How do you know it’s Crohn’s Disease?


Crohn’s disease is a chronic, inflammatory condition of the digestive tract that affects over 500,000 Americans. Diagnosing Crohn’s is challenging because the symptoms mimic other common intestinal disorders. Symptoms include: abdominal cramps after eating, frequent diarrhea, bleeding from your rectum, weight loss, night sweats, or a recurrent fever. Because there is no single test that can determine whether or not you have Crohn's, your doctor will probably order a combination of tests to rule out other conditions, such as inflammatory bowel disease (IBS), with similar symptoms.

                  Let’s take a look at some conditions with similar symptoms and how they can be distinguished from Crohn’s disease: 

Inflammatory Bowel Disease (IBS)

Unique to IBS, people do not usually experience pain during bowel movements, and their symptoms go away while they're sleeping. Unlike Crohn’s, it is usually not associated with significant weight loss, anemia, rectal bleeding, stool blood, or recurring fever — a sign of inflammation.

Celiac Disease

Gluten, which is found in wheat, barley, rye, and possibly oats, damages the small intestine in people with celiac disease.  Diagnosis is confirmed when blood tests show elevated levels of immunoglobulin A (IgA), antitissue transglutaminase (anti-tTG) antibodies and antiendomysium antibodies (AEA).

Ulcerative Colitis and Diverticular Disease

Distinguishing among Crohn's, ulcerative colitis, and diverticular disease is challenging. A detailed history and a complete physical exam, which may include checking your abdomen for tenderness or masses and checking your rectum for hemorrhoids, tears, or narrowing is typically needed.  Laboratory tests such as erythrocyte sedimentation rate (ESR), or SED rate, are instrumental in detecting an inflammatory response. Inflammation makes red blood cells sticky and prone to settling more quickly than usual. A higher-than-normal SED rate and an elevated C-reactive protein level confirm systemic inflammation.  Blood antibody testing, though not 100 percent reliable, can help distinguish between Crohn's and ulcerative colitis, since people with Crohn's tend to be positive for the anti-Saccharomyces cerevisiae antibody (ASCA) but negative for perinuclear antineutrophil cytoplasmic antibody, or pANCA.

What do you need to know?

Crohn’s disease is a very common chronic, inflammatory condition of the digestive tract. Diagnosis is challenging because symptoms of Crohn’s can be non-specific and often mimic other intestinal disorders. There are many diagnostic modalities to aid in diagnosing Crohn’s disease and distinguishing it from other gastrointestinal disorders. The history of symptoms and physical exam findings will direct which diagnostic technique your physician will use. Crohn's is a chronic disorder that can progress over time. It is important to get the right diagnosis is even if it means going through some uncomfortable testing procedures. A proper diagnosis will help you and your doctor decide on the best treatments to improve your daily life, ease your symptoms, and potentially bring on remission.