Crohn's disease, symptoms & treatment

Sadly, New Zealand has one of the highest rates of both Crohn’s disease and IBD in the world. In fact, around 20,000 Kiwis suffer debilitating pain from Crohn’s alone: that’s around one in every 500 to 700 Kiwis.

Crohn’s disease affects both males and females equally, and although it tends to be more common in people between the ages of 18 and 35, any age group is at risk.

Symptoms of Crohn’s disease

Crohn’s symptoms will vary, depending on which part of the gastrointestinal tract is affected. Symptoms may also be very similar to other bowel conditions, such as irritable bowel syndrome (IBS), bowel cancer, or coeliac disease.

Crohn’s disease symptoms might include:

• Chronic diarrhoea
• Frequent, urgent bowel motions
• Constipation
• Rectal bleeding
• Abdominal pain
• Fatigue
• Weight loss
• Anal fissures or abscesses. 

A range of additional symptoms, such as night sweats, asthma, mouth ulcers, arthritis, and other joint diseases, could also be experienced. 

Some Crohn's disease symptoms are specific to women. These might include irregular and painful menstrual cycles, painful sex, fertility issues, anaemia, or osteoporosis.

Periodic relapses, known as ‘flare-ups’ are common for all sufferers, and up to 53% will experience a relapse within one year of diagnosis and treatment. 

As with any inflammatory disease, early diagnosis and treatment can help alleviate symptoms before they worsen.

What causes Crohn’s disease?

The specific cause of Crohn’s disease is unclear. However, it is believed that environmental issues contribute to its development, especially among genetically predisposed individuals.

Influencing factors:

• Genetics - There are more than 200 genes that increase your risk of developing an IBD such as Crohn’s.
• Westernised lifestyles - Smoking, diet, modern chemicals, pesticides, and environmental pollution are often cited as potential triggers for the disease.
• Obesity - can increase your risk of developing Crohn’s disease and any complications associated with the condition.
• Antibiotic use - may be related, particularly for young children.
• Gut microbiota - changes to the gut’s natural microflora, either due to diet or travel.
• Hygiene habits - Early childhood exposure to microorganisms, allergens, and parasites can build a strong immune system, while excessive hygiene can have the opposite effect.

Globally, there has been a significant increase in the incidence rate of Crohn’s disease since the 1950s. While Crohn’s disease was once thought to be largely a Western European problem, Asia, South America, and Africa - traditionally countries with very low numbers - are now seeing upsurges in Crohn’s and other IBDs.

This may be due to the widespread influence and adoption of westernised lifestyles, although research has not proven this conclusively.

How is Crohn’s disease diagnosed?

There is often a lag in diagnosing Crohn’s disease. This is partly because its symptoms can be similar to other conditions, but also because of patient embarrassment and reluctance to talk about the problem.

Early diagnosis is important, so see your GP as soon as possible if you have symptoms. Your GP will want to take some blood tests and stool samples to identify inflammation in your body and rule out other possibilities, such as bacterial infections or bowel cancer.

X-rays (in combination with a barium enema) usually provide a definitive diagnosis. A biopsy, MRI, colonoscopy, or endoscopy may also be recommended.

It’s important to seek a diagnosis and treatment for Crohn’s disease immediately, as delaying can exacerbate your condition. Bear in mind that New Zealand’s public healthcare system is under-resourced, and wait times for treatments and specialist consultations often extend to many months.

This is why health insurance is important. Arrange a 5-minute call-back with one of our Policywise advisers, and we can help you compare health insurance policies that will give you and your loved ones the cover you need.

Crohn’s disease treatment

Although there is currently no cure for Crohn’s disease, careful treatment and management may lead to lighter symptoms and even long-term remission. 

Identifying and pinpointing the affected part of the gastrointestinal tract is key to finding the best Crohn's disease treatment. Once diagnosed, your treatment plan will focus on managing symptoms, reducing inflammation, and minimising flare-ups.

MEDICAL

Crohn’s disease symptoms vary with each individual and there is a range of drugs available to help manage them. Your doctor might prescribe some of the following:

• Anti-inflammatory drugs, such as aminosalicylates
• Immune suppressors or steroids, such as prednisolone and hydrocortisone
• Biologics (TNF inhibitors), such as infliximab
• Antibiotics may also be necessary to fight infections.

Unfortunately, the list of publicly-funded drugs available in New Zealand is relatively small. Crohn’s disease specialists and advocates say that some of the best drugs are still difficult to source unless you can afford to pay many thousands of dollars each month.

Surgical

Surgery for Crohn’s can be effective but is typically recommended only after drug management has been tried and shown to be unsuccessful.

A number of surgical operations are possible, such as draining abscesses, removing obstructions in the bowel, and removing parts of the intestine or large bowel.

Major surgeries, such as the removal of the colon or portions of the intestine, may lead to significant and permanent lifestyle changes. Your doctor will explain them fully.

LIFESTYLE

Managing flare-ups or recurrences is an important part of your Crohn’s disease treatment. It’s sensible to maintain a healthy diet and balanced lifestyle, by:

• Getting regular exercise
• Eating healthy foods
• Avoiding spicy, fatty foods
• Stopping smoking
• Reducing stress levels
• Following a Crohn’s disease diet.

A good Crohn's disease diet will include easily digestible foods that are not irritating to the gut. Eating smaller meals and increasing fluid intake (plain water) may also help. You might find that during an episode, some foods you normally tolerate could cause problems. Taking direction from your specialist or registered dietician is a positive move forward.

Longer-term management

Long-term management depends on the degree of your symptoms. Some patients experience years without any flare-ups. However, Crohn’s disease does increase your risk of bowel cancer, so regular screening is advisable.

Severe Crohn’s disease may impact your body’s ability to absorb essential nutrients and minerals needed for good health. It’s important to have your levels monitored regularly and take supplements to remedy deficiencies, such as iron, calcium, B12, and zinc.

What are the costs of having Crohn’s disease?

Around 16 Kiwis per 100,000 have Crohn’s disease. Delays in diagnosis (one survey reports that 20% of sufferers waited more than two years) and long-drawn-out medical pathways make Crohn’s disease an extremely expensive disease. 

Treatments and appointments, plus mental health and social wellbeing challenges, increase costs still further. New Zealand studies show that Crohn’s disease can cost a patient more than $20,000 each year.

Crohn’s disease also negatively impacts productivity in the workplace. People with Crohn’s disease take up to 21 days off work each year, and estimates place the overall cost to New Zealand at more than $245 million annually.

Are you prepared for life’s uncertainties?

You may not have an inflammatory bowel disease but that’s no guarantee it won’t happen to you or someone you love. Think about how health insurance can cover you for the possibility.

Not all health insurance plans are the same. Some plans only pay for a tiny fraction of your treatment expenses.

Don’t let this happen to you. When buying health insurance, talk to a Policywise adviser about maximum benefit amounts for Crohn’s disease treatments, non-Pharmac cover, inclusions, and any exclusions.

We provide clear, easy-to-understand plan comparisons from different insurers so you can choose the policy with the best cover. Our service is free - and might just change your life for the better.