What is Crohn’s Disease?

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Crohn’s is a form of inflammatory bowel disease that impacts nearly 800,000 Americans each year. It can affect any part of the gastrointestinal tract, which serves to digest and derive nutrients from food. Symptoms can develop from the mouth to the anal tract.

Crohn’s disease most commonly affects the small intestine and the colon. It often affects one or a few parts of the GI tract severely without causing symptoms elsewhere. Symptoms can be mild or very serious. They may worsen or even completely change over time.

The disorder is perhaps best known for its characteristic cycle of remission and relapse. At some times, swelling of the GI tract may subside completely. These remissions can last for months or even years before symptoms return without any apparent cause.

For most sufferers, diarrhea and abdominal cramps are both the most persistent and intense symptoms. Periodic fever, fatigue, and loss of appetite may accompany flare-ups. When distress lasts a long time, there may be weight loss or bleeding from the rectum.

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What Causes Crohn’s Disease?

The causes of Crohn’s disease are poorly understood. Experts believe there is a strong genetic component to the disease. Up to 20% of people diagnosed with the condition have a parent, sibling, or child with Crohn’s.

Environmental factors can aggravate Crohn’s symptoms:

  • Age – Older people are more likely than younger ones to have severe symptoms
  • Status as a smoker – Smoking seems to make Crohn’s flare-ups more likely
  • Duration of illness – Symptoms have a tendency to become worse over time
  • Complications – Crohn’s affecting the rectum produces more severe symptoms

Crohn’s disease clinical trials are being performed by many companies and government agencies. Despite great interest in it, clinical resources for Crohn’s disease are still limited.

How is Crohn’s Disease Diagnosed?

There is no single test for diagnosing Crohn’s disease. Instead, the doctor must rule out other causes of distress. Blood tests are done to look for signs of anemia or infection. A stool sample may also be taken to test for the presence of blood.

A variety of different medical imaging technologies can be used to evaluate the bowels, colon, and intestines. These include CT scans, MRIs, and others. The most common is the colonoscopy, which allows the doctor to see the entire colon using a tiny camera.

How is Crohn’s Disease Treated or Cured?

Treatment is medication-centered and focuses on finding a combination of anti-inflammatory drugs that reduce symptoms and prevent complications. Crohn’s disease patients will find that a doctor will recommend a specific treatment that will fit their specific situation. Immunosuppressants can also be used to target the natural substances that cause inflammation.

Patients who have abscesses or fistulas as a result of Crohn’s disease may benefit from antibiotics. These reduce drainage and enable the body to heal tissue damage. Some researchers feel they have a positive influence on the microbial makeup of the intestine. Currently there is no cure for Crohn’s disease but many treatment options do exist.

Crohn’s Disease Lifestyle Changes

Although the mechanisms of Crohn’s are not well understood, certain lifestyle changes help the majority of patients. Maintaining a healthy weight helps reduce the odds of certain complications. Complete smoking cessation might make future flare-ups less common.

Many people with Crohn’s have specific food triggers that worsen their symptoms. Keeping a daily symptom journal makes it easier to discover these over time. Foods that cause severe symptoms should be restricted or eliminated.

Foods that may be hard to digest include fatty foods, dairy, raw fruits or vegetables, red meat, butter, and high-fiber foods.

Interview with an Expert

Dr. Lijo John

Dr. Lijo John is a community pharmacist with 9 years of experience and graduated from Rutgers University in 2012.  He has extensive experience serving patients with a focus in geriatric medicine, diabetes management, and preventative medicine such as immunizations and lifestyle modification counselling. Dr. John also enjoys writing and presenting on complex medical topics aimed at the general population to drive positive behavioral change in topics such as vaccine hesitancy and smoking cessation.

An Overview of Crohn’s disease

Crohn’s disease is a subtype of inflammatory bowel disease (IBD) along with Ulcerative colitis and has an unknown cause and no cure. Crohn’s disease can affect the entire GI tract, whereas Ulcerative colitis is confined to the colon and rectum. Although the cause is unknown, infectious, genetic, immunologic, and environmental factors have been proposed as possible culprits1.

How has treatment developed over time?

Nonpharmacologic therapy starts with nutritional support, as patients with this disease often suffer from malnutrition and malabsorption. They may try various diets, such as avoiding dairy, low FODMAP etc, but will probably have varying levels of success. Surgery is often also required for these patients, with a 10 year cumulative risk at 40-55%1.

What is the current standard of care?

Pharmacologic therapy in IBD includes aminosalicylates (ASA’s) such as mesalamine and sulfasalazine, corticosteroids, immunomodulators, immunosuppressive agents, as well as biologics. There are various ASA’s, as well as various formulations such oral tablets, extended-release tablets, enemas etc. Corticosteroids are used to treat acute exacerbations. Immunomodulatory drugs such as mercaptopurine and azathioprine are also effective in patients who have failed ASA therapy and/or are dependent on corticosteroids. Biologics such as infliximab and adalimumab are used in patients with severe or refractory disease and work through various mechanisms of action1.

What are some newer treatments?

New research into Crohn’s disease includes investigation of newer biologic agents such as Upadacitinib. This agent appears to improve remission rates while retaining a safe adverse event profile and improved quality of life in Crohn’s patients2. Ustekinumab, an IL-12/23 inhibitor, has also shown long term efficacy and safety in patients who have failed previous biologic use3. Since heritability is thought to be one of the factors in Crohn’s disease, stem cell treatment is another avenue being pursued. Though there are trials in place, more studies and evidence is required before it becomes a part of the standard of care.

Crohn’s Disease Clinical Trials

There are currently hundreds of Crohn’s Disease clinical trials actively recruiting participants. If you’re unfamiliar with clinical trials, this is how pharmaceutical companies test whether or not new drugs are safe and effective for people with specific conditions.

There are many benefits to participating in clinical trials. Some of these benefits may include monetary compensation, access to cutting edge drugs/treatments, and the ability to help advance Crohn’s disease research.

One of the most challenging aspects of new drug research is filling clinical trials with participants. A lot of times, important studies fail because they simply cannot find enough individuals that meet their criteria to volunteer for the study. That is one of the reasons why we’ve created an easy tool to connect volunteers with Crohn’s disease with clinical research organizations. Simply click “start matching” above, and you will be alerted whenever there is a relevant trial in your area.

You can also find some of the newest Crohn’s disease studies below. If you’re looking for clinical trials that are in your specific area, you can navigate to the “States” section of the main menu, and filter studies by your state.

The following clinical trial are the most recent offered by Clinicaltrials.gov. If you would like us to feature any additional trials, please contact our team.

ClinicalTrials.gov: Recruiting Studies | Crohn Disease | Last update posted in the last 300 days Studies found on ClinicalTrials.gov by a search of: Recruiting Studies | Crohn Disease | Last update posted in the last 300 days

Match to Crohn’s Disease Clinical Trials

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  • Latest clinical trials
  • Find trials in your area
References
  1. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. eds. Pharmacotherapy: A Pathophysiologic Approach, 10e. McGraw-Hill; Accessed February 23, 2021. https://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=146028752
  2. Sandborn WJ, Feagan BG, Loftus EV Jr, et al. Efficacy and Safety of Upadacitinib in a Randomized Trial of Patients With Crohn’s Disease. Gastroenterology. 2020;158(8):2123-2138.e8. doi:10.1053/j.gastro.2020.01.047
  3. Panaccione R, Danese S, Sandborn WJ, et al. Ustekinumab is effective and safe for ulcerative colitis through 2 years of maintenance therapy. Aliment Pharmacol Ther. 2020;52(11-12):1658-1675. doi:10.1111/apt.16119