How does Crohn's Disease affect the digestive system?

**Trigger warning: discussion of diet & my past with food**

29th May is World Digestive Health Day.

Crohn’s Disease can affect anywhere in the digestive system, from the mouth to the anus. It causes inflammation which can then lead to symptoms such as abdominal pain, fatigue, blood and mucus in your stool, diarrhoea or constipation, weight loss & mouth ulcers.

The inflammation within the digestive system, such as that within the bowel, can actually penetrate into the bowel’s deeper layers. People with Crohn’s often struggle to absorb nutrients & the things that the body needs from food, so malnutrition is also caused by Crohn’s. Usually, as it has been with myself, this is because of under nutrition, so your body isn’t absorbing anywhere near the amount of nutrients it needs. Over nutrition is another type of malnutrition, where the body gets too many nutrients.

Treating malnutrition

Anybody can become malnourished, however, it is more common in those who have gut-health related conditions.

There is no set plan for all who have malnutrition as everybody is different & may be lacking in some nutrients, but okay in some, and vice versa. 

During the early years of my Crohn’s Diagnosis, around ages 7 - 11, I tried many things to increase my weight & get the right nutrients, but often I couldn’t stick with anything too long because of the debilitating pain, tiredness, constantly feeling cold, countless toilet trips & feeling sick that came with my Crohn’s flare-ups. Often, it would only take a whiff of food to have me doubled over in agony. I hated food for many years of my life & that only turned around 3-4 months after my ileostomy surgery in 2011.

The elemental diet

I went on many diets such as low residue, high calorie & the elemental diet, where I couldn’t consume anything but clear fluids, nutritional supplement drinks such as Ensure & Fortifresh/Fortisip and jelly sweets for several weeks at a time. I didn’t feel like eating anyway, but the problem was I didn’t want to digest anything. Even getting half way down one of the supplements often took hours & made me feel sick. Chilling them in the fridge definitely helped. 

Image from Amazon

The aim of the elemental diet was to give my inflamed bowel a rest. Unfortunately, these diets weren’t very successful for me. This was down to a mix of things including the extent of my disease, my body’s reliance on steroids & my reluctance to help myself due to the side effects & generally not being able to see a light at the end of the tunnel.

Crohn’s is more than just a “toilet disease”

Because of the vital role of the digestive system within our bodies, understandably this can have a knock on effect on other systems within our bodies such as the immune system. Crohn’s Disease is classed as an auto-immune disorder. This is where mistakenly our bodies fight against healthy tissue and attack it. 

In the early stages of Crohn’s, it may only affect a small part of the digestive system, but unfortunately it can progressively affect other areas if it is not effectively controlled. These effects are called “extraintestinal manifestations” of Crohn’s, so it affects the body away from the intestines. 

(image credit: WebMD)

It can cause eye inflammation, liver problems, problems with the biliary tract (liver, gallbladder & bile ducts) such as gallstones, which I actually have at the moment. It can affect the kidneys and manifest in ways such as urinary tract infections (I’ve lost count of how many of these I’ve had, especially pre-surgery). The joints can become inflamed and this can lead to arthritis and it can also affect the skin & the circulatory system. Crohn’s can also lead to things such as iron-deficiency anaemia from the body’s reduced ability to absorb iron from your food or you not being able to eat iron-rich foods. I have this often & had had liquid iron medication & iron infusions for this. Mentally, Crohn’s can and understandably does, take its toll. 

Luckily, there are lots of tests, medications & treatments that can often be done to get flare-ups of the disease under control. Medication & treatment themselves have side effects too. Wouldn’t it just be great if we could have a treatment with positive side effects?!