammation. The exact trigger for this mistaken identity response is still under investigation.

Genetic Predisposition: Having a close relative with Crohn’s disease increases your risk significantly. Researchers have identified over 200 genes associated with an increased risk of developing Crohn’s. These genes don’t directly cause the disease, but they may make an individual more susceptible to environmental triggers.

Gut Microbiome Imbalance: The gut microbiome is the vast community of bacteria residing in our intestines. These bacteria play a crucial role in digestion, nutrient absorption, and immune function. A disruption in this delicate balance where a decrease in beneficial bacteria and an overgrowth of harmful ones, is increasingly seen as a potential contributor to the chronic inflammation in Crohn’s disease.

Environmental Triggers: Smoking is the most established environmental risk factor for Crohn’s disease. Smoking appears to alter the gut microbiome and may impair the immune system’s function in the gut. Certain medications, like nonsteroidal anti-inflammatory drugs (NSAIDs), may also increase the risk of developing Crohn’s disease or worsen symptoms in existing cases.

digestive issues caused by crohn's diseaseThe Search for Answers Continues

Researchers are actively investigating other potential contributing factors, including your diet. While there’s no single Crohn’s disease diet, certain dietary components may play a role in triggering flares. It may be a good idea to see each of the food components affect your body in different ways.

Some studies have also suggested a possible link between an appendectomy and an increased risk of Crohn’s disease. This might just be one of those instances where there happens to be correlation without causation, because the reasons for this still remain unclear.

Diagnosis and Treatment of Crohn’s

Crohn’s disease often presents a diagnostic challenge due to its varied symptoms and a lack of a single definitive test. Fortunately, a combination of approaches can help pinpoint Crohn’s and guide treatment strategies.

The journey to diagnosis starts with a detailed discussion about your medical history and current symptoms. 

Family history: Having a close relative with Crohn’s disease increases your risk.

Blood tests: These can check for anemia, inflammation markers, and rule out other conditions.

Stool tests: They can detect blood in the stool, indicating possible inflammation.

Imaging Techniques: X-rays, CT scans, and MRIs can visualize the digestive tract and reveal signs of inflammation, blockage, or fistulas (abnormal connections between bowel segments).

Endoscopes: A colonoscopy or capsule endoscopy allows direct visualization of the gut lining, helping identify inflammation and collect tissue samples (biopsies) for further analysis.

Treatment Options for Combating the Inflammation

While there’s no cure for Crohn’s disease, a multi-pronged approach can manage symptoms and achieve remission (periods without flares). 

Anti-inflammatory drugs: These (5-aminosalicylates and corticosteroids) aim to reduce inflammation in the gut.

Immunomodulators: These medications suppress the overactive immune system response that fuels inflammation.

Biologics: These newer targeted therapies block specific proteins involved in the inflammatory process.

Antibiotics: These are used to treat bacterial infections that can worsen Crohn’s symptoms.

Diet and Nutrition: Following a bland diet that’s easy to digest can help manage symptoms, especially during flares.

Nutritional counseling ensures you get the essential vitamins and minerals needed for overall health.

In severe cases, enteral nutrition (feeding through a tube) or parenteral nutrition (intravenous feeding) may be necessary.

Surgery: May be needed to remove damaged sections of the bowel or address complications like blockages or fistulas.

Taking a Look at Crohn’s Daily Management

Crohn’s disease can throw a wrench into your daily routine. Unpredictable flare-ups and constant management can be daunting, but with the right approach, you can live a fulfilling life. Here are some strategies to navigate life with Crohn’s disease:

Building Your Healthcare Team

  • Gastroenterologist: This specialist is your primary partner in managing Crohn’s. They’ll create a treatment plan, monitor your progress, and adjust medications as needed.
  • Registered Dietitian: A dietitian can help you develop a personalized diet plan that minimizes symptoms and ensures you get the nutrients your body needs.
  • Mental Health Professional: Crohn’s can take a toll on your mental well-being. A therapist can equip you with coping mechanisms for stress, anxiety, or depression.

Taking Charge of Your Health

  • Medication Adherence: Medications are key to managing Crohn’s. Take them exactly as prescribed, even during symptom-free periods.
  • Food as Ally, Not Enemy: While there’s no one-size-fits-all Crohn’s diet, keeping a food diary can help you identify trigger foods that worsen symptoms.
  • Hydration is Key: Dehydration can exacerbate symptoms. Aim for eight glasses of water daily and consult your doctor about electrolyte replacement if needed.
  • Stress Management: Stress can trigger flares. Relaxation techniques like yoga, meditation, or deep breathing can be immensely helpful.
  • Open Communication: Talk openly with friends, family, and employers about your condition. Understanding and support can make a big difference.

Time to Start Building Resilience

Join a Support Group and connect with others who understand the challenges of Crohn’s. It can provide invaluable emotional support and practical tips. Staying active with regular exercise can improve your overall well-being and reduce fatigue. 

However, it’s important to listen to your body and adjust your activity level during flares.

Prioritizing sleep is another important one to remember. Getting enough quality sleep is essential for managing any chronic illness. Establish a regular sleep schedule and practice good sleep hygiene.

If you’ve only just been diagnosed then you need to educate yourself about Crohn’s and be your own healthcare advocate. Don’t hesitate to ask questions and express your concerns to your doctor.

Remember, you are not alone in this journey. By taking an active role in your health and building a strong support system, you can thrive with Crohn’s disease.

Can Physical Therapy Help with Crohn’s Disease?

It shouldn’t be a surprise to you that physical therapy can be a valuable tool for people living with Crohn’s disease. Physical therapy will never be able to cure Crohn’s disease, there are many ways that it can be helpful to you.

  • Pain Management: Physical therapy can address pain caused by inflammation, muscle tension, and joint stiffness. Techniques like manual therapy, heat therapy, and electrical stimulation can provide pain relief.
  • Improved Mobility and Flexibility: Crohn’s disease flare-ups can lead to reduced activity levels and stiffness. PT exercises can help improve flexibility and range of motion, making daily activities easier.
  • Strengthening Core Muscles: A strong core improves posture, reduces back pain, and supports the digestive system. PT can provide tailored exercises to strengthen core muscles.
  • Stress Management: Stress can worsen Crohn’s symptoms. PT can teach relaxation techniques like deep breathing and meditation to help manage stress and improve overall well-being.
  • Pelvic Floor Dysfunction: Crohn’s disease can affect the pelvic floor muscles, leading to urinary incontinence or fecal urgency. PT can offer specialized exercises to strengthen and improve control of these muscles.
  • Post-Operative Rehabilitation: If surgery is required for Crohn’s disease complications, PT can help with recovery, regaining strength, and improving mobility.

Working with a Physical Therapist for Crohn’s

A physical therapist experienced in working with IBD patients will create a personalized treatment plan based on your specific needs and condition. It’s important to communicate openly about your symptoms and limitations. Contact me today and let’s put together a plan that will complement your existing medical treatment plan.

Nancy Branberg

Nancy Branberg

Nancy has long had a passion for helping people - especially those who felt they were powerless over their pain. After becoming a mom and having her own “child-birth” traumas to deal with, Nancy became interested in learning about the pelvis - not just the musculo-skeletal system, but the reproductive and digestive system as well. Every day she is amazed by the complexity and the inter-relatedness of all the systems. Nancy is Fall Church’s leading physical therapist who is able to help you overcome these problems without medication or surgery. Nancy Branberg Physical Therapy, LLC empowers women to take control of their pelvic issues so that their energy and attention can shift towards doing all of the things they love to do.
Nancy Branberg

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