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Causes

By Mayo Clinic staff

The exact cause of Crohn's disease remains unknown. Previously, diet and stress were suspect, but now doctors know that although these factors may aggravate existing Crohn's disease, they don't cause it. Now, researchers believe that a number of factors, such as heredity and a malfunctioning immune system, play a role in the development of Crohn's disease.

  • Immune system. It's possible that a virus or bacterium may cause Crohn's disease. When your immune system tries to fight off the invading microorganism, the digestive tract becomes inflamed. Currently, many investigators believe that some people with the disease develop it because of an abnormal immune response to bacteria that normally live in the intestine.
  • Heredity. Mutations in a gene called NOD2 tend to occur frequently in people with Crohn's disease and seem to be associated with a higher likelihood of needing surgery for the disease. Scientists continue to search for other genetic mutations that might play a role in Crohn's.
Risk factors Symptoms
References
  1. Crohn's disease: Clinical features. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Saunders Elsevier; Philadelphia, Pa.: 2006. http://www.mdconsult.com/das/book/body/144932667-3/0/1389/810.html?tocnode=51643270&fromURL=810.html#4-u1.0-B1-4160-0245-6..50113-X--cesec14_5163. Accessed June 21, 2009.
  2. Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/. Accessed June 21, 2009.
  3. Crohn's disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec02/ch018/ch018b.html. Accessed June 17, 2009.
  4. Peppercorn MA. Clinical manifestations, diagnosis and natural history of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
  5. Living with Crohn's disease. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/crohns2005.pdf. Accessed June 17, 2009.
  6. Werman HA, et al. Ileitis, colitis, and diverticulitis. In: Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, N.Y.: McGraw Hill; 2004. http://www.accessmedicine.com/content.aspx?aID=592744. Accessed June 21, 2009.
  7. Learning about Crohn's disease. National Human Genome Research Institute. http://www.genome.gov/pfv.cfm?pageID=25521854. Accessed June 17, 2009.
  8. Inflammatory bowel disease. In: Rakel RE, et al. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/144932667-4/854785995/1621/261.html#4-u1.0-B978-1-4160-4435-2..50133-3--cesec17_2085. Accessed June 21, 2009.
  9. Accutane (prescribing information). Nutley, N.J.: Roche. 2008. http://www.rocheusa.com/products/accutane/pi.pdf. Accessed June 23, 2009.
  10. Draganov PV. Colorectal cancer surveillance in inflammatory bowel disease: The search continues. World Journal of Gastroenterology. 2009;15:61.
  11. Ingle SB, et al. The natural history of perianal Crohn's disease. Digestive and Liver Disease. 2007; 39:963.
  12. Piton G, et al. Big risk, small risk: Small bowel cancer in Crohn's disease. Inflammatory Bowel Diseases. In press. Accessed June 23, 2009.
  13. Crohn's disease: Treatment. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/144932667-3/0/1389/813.html?tocnode=51643292&fromURL=813.html#4-u1.0-B1-4160-0245-6..50113-X--cesec36_5185. Accessed June 21, 2009.
  14. Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
  15. FDA approves new treatment for Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
  16. FDA approves Cimzia to treat Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
  17. FDA approves Tysabri to treat moderate-to-severe Crohn's disease: Drug currently approved for use in treating some forms of multiple sclerosis. Accessed June 23, 2004.
  18. Diet and nutrition. Crohn's and Colitis Foundation of America. http://www.ccfa.org/info/diet. Accessed June 23, 2009.
  19. Markowitz J, et al. Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease. Inflammatory Bowel Diseases. 2004;10:599.
  20. Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
  21. Korzenik JR. Investigational therapies in the medical management of Crohn's disease. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
  22. Picco MF (expert opinion). Mayo Clinic. Jacksonville, Fla. July 9, 2009.
  23. Follow-up to the June 4, 2008, early communication about the ongoing safety review of tumor necrosis factor (TNF) blockers (marketed as Remicade, Enbrel, Humira, Cimzia and Simponi). Food and Drug Administration. Accesed August 4, 2009.

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Aug. 8, 2009

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