What Is Crohn's Disease - All About IBD
Updated: Aug 5
Before I begin discussing my personal experiences dealing with my Crohn's Disease as a child and adult, I wanted to set up some basic details and facts about the auto-immune condition.
The details below are from medical sources found online and not my opinion, just the facts of what we know for the most part. There may always be changes and new discoveries in the future about the disease, but this is what's recorded for now.
August 2026 Question and Answer: What Causes Crohn's Disease.
There still is no singular fact or theory solidified yet for the true cause of all Crohn's Disease and Ulcerative Colitis. However, I am attempting to put my own non-profit together to try and gather similarities between patience and gastroenterologists all around the world.
To get myself updated on the most current, primary or credible sources (and I still have much more research and interviewing to go), I did a quick Ai search on Deep Seek. I did this because their Ai model is more efficient and accurate while also not destroying our climate like the remaining, leading Ai models like Claude, Gemini, Chatgpt, etc.
As a writer, I am against Ai for creative assistance (as that takes the fun out of doing it with myself or friends) but it is a great tool for information quickly. Therefore, I am going to paste over my exact question and the Ai's response so that nothing can be taken out of context. I just thought this was interesting and wanted to update my blog on new research findings.
No, I am not a communist for using Deep Seek, that is just a marketing tactic USA companies use to make people want theirs more.
ME: "Based on all the peer reviewed research around the world that are most recent scientific and medical findings, what are they suspecting the cause or causes of Crohn's Disease are? And what have they learned it is not?"
DEEPSEEK: "Based on the most recent peer-reviewed research, the scientific consensus is that Crohn's disease does not have a single cause. Instead, it is understood to be a multifactorial disease that arises from a complex interplay of factors.
The prevailing model suggests that Crohn's develops when an environmental trigger (like diet or a change in the microbiome) causes an abnormal, overactive immune response in a person who is genetically predisposed to the disease.
💡 What Are the Suspected Causes?
Recent research points to a combination of factors that work together to initiate and sustain the inflammation seen in Crohn's.
Genetic Susceptibility: A person's genes are a major piece of the puzzle. Researchers have identified over 200 genetic loci (specific locations on chromosomes) associated with Inflammatory Bowel Disease (IBD), many specific to Crohn's. These genes are often involved in how the immune system senses and responds to bacteria.
A key discovery is the NOD2 gene, which helps the immune system recognize bacteria. Certain mutations in NOD2 significantly increase the risk of developing Crohn's.
Other significant genes linked to Crohn's include ATG16L1 (involved in a cellular housekeeping process called autophagy) and IL23R (part of the immune system's inflammatory pathway).
The search for new genes is ongoing. A recent 2026 study identified a mutation in the NFASC gene, which is crucial for communication between the nervous and immune systems in the gut. This mutation may lead to inflammation by disrupting this "neuro-immune crosstalk". Another study also linked changes in the BIRC3 gene to a rare form of Crohn's that disrupts the TNF pathway, a well-known driver of inflammation.
Environmental Triggers & Lifestyle: Genetics alone do not explain Crohn's; environmental factors are essential to "trigger" the disease in a susceptible person.
Diet: Recent large-scale meta-analyses have provided strong evidence for diet's role. Diets high in ultra-processed foods and those with a high "inflammatory diet" score are linked to a significantly higher risk of developing Crohn's. Conversely, a high-fiber diet, Mediterranean diet, and unprocessed foods are associated with a lower risk.
Smoking: Cigarette smoking is a well-established risk factor that worsens the course of Crohn's disease.
Gut Microbiome (Dysbiosis): An imbalance in the gut's bacterial community is a hallmark of Crohn's. This "dysbiosis" involves a decrease in beneficial bacteria and an increase in potentially harmful ones. For instance, a type of bacteria called Adherent-Invasive E. coli (AIEC) is found more frequently in the guts of people with Crohn's and may contribute to inflammation.
A "Leaky Gut": Research increasingly points to a defect in the intestinal barrier. This barrier, made up of a single layer of cells, controls what passes from the gut into the body. Studies show that an abnormally high intestinal permeability (often called a "leaky gut") can precede the development of Crohn's by years, potentially allowing bacteria and other substances to trigger an immune reaction.
Immune System Dysfunction: Ultimately, the disease is driven by an inappropriate and persistent immune response. This involves cells like macrophages and pathways like JAK/STAT which drive inflammation. A 2026 study also showed that disruption of the body's daily rhythm (circadian rhythm) can impair the production of protective ketone bodies by the gut microbiome, leading to a specific type of inflammatory macrophage death that worsens colitis.
❌ What Has Science Learned It Is NOT?
While the exact cause remains unknown, research has helped clarify what does not cause Crohn's disease.
Not a Simple Infectious Disease: For decades, researchers considered the possibility that a single bacterium or virus causes Crohn's. While the microbiome plays a role, no single "Crohn's germ" has been found, and the disease does not act like a contagious infection.
Not Caused by Psychological Factors or Stress: While living with Crohn's is stressful, and stress can worsen flare-ups in someone who already has the disease, it is not considered a root cause.
🧩 A Multi-Step, Multi-Factor Model
This evidence supports a model where the disease develops in steps. A person is born with certain genetic variants that make them more susceptible. Then, an environmental factor (such as a Western diet or a change in their gut bacteria) acts as a trigger. This leads to a breakdown of the gut barrier and an abnormal, overactive immune response that results in the chronic inflammation characteristic of Crohn's disease.
I hope this overview of the current scientific understanding is helpful for you. Please remember that this is a summary of research findings and is not medical advice. If you have concerns about Crohn's disease or your health, it is always best to consult a healthcare professional."
ME: "Thanks for the info! What are the rates of Crohn's Disease in first world countries besides the USA including Mexico, Canada, India, China, Japan, Italy, Ireland, UK, Germany, etc."
DEEPSEEK: "Based on the most recent peer-reviewed research, the rates of Crohn's disease show a clear and significant global pattern. While it was once considered a disease primarily of Western, industrialized nations, the epidemiology is rapidly changing. The rates are generally highest in North America and Western Europe, but are rising fastest in newly industrialized countries across Asia and other regions .
Here is a summary of what the data reveals for the countries you asked about, based on incidence (new cases per 100,000 people per year) and prevalence (total living with the disease).
📊 Crohn's Disease Rates by Country
Country | Key Epidemiological Data |
Canada | High prevalence and incidence, similar to the U.S. The prevalence is around 319 per 100,000 . |
United Kingdom | High prevalence in Western Europe; a major market for IBD, where prevalence is rising . |
Italy | High prevalence in Southern Europe; a significant market with rising total cases . |
Germany | High prevalence in Central Europe; it had the highest IBD prevalence among the EU4 and the UK in 2025 . |
Mexico | Specific rates for Mexico are not prominent in the provided data. However, research shows that Tropical Latin America (which includes Mexico) is one of the regions where the disease burden is worsening independently of demographic factors . This indicates a genuine rise in disease rates. |
Japan | Historically low, but now increasing. The incidence has risen from virtually zero to ~2.0 per 100,000 . Prevalence is projected to rise significantly, reaching an estimated ~646 per 100,000 by 2032 . |
India | Rates are low but increasing. A population-based study reported a surprisingly high annual IBD incidence of 9.31 per 100,000 in one region, though this may not represent the entire country . |
China | Low but rapidly rising. The annual incidence of CD has increased from 0.28 per 100,000 in 2002 to 0.85 per 100,000 . |
Ireland | Specific rates for Ireland are not detailed in the provided data, but as a Western European nation, its rates are likely within the high range observed for the region. |
🌍 The Key Trend: A Global Shift
The most important finding from recent research is the "epidemiological transition" of Crohn's disease .
High-Income Countries (Plateauing): In many first-world nations like the US, Canada, and Western European countries, the incidence (rate of new cases) appears to be stabilizing or plateauing. However, the prevalence (total number of people living with the disease) continues to rise because people are living longer with it and new cases still outpace deaths .
Newly Industrialized Countries (Rising): In countries that have recently industrialized—including nations in Asia (Japan, India, China), Latin America, and the Middle East—the incidence of Crohn's is increasing sharply. This trend is closely linked to the adoption of a more "Western" lifestyle and diet . The increase in Asia has been dramatic; for instance, South Korea saw a 40-fold increase in Crohn's incidence over 30 years . This pattern is a major piece of evidence supporting the role of environmental factors in causing the disease.
In summary, while the United States and Europe still have the highest number of people with Crohn's disease today, the most significant growth and future burden are expected in newly industrialized countries. This suggests that as a country's economy and lifestyle change, so does its population's risk for the disease."
ME: "Do microplastics or chemicals used in American foods cause Crohn's"
DEEPSEEK: "Based on the most recent peer-reviewed research, there is no conclusive evidence that microplastics or food chemicals directly cause Crohn's disease. However, the scientific consensus is rapidly shifting to view them as significant environmental risk factors that likely play a crucial role in exacerbating the disease in individuals who are already genetically predisposed.
Here’s a breakdown of the current scientific findings.
📊 What the Research Shows on Specific Substances
Researchers are investigating a variety of substances found in our environment and food. The evidence for each varies, but here are some of the key findings.
Substance | Key Research Finding (The "What") | Methodological Context (The "How") |
Microplastics | Found in higher concentrations in inflamed gut tissue. In animal models, they worsen colitis and increase intestinal permeability. May be linked to a "pro-inflammatory" immune response. | Primarily animal and lab studies. Definitive human trials are currently ongoing (like the pilot study listed on ClinicalTrials.gov). |
Emulsifiers (e.g., Polysorbate-80, CMC) | A 2026 human study directly linked Polysorbate-80 and artificial sweeteners to active Crohn's disease. A clinical trial showed a low-emulsifier diet tripled the likelihood of symptom improvement. | The strongest human evidence comes from these recent 2026 clinical studies and dietary trials. |
Artificial Sweeteners | Bodily levels were significantly higher in Crohn's patients than in healthy controls and were linked to active disease. | This finding is from the same 2026 human study that measured actual levels in patients. |
Bisphenol A (BPA) | Identified as a chemical that may exacerbate Crohn's by disrupting immune balance and promoting inflammation. | Primarily based on bioinformatics and computational models, suggesting a strong molecular link that needs further biological validation. |
Other Chemicals (PFAS) | Higher levels of certain PFAS (found in non-stick cookware, etc.) are significantly associated with an increased risk of Crohn's disease. | Evidence from case-control human studies that show a strong statistical association. |
Food Colorants (e.g., Brilliant Blue) | Chronic exposure to some common artificial food colorants increased susceptibility to colitis in animal models. | Evidence is currently limited to preclinical animal studies at this stage. |
🧬 The Scientific Consensus: A 'Multi-Hit' Hypothesis
These findings fit into the leading scientific model of Crohn's disease, often described as a "multi-hit" or "multi-step" process:
A Vulnerable Foundation: A person is born with specific genetic variations that make their immune system more sensitive and their gut barrier more fragile.
A Triggering Event: An environmental factor, like a viral infection or a drastic change in diet, acts as a trigger.
A Sustaining Fuel: This is where substances like microplastics and food additives may play their most significant role. Research suggests they can act as a "sustaining fuel" by:
Damaging the Gut Lining: Disrupting the protective mucus layer and the "tight junctions" between cells, leading to a "leaky gut".
Altering the Microbiome: Shifting the balance of good and bad bacteria in the gut toward a more inflammatory state.
Driving Inflammation: Directly activating the immune system's inflammatory pathways.
💡 What This Means in Practice
The relationship is less like a single "cause" and more like a "risk factor" that contributes to an existing problem. The exciting part for future research is that these environmental factors are potentially modifiable. The clinical trial showing a low-emulsifier diet's benefit and the use of food additives as biomarkers for disease activity are actively exploring how diet might be a powerful tool in managing Crohn's.
I hope this overview of the latest research is helpful. It's an incredibly active area of study, and our understanding is evolving quickly. Please remember that this is a summary of scientific findings and is not medical advice. If you have questions about Crohn's disease or your health, it is always best to consult a healthcare professional."
That is the end of my 2026 update and Ai's response. This blog was published in 2025.
Facts To Know About Crohn's Disease: All About IBD
1. How many people in the USA suffer from Crohn's compared to other countries?
In the USA: Approximately 1.6 million Americans have Inflammatory Bowel Disease (IBD), which includes both Crohn's and Ulcerative Colitis. It's estimated that about 780,000 Americans have Crohn's Disease specifically. The CDC and CCF note that this number is rising, especially in newly industrialized parts of the world.
Globally: IBD is most common in North America and Europe. However, its incidence is increasing globally as countries become more industrialized. This suggests environmental factors (like diet, pollution, hygiene) play a significant role.
Keyword Phrases: "Crohn's disease prevalence," "how common is Crohn's," "IBD statistics," "Crohn's disease USA vs world." are mentioned to help connect a correlation or causation to the onset of IBD.
2. What is Crohn's Disease? (The Core Explanation)
Crohn's Disease is a chronic (lifelong) condition and a form of Inflammatory Bowel Disease (IBD). It is an autoimmune condition, which means the body's immune system mistakenly attacks its own healthy tissues.
What Happens: This attack causes inflammation anywhere in the gastrointestinal (GI) tract, from the mouth to the anus. Unlike Ulcerative Colitis, which only affects the colon, Crohn's inflammation is often patchy and can penetrate through the entire thickness of the bowel wall.
Keyword Phrases: "Crohn's disease definition," "what is inflammatory bowel disease," "is Crohn's autoimmune," "chronic digestive disease."
*As a Crohn's patient, I wonder what the commonalities and differences are between me (along with other Crohnies) and the Ulcerative Colitis patients. Why does their IBD stop in the large colon? What happened in their nature or nurture to not make the disease expand. Are there different levels of these diseases like cancers?
3. Who Normally Gets Crohn's Disease? (Risk Factors)
While anyone can get Crohn's, certain factors increase the risk:
Age: It's most often diagnosed in adolescents and young adults (ages 15-35), but can occur at any age.
Family History: Having a close relative (parent, sibling, child) with IBD significantly increases your risk.
Smoking: This is the most significant controllable risk factor, doubling the risk and leading to more severe disease.
Ethnicity: More common in Caucasian populations, especially those of Ashkenazi Jewish descent, but rates are rising in all ethnicities.
Geography: More common in urban areas and industrialized countries.
Keyword Phrases: "Crohn's disease risk factors," "who gets Crohn's," "causes of Crohn's," "is Crohn's genetic."
*My grandpa on my father's side died of colon cancer in his old age, but my mother was diagnosed with Multiple Sclerosis in her 30's. M.S. is also an auto-immune disease, except it effects your spinal cord, not G.I. tract.
4. How Bad Is It To Have Crohn's Disease? (Disease Severity & Impact)
Crohn's is a serious, chronic condition with a wide spectrum of severity. It's not just a "bad stomachache."
It's Unpredictable: People experience periods of active symptoms (flares) and periods of little to no symptoms (remission).
Impact on Life: It can cause severe pain, debilitating fatigue, and urgent, frequent trips to the bathroom, which can interfere with work, school, and social life.
Progressive Disease: Over time, severe inflammation can lead to complications like strictures (narrowing of the bowel), fistulas (abnormal tunnels), and abscesses, which may require surgery.
Keyword Phrases: "life with Crohn's disease," "Crohn's flare symptoms," "is Crohn's disease debilitating," "Crohn's disease prognosis."
*As a child, I faced chronic inflammation - mostly stomach pain, acid reflex, frequent bathroom trips, and canker sores. I had ulcers come and go with every new treatment. As I grew into an adult, the disease shifted mostly into my small and big intestine. Eventually, after having strictures, fistulas, and large ulcers that luckily never turned into abscesses, I had surgeries to remove the diseased parts. Now without my large colon, rectum, or anus, my Crohn's has moved back into my stomach and mouth more.
5. What Are the Treatment Options?
There is no cure yet, but treatments are highly effective at controlling inflammation and achieving remission. The goal is symptom control, healing the gut, and preventing complications.
Anti-inflammatory Drugs: Aminosalicylates (5-ASAs).
Corticosteroids: Like prednisone, used for short-term flare control due to significant side effects.
Immunomodulators: Suppress the overactive immune system (e.g., Azathioprine, Methotrexate).
Biologics: Advanced drugs that target specific proteins causing inflammation (e.g., Remicade/infliximab, Humira/adalimumab).
Small Molecule Drugs: Like JAK inhibitors (e.g., Xeljanz/tofacitinib).
Surgery: Required when medications fail or complications arise (e.g., strictures, fistulas). Surgery involves removing the damaged section of the bowel, but it is not a cure, as inflammation often returns.
Diet & Nutrition: Nutritional therapy (like exclusive enteral nutrition) can help induce remission. Diet modifications are crucial for managing symptoms.
Keyword Phrases: "Crohn's disease treatment options," "biologics for Crohn's," "Crohn's surgery," "diet for Crohn's disease."
*I think I've tried all of the Crohn's medications under the sun, except for the most recent biologics because new ones are constantly being released for passing their clinical trials.
6. What Are Symptoms of Crohn's?
Symptoms vary but often include:
Common GI Symptoms: Persistent diarrhea, abdominal pain and cramping, rectal bleeding, urgency to have a bowel movement, feeling of incomplete emptying.
Systemic Symptoms: Unintended weight loss, fever, severe fatigue.
Other Manifestations: Mouth sores, loss of appetite, perianal disease (pain or drainage near the anus).
Keyword Phrases: "signs of Crohn's disease," "Crohn's symptoms in women/men," "abdominal pain and diarrhea," "blood in stool Crohn's."
7. Why Is Crohn's So Damaging?
The damage comes from the nature of the inflammation:
Transmural Inflammation: It affects all layers of the intestinal wall, unlike UC which is mostly superficial. This deep inflammation can lead to:
Strictures: Scar tissue builds up, narrowing the intestine and causing blockages.
Fistulas: Abnormal tunnels from the intestine to another organ (e.g., the skin, bladder, or vagina) or a different loop of intestine.
Abscesses: Pockets of infection.
Malabsorption: Chronic inflammation damages the lining of the small intestine, which is responsible for absorbing nutrients. This can lead to vitamin deficiencies, malnutrition, and weight loss.
Keyword Phrases: "complications of Crohn's disease," "Crohn's stricture," "fistulizing Crohn's," "malabsorption Crohn's."
8. Do They Think Prion Diseases Trigger Crohn's or Other Chemical Imbalance?
This is a great question about causes. The short answer is no, prion diseases are not a trigger for Crohn's.
Prion Diseases (like Mad Cow Disease) are caused by misfolded proteins and are entirely different from autoimmune diseases.
The Current Scientific Understanding: The exact cause of Crohn's is unknown, but it's believed to be a combination of three factors:
Genetics: A person is born with a genetic predisposition.
Immune System Dysregulation: The immune system malfunctions and doesn't "turn off" properly.
Environmental Triggers: Something in the environment (e.g., a virus, bacteria, diet, antibiotic use) "flips the switch" in a genetically susceptible person, triggering the abnormal immune response.
Keyword Phrases: "what causes Crohn's disease," "is Crohn's genetic," "Crohn's disease immune system," "triggers for Crohn's flare."
*This is where I think prion disease might cause this disfunction just like other colds may, but I'm just a creative storyteller, not a medical professional. I had Asthma as a child, and I wouldn't be surprised if my diet of processed foods caused a chemical imbalance whenever I'd get extra sick from the flu. I also grew up in an overly anxious home, so I think this trifecta is what triggered my disease at 10.
9. What Is the Difference Between Crohn's and UC?
This is a crucial distinction. Both are IBD, but they are different diseases.
Feature | Crohn's Disease | Ulcerative Colitis (UC) |
Location | Can affect any part of the GI tract (mouth to anus). Most common in the end of the small intestine & colon. | Only affects the colon (large intestine) and rectum. |
Inflammation | Patchy ("skip lesions"). Can be healthy areas next to inflamed ones. | Continuous, starting from the rectum and extending upward. |
Depth | Transmural (affects all layers of the bowel wall). | Superficial (affects only the innermost lining, the mucosa). |
Common Symptoms | Abdominal pain (often in right lower quadrant), weight loss, perianal disease. Bloody diarrhea, urgency, tenesmus (constant feeling of needing to go). | Bloody diarrhea, urgency, tenesmus (constant feeling of needing to go). |
Keyword Phrases: "Crohn's vs UC," "difference between IBD and IBS," "types of inflammatory bowel disease." |
10. What Are the Consequences of Crohn's Disease?
Beyond the daily symptoms, long-term consequences can include:
Nutritional Deficiencies: Anemia (iron/B12 deficiency), Vitamin D deficiency.
Bone Loss: Due to chronic inflammation and steroid use.
Increased Risk of Colon Cancer: With long-standing, extensive colon involvement.
Mental Health Impact: High rates of anxiety and depression due to the chronic, unpredictable nature of the disease.
Arthritis, Skin, and Eye Problems: These are common "extra-intestinal manifestations."
Keyword Phrases: "long-term effects of Crohn's," "Crohn's and cancer risk," "Crohn's and mental health," "extra-intestinal manifestations of IBD."
*I've had all of these symptoms - except for cancer - and more symptoms than just these mentioned.
11. What Do People With Crohn's Disease Have to Do Differently?
Life with Crohn's involves significant adaptation and vigilance:
Bathroom Mapping: Always knowing where the nearest restroom is in any new location.
Dietary Vigilance: Carefully watching what they eat, as certain foods (like high-fiber, spicy, or greasy foods) can trigger symptoms. There is no one-size-fits-all diet.
Medication Adherence: Taking medication even when feeling well to maintain remission.
Energy Management ("Spoon Theory"): Learning to pace themselves due to profound fatigue.
Advanced Planning: For trips, social events, and work, always having a "plan B" in case a flare strikes.
Advocating for Themselves: Communicating their needs to employers, friends, and family, and being a proactive partner in their healthcare.
Keyword Phrases: "living with Crohn's disease," "Crohn's and work life," "traveling with Crohn's," "spoon theory chronic illness," "Crohn's diet tips."
*These are pretty accurate, and of course this isn't the only items we are managing - it's much harder to function through this when it feels like you are digesting concrete rubble during normal activities.
Medical Sources for this Blog
The information below is synthesized from these highly reputable organizations.
Crohn's & Colitis Foundation (CCF): The leading non-profit dedicated to Crohn's and Ulcerative Colitis research and patient support. An excellent source for patient-friendly language.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): A branch of the U.S. National Institutes of Health (NIH). Provides deep, evidence-based medical information.
Centers for Disease Control and Prevention (CDC): Provides data on prevalence and public health impact in the USA.
World Gastroenterology Organization (WGO): Offers a global perspective on digestive diseases.
What Else Have I Been Through With Crohn's Disease?
Diseases affect everyone differently, because we all have different personalities and preferences.
Feel free to ask me questions or tell me about your experience with you or someone you know with Irritable Bowel Disease.
Check out my other blogs that discuss my Crohn's symptoms during childhood specifically or a more personal blog about experiencing the disease.
Medical Procedures For Crohn's Disease, Colitis, and IBD.
ENDOSCOPIC PROCEDURES
My first endoscopy was at 11 and my first colonoscopy, I was 12 or 13 years old. Now that I am missing my big colon, rectum, and anus, they go through my stoma. They do not go as deep with the ileoscopies, I am not sure if it is due to safety or comfortability level.
When I had my worst inflammation in my sigmoid colon (the lowest section of the colon, right before the rectum) I would luck out with sigmoidoscopies instead. Prepping for those are much less intense than colonoscopies since you don't need to starve yourself for 24 hours before the damn procedure. I've probably had more than twenty colonoscopies out of the 25 years that I had an asshole.
I've never done the pill kind, nor will I because I am a big baby when it comes to swallowing pills.
Core Crohn’s/IBD Diagnostic & Monitoring Procedures
Colonoscopy
Visualizes colon + terminal ileum
Allows biopsies
Standard test for diagnosis and routine monitoring
Upper Endoscopy (EGD / Gastroscopy)
For Crohn’s affecting stomach or duodenum
Biopsies for inflammation, ulcers, infection
Ileocolonoscopy
Same as colonoscopy but specifically includes entering ileum
Flexible Sigmoidoscopy
Partial colon view, used during flares or for quick checks
Capsule Endoscopy (Pill Cam)
Examines small intestine where scopes can’t reach
Useful for small-bowel Crohn’s
Advanced / Special Endoscopic Tests
Balloon-Assisted Enteroscopy (Double or single balloon)
Allows biopsy deeper into the small bowel
Endoscopic Ultrasound (EUS)
For suspected abscesses or fistulas near rectum
Stricture Dilation / Strictureplasty Endoscopically
Opens narrowed areas without full surgery
All upper and lower scopes grab samples with their little tool thingy. I did not need any special biopsies taken to test for inflammation or infection. I received a ballooning scope when we were pushing off the need for surgery. Of course, I am still suffering before and after, but it is easier to manage life with widened intestines when they are so used to being shriveled and scarred. Having strictures is extremely painful and taxing on the body.
Ballooning the intestines are only short-term solutions to try and get medicine to work on taking down the inflammation - but when medicines fail, surgery is considered as the next option.
IMAGING STUDIES
Small Bowel & Fistula-Focused Imaging
MR Enterography (MRE)
Preferred for Crohn’s
No radiation
Detects inflammation, strictures, fistulas, abscesses
CT Enterography (CTE)
Similar to MRE but uses radiation
Often used in ER settings
I've never had the two mentioned above done. I've had MRI's, both contrast dye and non-contrast. Also, X-Rays, and CT-Scans to check for inflammation damage. When I developed my fistula, it was just taken out during the surgery.
I've also had a barium X-Ray, where you drink the gross liquid, and a barium enema, where the liquid is inserted in your...bum.
Other Imaging
Pelvic MRI
For perianal Crohn’s, fistulas, abscesses
Abdominal Ultrasound
Used more in Europe; can detect thickened bowel loops
Small Bowel Follow-Through (SBFT)
Older test but still used
Barium Enema
Rare today except in special cases
Plain Abdominal X-ray
Used for obstruction or perforation evaluation
CT Abdomen/Pelvis
ER test for acute complications
BIOPSIES
Routine Biopsies
Mucosal biopsies (taken during colonoscopy or EGD)
Confirm diagnosis
Evaluate inflammation, granulomas
Check for dysplasia in long-term IBD
Special Biopsies
Small intestinal biopsies (via enteroscopy)
Perianal fistula biopsy
Rare, used to rule out malignancy in chronic fistulas
Skin biopsies
For IBD-related conditions (erythema nodosum, pyoderma gangrenosum)
I've only done the normal mucosal biopsies during routine or urgent endoscopies.
BLOOD TESTS
Standard IBD Monitoring Bloodwork
CBC (Complete Blood Count)
Checks anemia, infection, inflammation
CMP (Comprehensive Metabolic Panel)
Liver, kidneys, electrolytes
CRP (C-Reactive Protein)
Systemic inflammation marker
ESR (Sed Rate / Erythrocyte Sedimentation Rate)
Inflammation indicator
Albumin / Total Protein
Malnutrition, inflammation
Iron studies
Ferritin, iron, TIBC
Crohn’s often causes iron-deficiency anemia
Tests Related to Medication Toxicity
(Due to biologics, immunosuppressants, steroids, etc.)
Liver Function Tests (LFTs)
Especially with methotrexate, azathioprine, 6-MP
Kidney function tests
For dehydration, NSAID effect, certain meds
TPMT + NUDT15 enzyme tests
Required before azathioprine or 6-MP
Predicts risk of bone marrow suppression
CBC every 3 months
To monitor bone marrow suppression from immunomodulators
Vitamin Levels (common deficiencies with Crohn’s)
Vitamin B12 (especially ileal Crohn’s)
Vitamin D
Folate
Magnesium
Zinc
Medication-Specific Immunological Tests
Biologic Drug Levels & Antibodies
Infliximab level + antibodies
Adalimumab level + antibodies
Ustekinumab or Vedolizumab levels
Determines if medication is working or failing
TB Screening
Quantiferon TB Gold or PPD
Required before starting biologics
Hepatitis Panel
Required before biologic therapy
STOOL TESTS
Core IBD Stool Tests
Fecal Calprotectin
Best test for intestinal inflammation
Used to monitor disease activity
Fecal Lactoferrin
Another inflammation marker
Stool Occult Blood / FOBT
Checks hidden blood
Infection Screening
C. difficile toxin / PCR
Especially important for IBD patients on antibiotics or biologics
GI Pathogen PCR Panel (detects 20+ infections)
Ova & Parasite exam (O&P)
Stool culture
H. pylori antigen (if upper GI symptoms)
SURGICAL PROCEDURES CROHN’S PATIENTS MAY NEED
Common Surgeries
Resection of diseased bowel
Ileal resection
Small bowel resection
Colon resection
Strictureplasty
Fixes narrowing while keeping bowel intact
Fistula surgeries
Seton placement
Fistulotomy
Fistula plug or LIFT procedure
Abscess drainage
Percutaneous drainage
Surgical drainage
Stoma-related Procedures
Ileostomy or colostomy creation
Stoma revision
TESTS RELATED TO CROHN’S COMPLICATIONS
Bone Health
(Because steroids cause bone loss)
DEXA Scan (Bone Density Scan)
Eye Exams
(Crohn’s medications can cause eye changes)
For uveitis, episcleritis, steroid-induced glaucoma or cataracts
Dermatology Exams
(Biologics can cause psoriasis-like rashes)
Cardiac Screening
Sometimes needed for long-term chronic inflammation or medication interactions
MEDICATION SAFETY MONITORING (due to long-term use)
For Immunosuppressants (Azathioprine, 6-MP, Methotrexate)
CBC every 1–3 months
Liver enzymes
Checking for pancreatitis if symptoms arise
Annual skin exams (increased skin cancer risk)
For Biologics
TB testing annually
Hepatitis panel periodically
CBC & LFT monitoring
Regular assessments for infection risk
For Steroids
Blood sugar monitoring
Bone density (DEXA)
Eye exams
Blood pressure checks
NUTRITION & MALABSORPTION TESTS
B12 levels
Folate
Magnesium
Zinc
Vitamin D
Iron panel + Ferritin
Prealbumin (nutrition marker)
OTHER POSSIBLE TESTS
Hydrogen Breath Test
For SIBO (small intestinal bacterial overgrowth)
Liver imaging (ultrasound or FibroScan)
For medication effects or PSC screening (more common in UC but possible in Crohn’s)
Thyroid panel
Because autoimmune conditions tend to cluster
Comments