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Crohn’s Disease

Crohn’s disease is a long-term condition that causes inflammation in the digestive tract. Unlike ulcerative colitis, which only affects the colon and rectum, Crohn’s disease can affect any part of the gastrointestinal (GI) tract—from the mouth to the anus. The inflammation can occur in patches and may extend deeper into the bowel wall.

Crohn’s disease and ulcerative colitis are the two main forms of inflammatory bowel disease (IBD).

Over 20,000 people in New Zealand are affected by IBD, and this number continues to rise.

Crohn’s disease can cause strictures (narrowing of the bowel), fistulas (abnormal connections between organs), or abscesses. These complications may require specialised treatment or surgery.

Crohn’s disease can develop at any age, but it most often begins in adolescence or early adulthood.

Symptoms of Crohn's Disease

Symptoms can vary widely depending on which part of the digestive tract is affected and how active the inflammation is.

Common symptoms include: 

  • Diarrhoea, which may be persistent 

  • Abdominal pain or cramping 

  • Fatigue 

  • Unintended weight loss 

  • Fever 

  • Nausea or reduced appetite 

  • Blood or mucus in the stool 

Crohn’s disease can also cause symptoms outside the gut, including: 

  • Joint pain or swelling 

  • Skin problems 

  • Eye inflammation 

Treatment for Crohn's Disease

Treatment is individualised and aims to reduce inflammation, relieve symptoms, achieve healing of the bowel lining, and maintain remission. 

Management of Crohn’s disease is overseen by a gastroenterologist. It often involves a combination of medications, monitoring, and in some cases, surgery. 

Crohn’s disease is a lifelong condition with periods of flare-ups and remission. With proper treatment and monitoring, many people with Crohn’s are able to manage their symptoms and lead full, active lives. 

Your gastroenterologist will work with you to ensure regular monitoring, adjustment of treatment if needed, and surveillance for complications. They will guide you through the treatment options and support your long-term care. 

Medications

There are several types of medications used to treat Crohn’s disease, depending on the severity and location of the inflammation: 

Aminosalicylates (e.g., mesalamine) – used less commonly for Crohn’s than UC 

Corticosteroids (e.g., prednisolone) – used short-term during flare-ups 

Immunosuppressants (e.g., azathioprine, methotrexate) – to calm the immune system 

Biologics (e.g., infliximab, adalimumab, vedolizumab) – target specific pathways in the immune response 

JAK Inhibitors (e.g., upadacitinib) – small molecule drugs used in moderate to severe cases 

Surgery

Surgery may be required if medication is not effective, or if complications such as strictures, fistulas, or abscesses occur.

Unlike ulcerative colitis, surgery does not cure Crohn’s disease, but it can help manage symptoms and improve quality of life.

Your gastroenterologist will work closely with you and your colorectal surgeon to decide if surgery might be helpful to you. 

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