health articles

Crohn’s disease

Crohn’s disease is a condition that causes inflammation of the digestive system; it is estimated to affect one in every 650 people in the UK.1

At present, there is no cure for Crohn’s, but medication and, sometimes, surgery can provide relief from symptoms. If you are worried about your bowel health, the experienced doctors at Virtually Healthcare can provide expert assessment, sensitive support and speedy referral when necessary.

Irritable bowel syndrome or IBS is an unpleasant condition that causes cramps, bloating and bowel disturbance. IBS can affect your health, wellbeing and lifestyle; you may need to plan outings, activities and work around the food you eat and the access you’ll have to the nearest toilet.

If your IBS affects your quality of life, the experienced doctors at Virtually Healthcare can provide expert investigation, support and treatment to help you control your symptoms and live a full and active life.

What is Crohn’s disease?

Crohn’s disease is a chronic or lifelong condition that makes parts of the digestive tract become inflamed2. Together with Ulcerative Colitis, Crohn’s is part of a group of diseases called Inflammatory Bowel Disease or IBD. Inflammation is the body’s natural reaction to injury, infection or irritation. When the bowel is inflamed, it can cause unpleasant and distressing symptoms, including abdominal pain, diarrhoea and the passage of blood and mucous through the back passage.

The doctors at Virtually Healthcare can provide treatment for Crohn’s disease, refer you to an NHS specialist team and support you to live an active and fulfilling life with Crohn’s.

What are the symptoms of Crohn’s disease?

Crohn’s disease causes symptoms that can come and go over time. Symptoms worsen during ‘flare ups’, but there may be periods of ‘remission’ when you have no problems.

Crohn’s can affect any part of the digestive tract from your mouth through to your anus. Your symptoms will depend on the part of the bowel that is inflamed. The features include:

  • Abdominal pain and cramping.
  • Diarrhoea.
  • Mucous, blood or pus mixed in with the diarrhoea.
  • Tiredness: The illness can cause fatigue. However, the weight loss, anaemia and sleep disturbance from getting up in the night to go to the toilet can also contribute to the feeling of exhaustion.
  • Feeling unwell: You may feel feverish and weak.
  • Mouth ulcers
  • Reduced appetite and weight loss: Diarrhoea, decreased absorption of food nutrients, and loss of appetite can all contribute to weight loss.
  • Anaemia: Anaemia can make you tired, listless and lacking in energy. You may also find that you’re weak and may get dizzy or even faint.
  • Leakage: Crohn’s disease can lead to fistula formation. A fistula is an abnormal communication between the bowel and the skin, bladder, vagina or other structures. Bowel contents can leak through the fistula, causing abscesses, urine infections, leakage and unpleasant discharge.3

Crohn’s disease treatment at Virtually Healthcare

Virtually Healthcare is an innovative GP practice, providing expert care in your home’s comfort, safety, and privacy. The Virtually Healthcare service is designed to fit with modern lives. Consultations are easy to access, discreet and convenient, with virtual appointments available seven days a week.

The highly skilled team includes more than 40 clinicians working together to investigate and treat disease and help you optimise your health and wellbeing. As well as experienced GPs, the team includes sexual health specialists, physiotherapists and practice nurses to offer a comprehensive primary care service.

During the pandemic, many patients are finding it more challenging to access healthcare. Virtually Healthcare provides quick access video or telephone appointments, with consultations available the same day if you contact us before 3 pm. Our clinicians can provide professional assessment and advice, arrange investigations, prescribe treatment or arrange for a face-to-face review.

At Virtually Healthcare, our focus is on you. Our clinicians take a holistic approach to IBD treatment. They can arrange investigations, provide support and advice, follow NICE best-practice treatment guidelines4 and guide you to reliable information about Crohn’s disease.

How do you diagnose Crohn’s Disease?

The experienced GPs at Virtually Healthcare can diagnose Crohn’s disease based on your symptoms, clinical history and the results of investigations. They will arrange tests that check for inflammatory bowel disease and also exclude other conditions:

  • Full blood count (FBC) to check for anaemia.
  • Blood test for inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
  • Stool sample for blood and inflammatory markers (calprotectin.)
  • Blood test for coeliac disease.
  • Stool sample for infection.
  • Referral to a hospital team for flexible sigmoidoscopy, upper GI endoscopy or colonoscopy and biopsy.
  • Referral for a CT scan or MRI.5

What causes Crohn’s disease?

We do not fully understand the causes of Crohn’s disease; it is believed to be linked to several factors. Your genes are likely to play a role; an individual is more likely to get Crohn’s if a close family member has inflammatory bowel disease. It may also be linked to smoking, abnormal gut bacteria, previous stomach infection and problems with the body’s immune system that makes it attack the digestive tract.6

What is the treatment for Crohn’s disease?

The GPs at Virtually Healthcare provide empathetic and supportive care for all our patients with IBD. They follow NICE guidelines and work with you to control the difficult and distressing symptoms. They will refer you to a hospital gastroenterology team for specialist investigations and care, prescribe treatments and offer support. Treatments include:

  • Providing advice and offer reliable sources of online information and support.
  • Advice about diet and nutrition. There is no evidence that diet causes Crohn’s, but dietary changes can help control symptoms and help you maintain a healthy weight.
  • Medication to reduce inflammation. Usually, a course of steroid tablets is given initially to control inflammation and induce remission.
  • Medication to prevent inflammation from returning and maintain remission. These suppress the immune system and can be either tablets or injections, including azathioprine, methotrexate.
  • Biological medicines can be effective in people whose Crohn’s has not responded to immunosuppressant therapy. These innovative medications include adalimumab, infliximab, and vedolizumab.
  • A liquid elemental diet can be effective in reducing inflammation in some patients.
  • Sometimes your hospital team will recommend surgery to remove part of the bowel. This can be more effective than drugs, particularly if a small section of the intestine is severely affected.

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Hot topics in IBS

How can you help yourself with Crohn's disease?

One of Virtually Healthcare’s GPS reports on the questions and concerns that they are currently seeing in their consultations.

Self-help can be very helpful in controlling Crohn’s disease, helping you live a fuller, freer life. Check out the linked information resources and chat with your medical team so that you become an expert in monitoring and managing your condition:

  • Track your symptoms: Get to know your bowels and your body. Identify flare-ups at an early stage so that you can access treatment before the inflammation becomes severe.
  • Identify triggers: Flare-ups can be caused by stress, medication changes, infections, antibiotics and even food. Try and work out your triggers so that you can avoid them in the future.9
  • Avoid NSAIDs Non-steroidal Anti-inflammatory drugs like ibuprofen or naproxen can cause flare-ups in some people; stick to paracetamol for pain relief.
  • Quit smoking: Smoking can trigger Crohn’s and make you more likely to need surgery.
  • Stressbusting: Stress can increase IBD symptoms. Try relaxation exercises, breathing techniques, meditation or cognitive behavioural therapy to help you manage the stress in your life more effectively.
  • Monitor your diet: A food diary can help you identify items that worsen your symptoms. Some patients have found that avoiding gas-producing vegetables like beans and broccoli, cooking vegetables well, limiting high-fibre foods and reducing greasy and fast foods can help.
  • Reduce or avoid caffeine and alcohol, which may make symptoms worse.

What is the difference between IBS and IBD?

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are different bowel conditions. They have some similar symptoms, including pain, change of bowel habit and passage of mucous, but there are significant differences in bowel health and treatments.

  • IBS: Irritable bowel syndrome is a functional gastrointestinal disorder. There is a disturbance in bowel function but no significant changes in the structure and health of the bowel. IBS causes abdominal pain, cramping and bloating together with diarrhoea and constipation.
  • IBD: Inflammatory bowel disease includes Crohn’s disease and ulcerative colitis. These are diseases with destructive inflammation of the bowel, which can be seen on sigmoidoscopy or colonoscopy and biopsy. Chronic inflammation can lead to structural changes to the bowel and can increase the risk of bowel cancer. IBD causes bowel disturbance, pain, rectal bleeding, the passage of mucous, malaise and weight loss. Crohn’s disease can lead to fistula formation ( abnormal communications between the bowel and the skin, bladder, vagina or other structures.) IBD treatments are often powerful and can be toxic. They target inflammation and are not effective in people with irritable bowel syndrome.

Can Crohn’s increase the risk of bowel cancer?

Bowel or colon cancer is a common disease that can affect anyone; however, some people are more likely to be affected. It is more common in people with a close relative who had bowel cancer and in people with long-standing inflammatory bowel disease like Crohn’s disease.

The good news is that only a small number of people will develop colorectal cancer. Anyone with IBD will have regular screening to check for cancer so that any abnormalities swiftly and effectively.

Crohn’s and Colitis UK says:

‘If you have Ulcerative Colitis or Crohn’s Colitis, it is recommended that you have a colonoscopy 8 to 10 years after the start of your symptoms to see whether there have been changes in your colon.

It is best to have a surveillance colonoscopy done when your Crohn’s or colitis is not active. It is recommended that you have follow-on colonoscopies every 3 or 5 years or, less commonly, yearly. This will depend on what was seen during your previous colonoscopy and any other risk factors you may have.’11

Types of consultations we offer

We offer written, telephone and video consultations with a range of male and female clinicians from GPs, nurse practitioners, and primary care specialists such as physiotherapy.