Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Crohn's disease is one of the two main types of inflammatory bowel disease. The other major inflammatory bowel disease is ulcerative colitis. Crohn's disease can develop anywhere in the digestive system, from the mouth to the anus. Most commonly, it affects the end of the small intestine where it connects to the colon (large intestine). It is a chronic illness and can recur many times in a person's life.
It is thought that Crohn's disease is caused by an abnormal response by the body's immune system. Sometimes there are no symptoms and no treatment is needed. Other times, symptoms may suddenly flare up. Medications and diet changes are often effective treatment methods. In some cases, surgery may be needed.
Crohn's disease can affect people of any age, but it mostly affects adolescents and adults between 15 and 35. It can also affect people who are 70 or older and young children.
The disease is named after Dr. Burrill B. Crohn who discovered it in 1932 with two colleagues, Dr. Leon Ginzberg and Dr. Gordon D. Oppenheimer.
If you have Crohn's disease, your symptoms in or around the digestive system might include:
Symptoms in or around the anus may include:
Symptoms and complications outside the digestive system may include:
Crohn's disease can be difficult to diagnose, and there is no single test. Crohn’s disease often goes undiagnosed for years because symptoms generally develop over time and other diseases (such as irritable bowel syndrome) have similar symptoms.
When you come in for an appointment, we will start with a discussion of your medical history. Then, we will do a physical exam and perform one or more of the following tests:
We do not know the exact cause of Crohn's disease. Research studies suggest that it may be related to an abnormal response by your immune system to certain intestinal bacteria.
Certain people are at greater risk of developing Crohn's disease than others. There are some risk factors (such as genetics) that can’t be changed or controlled. Other factors such as lifestyle choices can be altered to lower your risk.
Unfortunately, there is no cure for Crohn's disease. Home treatment methods can reduce pain and discomfort. Many people who have Crohn's disease continue to lead healthy and active lives.
Your treatment will depend on your symptoms and how severe they are. Depending on your symptoms, we will work together to choose one or more of the following treatment options:
We might need to try more than one combination of treatments to ease your symptoms. Long-term treatment is usually necessary to manage Crohn’s disease.
Home treatment for Crohn’s disease, depends on the severity of your symptoms.
We do not recommend the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to treat Crohn's disease. Research has linked these pain relievers with Crohn's disease flare-ups.
If you are experiencing mild symptoms, we recommend trying:
Medication treatment for Crohn's disease depends on:
If you are experiencing mild or moderate symptoms, we may recommend:
If you are experiencing moderate to severe symptoms, we may recommend:
Possible short-term side effects of taking corticosteroids include:
Possible long-term side effects of taking corticosteroids include:
For more information on corticosteroids and Crohn’s disease, see Crohn's and Colitis Foundation
Surgery is not a common treatment for Crohn's disease, but may be recommended in certain situations:
Because there is no cure for Crohn's disease, many people consider complementary or alternative medicines to help ease symptoms. While not all of these therapies have been proven equally effective for Crohn's disease, many may improve your overall well-being.
If you are interested in trying complementary and alternative medicines, we strongly recommend that you consult with us first. Certain alternative medicines, vitamins, or nutritional supplements can have side effects or contraindications when taken with prescription or over-the-counter medicines. We can work together to manage your medications.
Some of the common complementary therapies include:
Scientists are just beginning to document the benefits of mind-body and herbal approaches for chronic health issues like Crohn's disease. You can try some complementary and alternative approaches to see if they help reduce your symptoms.
We recommend that complementary and alternative approaches be combined with a healthy diet and a regular exercise routine.
In some cases, Crohn's disease can lead to more serious problems such as:
Malnutrition or nutritional deficiencies. If the disease has progressed for long periods of time, you may become deficient in proteins, calories, and vitamins. Nutritional supplements and medical treatment are usually effective in replacing these nutrients.
Sores or ulcers (fistulas) in the digestive system. These are abnormal passages that affect about 30 percent of people with Crohn's disease. Medical treatment can help heal small fistulas. Surgery may be recommended if you experience fever or persistent symptoms associated with large or multiple fistulas.
Abscesses or a collection of pus. Sometimes, fistulas can develop into an abscess near the intestine. If this happens, we may recommend draining the infected area.
Obstruction or intestinal blockage as a result of swelling and scar tissue. Symptoms may include cramps, stomach pain and vomiting. Medication can help reduce inflammation, but surgery might be necessary if the obstruction is severe and does not respond to treatment.
An increased risk of arthritis. There are two different kinds of arthritis:
Increased risk of developing osteoporosis. The long-term use of certain medicines, such as corticosteroids, can interfere with normal bone development and growth. If you take these corticosteroids for more than 2 to 3 months, we may recommend taking calcium and vitamin D supplements or other medicines to prevent osteoporosis. To learn more about osteoporosis and Crohn's disease, see the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Other complications include liver disease, kidney stones, gallstones and mouth ulcers that prohibit swallowing or eating.
Symptoms of Crohn’s disease can last for many years and are unfortunately not curable. However, for many people, symptoms get better with lifestyle changes and medications. There are things you can do to reduce the severity of the disease, such as:
We can help you develop a strategy to manage your symptoms and live a healthy, active life.
Crohn’s disease is a chronic long-term condition. Either I, or another gastroenterologist in our department, will manage your ongoing care. I will work closely with your personal physician, who will continue to oversee your care for non-Crohn’s health issues.
Mild symptoms of Crohn’s disease can be treated at home.
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
• View and compose secure e-mail messages.
• Manage your prescriptions.
• View your past visits and test results.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.
• Read about causes, symptoms, treatments, and procedures.
• Find interactive health tools, videos, and podcasts to help you manage your condition.
• View programs to help you decide on or prepare for a surgery or procedure.
• Locate health education classes and support groups offered at every medical center.
• Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
• View your Preventive Services to see whether you are due for a routine screening or updated immunization.
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.