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The different types of Crohn's disease

Crohn's disease (CD) is a chronic disease that causes inflammation in the bowel. It can occur in any part of the digestive tract.

There are various types of CD, named according to where the inflammation is located, each with different symptoms and complications:

Ileocolitis is the most commonly occurring kind of CD. In this condition, inflammation develops in the lowest part of the small intestine (the ileum) and also in the colon. It can cause diarrhoea, abdominal pain and weight loss.

Ileitis, which is found in the ileum alone, produces the same symptoms, and can also give rise to fistulas or abscesses in the lower abdomen. (Fistulas are abnormal connections between organs or structures in the body, for example between two loops of intestine, or between the intestine and the vagina or the bladder.)

Crohn’s (granulomatous) colitis only affects the colon. This can give rise to joint pains, diarrhoea, skin lesions, fistulas, abscesses, rectal bleeding and ulcers.

Gastroduodenal CD affects the stomach and duodenum (the topmost part of the small intestine). It causes nausea, loss of appetite and weight loss. If segments of bowel are obstructed, this may cause vomiting.

Jejunoileitis causes patches of in?ammation in the jejunum (the part of the small intestine that lies between the duodenum and the ileum), resulting in cramps, fistulas, diarrhoea and abdominal pain.

It is possible for a person to have one or more of these types of CD, sometimes at the same time. The development of CD may also follow different patterns:

• In luminal-?brostenosing CD, intense ?are-ups of symptoms alternate with periods of remission (symptom-free). “Fibrostenosing” means that there are strictures – sections of the intestine that have become narrowed.

• “Luminal” refers to the lumen, which is what the tube of the intestine is called. Many people with luminal CD – a little more than half of those diagnosed – can go for long periods free from symptoms. For others, the disease is more active and intense.

• A third pattern is ?stulising CD. People with CD have an increased risk of developing a fistula in their lifetime, and these often recur.

Crohn’s disease can manifest very differently in different people, and at different times in one person’s life. The exact nature and course of your disease will be specific to you.

Source: Crohn’s and Colitis Foundation of America (www.ccfa.org)
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