Crohn's Disease
Crohn's is chronic, but it's more manageable now than ever before.
Modern medications, targeted nutrition, and when needed surgery give most patients long stretches of remission and a good quality of life.
Crohn's disease is a chronic inflammatory bowel disease (IBD) that can affect any part of the digestive tract, from the mouth to the anus. It most often involves the end of the small intestine and the beginning of the colon. Like ulcerative colitis, it follows a pattern of flares and remissions, with inflammation that can extend through the full thickness of the bowel wall. While the exact cause remains unclear, experts believe genetic predisposition, immune system dysfunction, and environmental triggers all play a role. Dietary habits and stress can aggravate symptoms but do not directly cause the disease.
Crohn's Disease at a Glance
Affects
Any part of the GI tract
Pattern
Patchy, full-thickness
Course
Flares and remissions
Onset age
Most common 15 to 35
How It Differs from Ulcerative Colitis
Crohn's disease and ulcerative colitis are both forms of IBD, and they share many symptoms. The differences matter clinically. Crohn's can affect any part of the digestive tract, with patches of inflammation separated by healthy tissue (often called "skip lesions"). The inflammation can extend through the entire bowel wall, which is why Crohn's more commonly causes strictures, fistulas, and abscesses.
Ulcerative colitis, by contrast, affects only the colon and rectum with continuous inflammation limited to the bowel's inner lining. Another key difference: surgery does not cure Crohn's. Inflammation can return in previously unaffected areas of the GI tract, even after a segment is removed.
Common Symptoms
Crohn's symptoms vary widely from mild to severe depending on where inflammation occurs and how active the disease is. Common signs include:
Abdominal cramps and pain
Persistent diarrhea
Urgent bowel movements
Rectal bleeding
Fever
Fatigue
Weight loss and loss of appetite
Night sweats
Mouth sores (aphthous ulcers)
Perianal Crohn's disease is common and can cause additional symptoms including anal pain, drainage, skin tags, fistulas, and abscesses. Crohn's can also produce symptoms outside the digestive tract, including joint pain, eye inflammation, and skin problems. These can appear alongside GI symptoms or sometimes before them.
Causes and Risk Factors
The exact cause of Crohn's disease remains unclear, but several factors influence risk.
Family history
Having a first-degree relative with IBD significantly raises risk. Genetics plays a substantial role.
Age
Most commonly diagnosed between 15 and 35, with a second smaller peak between 50 and 70.
Smoking
The most important modifiable risk factor. Smoking significantly worsens Crohn's disease, increases flare frequency, raises complication risk, and reduces how well treatments work. Quitting meaningfully improves outcomes.
Ethnicity
Higher rates among people of Ashkenazi Jewish heritage. Crohn's occurs in all populations, with increasing rates globally.
Environment
Higher incidence in urban areas and Western countries. Early-life factors, including antibiotic use and diet, may influence risk.
Medications
Frequent NSAID use may trigger flares in some patients, although it isn't a direct cause of the disease.
Immune system factors
Abnormal immune responses to bacteria in the GI tract appear to drive the chronic inflammation seen in Crohn's.
How Crohn's Disease Is Diagnosed
At your initial consultation, Dr. Chung will thoroughly discuss your symptoms, lifestyle, and medical history to build a complete picture of your condition. Diagnostic testing confirms Crohn's and distinguishes it from other conditions like ulcerative colitis, IBS, or infection.
Colonoscopy with biopsy
Examines the colon and end of the small intestine, with tissue samples taken to confirm inflammation patterns characteristic of Crohn's.
Upper endoscopy
Used when upper GI involvement is suspected, examining the esophagus, stomach, and first part of the small intestine.
CT or MR enterography
Specialized imaging that provides detailed views of the small intestine, which standard colonoscopy can't reach. Helpful for assessing the full extent of disease.
Blood tests
Check for anemia, inflammation markers, nutritional deficiencies, and signs of infection.
Stool tests
Assess inflammation markers (fecal calprotectin) and rule out infectious causes of diarrhea.
Treatment Approaches
Treatment focuses on inducing and maintaining remission, reducing inflammation, healing the GI tract, and improving quality of life. Dr. Chung will tailor your plan to your symptoms, disease location, and severity.
First line
Medication
Medications are typically the starting point. Options include corticosteroids for active flares, immunomodulators (such as azathioprine or methotrexate), and biologic therapies like anti-TNF agents, anti-integrin agents, and anti-interleukin therapies. While medications don't cure Crohn's, they can induce and maintain remission, reduce flare frequency, and help the GI tract heal.
Supportive
Nutritional and dietary management
Diet doesn't cause Crohn's, but it can affect symptoms. Dr. Chung provides personalized dietary guidance, helping identify and avoid trigger foods while supporting nutrition during and between flares. Addressing nutrient deficiencies (iron, B12, vitamin D) is often part of long-term care.
When needed
Surgery
Roughly 70 percent of people with Crohn's disease will need surgery at some point, typically for complications like strictures (narrowed areas), fistulas, abscesses, or severe disease that hasn't responded to medication. Surgery provides substantial relief but does not cure Crohn's, so ongoing medical management usually continues after surgery.
Surgical Options
When surgery is the right answer, the specific approach depends on what the disease is doing and where. Dr. Chung will walk you through the options.
Bowel resection
Removing diseased segments
The affected portion of bowel is removed and the healthy ends are reconnected. Most commonly performed for strictures or severe inflammation in a specific segment. Can often be done minimally invasively.
Strictureplasty
Widening without removing
A bowel-sparing technique that widens narrowed areas without removing intestinal length. Especially valuable in Crohn's, where patients may need multiple surgeries over a lifetime and preserving bowel length matters.
Perianal Crohn's disease often requires specific procedures for fistulas and abscesses. Dr. Chung has particular expertise in this area, which can meaningfully improve day-to-day quality of life.
Long-term cancer surveillance: People with long-standing Crohn's disease involving the colon have an elevated risk of colorectal cancer. Regular surveillance colonoscopies are an important part of long-term care. Dr. Chung can advise on the right screening schedule for your situation.
Recovery and Ongoing Management
Crohn's is a long-term condition that benefits from a long-term partnership with a care team. For patients on medical management, the goal is to achieve and maintain remission on the lowest effective dose of medication, with regular monitoring to catch flares early.
After surgical treatment, detailed aftercare instructions and follow-up visits help ensure a smooth recovery. Most patients return to regular activities and experience meaningful symptom relief. Because Crohn's can recur in new areas, ongoing medical therapy is often continued after surgery to reduce that risk.
Get expert Crohn's care
Whether you're newly diagnosed, working through a flare, dealing with perianal disease, or considering surgery, Dr. Chung can help you build a plan that fits your disease and your life.
Book a consultation
Call (714) 988-8690
