Abdominal pain and cramping
This often occurs in the lower right abdomen and may be persistent or intermittent.

Diarrhoea
Chronic diarrhoea is common, and may be accompanied by blood or mucus.

Fatigue
Ongoing inflammation can cause extreme tiredness and a general lack of energy.

Unexplained weight loss
As a result of malabsorption and inflammation, individuals with Crohn’s may lose weight without trying.

Fever
Low-grade fevers are a common symptom, especially during flare-ups.

Reduced appetite
Inflammation in the digestive tract may cause a loss of appetite and nausea.

Bloody stools
This may occur if the disease causes ulcers or bleeding in the intestines.

Genetic factors
Crohn’s disease tends to run in families, suggesting a genetic predisposition. Certain genes have been linked to an increased risk of developing the disease, particularly genes involved in immune system regulation. However, not everyone with a family history of Crohn's will develop the condition, indicating that other factors also play a role.

Immune system dysfunction
One of the primary theories behind Crohn's disease is that the body’s immune system mistakenly attacks healthy cells in the gastrointestinal tract. This immune response leads to chronic inflammation, which is the hallmark of the disease.

Environmental factors
Environmental factors, such as diet, smoking, and stress, are believed to contribute to the development or exacerbation of Crohn’s disease. Smoking, in particular, has been strongly linked to an increased risk of developing the condition and can worsen symptoms in those already diagnosed.

Gut bacteria
The bacteria that naturally reside in the gut also play a role in Crohn’s disease. Research suggests that an imbalance in gut microbiota can trigger an abnormal immune response, contributing to the inflammation characteristic of Crohn’s.

Increased risks

• Age: Crohn’s disease typically develops between the ages of 15 and 35, though it can occur at any age.
• Family history: A family history of Crohn’s or other forms of IBD increases the risk of developing the condition.
• Smoking: Smoking significantly raises the risk and severity of Crohn’s disease.

Complications
Over time, Crohn’s disease can lead to a number of complications, including:

• Strictures and blockages: Chronic inflammation can cause narrowing of the intestines, leading to blockages that require surgical intervention.
• Fistulas: Abnormal connections may form between different parts of the intestines, or between the intestines and other organs like the bladder, vagina, or skin.
• Abscesses: Pockets of infection can develop in the abdomen or other areas.
• Nutritional deficiencies: Ongoing inflammation can impair nutrient absorption, leading to deficiencies in vitamins and minerals like iron, vitamin B12, and calcium.

Flare-ups and remission
Crohn’s disease typically follows a pattern of flare-ups (periods of active inflammation) and remission (periods with few or no symptoms). The goal of treatment is to reduce the frequency and severity of flare-ups and to maintain long-term remission. Factors like diet, stress, and even seasonal changes can trigger flare-ups, so managing triggers is essential for improving long-term outcomes.

Medication options

• Anti-inflammatory drugs: These medications, such as corticosteroids, help reduce inflammation in the digestive tract.
• Immunosuppressants: Drugs that suppress the immune system, like azathioprine or methotrexate, can help manage inflammation by calming the immune response.
• Biologics: These newer medications target specific proteins involved in the immune response. Examples include infliximab and adalimumab.
• Antibiotics: These are used to treat any infections that may arise, including abscesses or fistulas.
• Pain relievers and anti-diarrhoeal medications: These can help control symptoms but should be used under medical supervision to avoid complications.

Diet and lifestyle changes
Managing one’s diet and reducing stress are key aspects of living with Crohn’s disease. While no specific diet is proven to cure the disease, avoiding certain foods that irritate the gut (e.g., high fibre, dairy, fatty or fried, or spicy foods), eating smaller, more frequent meals, and ensuring adequate nutrition (iron, calcium, vitamin B12 and vitamin D), are important steps. Consulting a nutritionist or dietitian can help develop a personalised eating plan.

Surgery
In some cases, surgery may be necessary to remove severely damaged parts of the intestines, address complications such as blockages or fistulas, or drain abscesses. While surgery does not cure Crohn’s, it can provide relief from symptoms and improve quality of life.

Personalised treatment and early intervention
Personalised treatment plans tailored to an individual’s specific symptoms, severity, and response to medications are essential. Early intervention can help manage the disease more effectively, reduce the risk of complications, and prevent long-term damage to the intestines. Ongoing monitoring and adjustments to the treatment plan may be needed as the disease progresses.