Crohn's Disease

Crohn's disease is a chronic inflammatory condition of the digestive tract. It can affect any part from mouth to anus, but most often the end of the small intestine and the colon. The inflammation can go deep through the bowel wall, which is why Crohn's can cause complications like narrowings, abscesses and fistulas.

Symptoms

• Persistent loose stools, sometimes with blood or mucus.
• Crampy abdominal pain (often right-lower).
• Unexplained weight loss and fatigue.
• Low-grade fever.
• Mouth ulcers.
• Perianal problems — fissures, fistulas, abscesses.
• Joint pain, eye inflammation, skin rashes (associated features).

Why Indians need to be careful about diagnosis

Intestinal TB can mimic Crohn's disease almost exactly — and is common in India. Treating Crohn's with immune-suppressing drugs when the actual diagnosis is TB can be dangerous. So diagnosis should always include a careful look for TB: tuberculin skin test / IGRA, chest imaging, sometimes a trial of anti-TB treatment, and biopsy evidence. This is a big reason to get care from a specialist gastroenterologist who is aware of the India context.

Diagnosis

Colonoscopy with biopsies; MR enterography or CT enterography; blood and stool markers of inflammation; TB screening.

Treatment

• Medicines to control inflammation — steroids for flares; then longer-term disease-modifying drugs (thiopurines, biologics).
• Biologics — increasingly available in India, though cost can be a barrier.
• Nutrition support — Crohn's often causes deficiencies (iron, B12, vitamin D).
• Surgery — for complications (narrowing, abscess, fistula) or disease that doesn't respond to medicines. Surgery isn't a cure — disease can come back — but it can restore quality of life.
• Smoking makes Crohn's worse — quitting is particularly important.

Living with Crohn's

• Take medicines regularly, even when you feel well — stopping often triggers flares.
• Watch for worsening symptoms early — early treatment of a flare is more effective.
• Attend routine appointments and tests.
• Family planning is usually achievable with careful management — discuss before conception.
• Patient support networks exist in several Indian cities — useful practical help.