What type of Crohn's disease do you have?

[imisspopcorn]

Crohn's symptoms also depend upon the extent of inflammatory damage to organs. About 30 percent of patients have inflammatory Crohn's disease, or damage to the mucosa, the first layer of the lining of the organs, and to the supporting connective tissue under it.

Others suffer a more advanced form of the disease, called fistulizing or perforating Crohn's disease. In these cases, inflammation extends through the wall of the intestines leading to intra-abdominal fistulas, or abnormal passages through which fluids, secretions, and abscesses can pass. This type of Crohn's disease, known as internal or intra-abdominal fistulizing disease, affects about 20 percent of people with the disease. It does not include fistulas involving the anus, rectum and perineal region (region surrounding the anus and including the genitals).

Perineal or perianal disease (known as "Perianal Crohn's disease") occurs in about one third of patients and can become disabling if not treated aggressively. These include swelling of the anal sphincter or development of fissures and ulcers in the sphincter, causing bleeding and pain with defecation. Perirectal abscesses can cause fever, pain, or pus in the anal area. If fistulas have developed, mucus or pus may drain from openings into the skin surrounding the anus. Patients with perianal Crohn's disease frequently need surgical drainage of the abscesses and fistulas that form. Perianal Crohn's disease can involve the vagina. Fistulas from the rectum can let air and often stool pass through the vagina. This complication almost always requires surgery.



The third type of Crohn's is called stenosing or stricturing Crohn's disease. About 50 percent of patients with Crohn's disease affecting the lower portion of the small intestine follow this route. Early in the course of the disease, patients develop thickening, stiffening, and scarring. The narrowing of the small bowel may eventually result in a small bowel obstruction. The symptoms of obstruction are severe painful cramping, vomiting, nausea, and abdominal distention. As a consequence of chronic narrowing of the small intestine, fistulas or perforations of the bowel wall may develop. Most patients with stenosing Crohn's disease will require surgery, usually 7 to 10 years after the onset of Crohn's disease.
http://genomemedicine.com/content/1/11/103

 

[shazamataz]

Hmmmm, I seem to have 2 types!!! Urgh! I had fistulas and abscesses as well as stricture in my small bowel. I hate reading that fistulising is more advanced!

I ticked the fistula one but coulda ticked two

 

[imisspopcorn]

I knew I should have let people pick more than one option.....Sorry

 

[mwb3779]

You know I'm not really sure, doctor said it was moderate to severe. The pics showed ulcers everywhere. I mean everywhere. I asked him if it was bad. He didn't speak English very well (I think he is Koren or Vietnamese) and he looked at me and said "very bad". I'm assuming Peri-Anal due to do the definition. Sounds so bad, scares the hell out of me honestly. I hope I'm wrong.

 

[shazamataz]

It's best not to read too much to this stuff - freaked me out too!

 

[Pirate]

I have both inflammatory and strictural. At least I have suffered from both at one time or another.

 

[pb4]

There are 5 types of Crohn's Disease based on the gastrointestinal area affected. The lesions due to Crohn’s disease may appear in any part of the alimentary canal from the mouth to the anus.

Gastroduodenal Crohn’s Disease:
The type of Crohn’s Disease which affects the stomach and duodenum (the starting portion of the small intestine) is called gastroduodenal Crohn’s disease. Often, a correct diagnosis of GCD is not made until all options to treat an ulcer fail, or GCD is identified farther down the gastrointestinal tract. Symptoms of GCD consist of loss of weight and appetite, nausea, pain in the upper middle part of the abdomen and vomiting.

Vomiting indicates the obstruction of narrowed segments of the bowel.

Jejunoileitis:
Crohn’s disease affecting the longest portion of small intestine (jejunum), between duodenum and ileum, is called jejunoileitis. Mild to intense abdominal pain and cramps after meals, diarrhea, malnutrition caused by malabsorption of nutrients and Fistulas are some of the symptoms of this type.
The diseased portion of small intestine may be linked to another area of the intestine or another organ, such as the bladder and it is important to note that the risk of developing infections outside the digestive tract is high due to fistulas. Jejunoileitis may produce patchy areas of inflammation in the jejunum.


Ileitis:
Crohn’s disease affecting the lowest or last part of the small intestine (i.e., ileum) is called ileitis. The symptoms of ileitis Crohn’s include: cramping or pain in the right lower quadrant and periumbilical area after meals, malabsorption of vitamin B12 leading to tingling of fingers or toes, and folate deficiency hindering the development of red blood cells making the patient anemic.Complications may lead to fistulas or inflammatory abscess in right lower quadrant of abdomen.

Illeocolitis:
Illeocolitis is one of the more common types of Crohn’s disease and affects the lowest part of small intestine (ileum) and the large intestine (colon). Generally, the affected portion of the colon is continuous with the diseased portion of ileum involving the ileocecal valve between the ileum and the colon. In some cases, discontinuous inflammation in the colon with ileum may be observed. Symptoms are essentially the same as in ileitis with the addition of weight loss.

Crohn's Colitis (Granulomatous Colitis):
Crohn’s disease affecting the colon is called Crohn’s Colitis or Granulomatous Colitis. It differs from ulcerative colitis in two ways:

Ulcerative colitis is always continuous whereas in Crohn’s colitis, areas of healthy tissue are interspersed between areas of diseased tissue.
Ulcerative colitis always affects the rectum and areas of colon beyond rectum, whereas Crohn’s colitis appears only in the colon, but can still affect the rectom.
Diarrhea, rectal bleeding and disease around the anus (such as abscess, fistulas and ulcers) are the symptoms of this type. Skin lesions and joint pains are common in this type, perianal crohn's skin tags are often common as well with those that suffer with crohn's colitis.

I have crohn's colitis, have never had an abcess or fistula in the entire 18 yrs I've had crohn's colitis (flaring to some degree, usually severe/moderate) so of course nothing is written in stone, thank goodness cuz I do have the perianal crohn's skin tag issues and dealing with those has been bad enough. Perianal crohn's skin tags look a little bit like a hemmie but are not at all the same, nor should they be treated the same, many are unaware of these skin tags/have never heard of them.

 

[GoJohnnyGo]

I've had inflammation and strictures in two spots: The duodenum and the terminal ileum. So basically, at opposite ends of the small intestine. Both resections at the same time.

My last flare was in the esophagus and also in the ileum.

 

[imisspopcorn]

I was always curious why some people get fistulas etc....I stumbled across the noted article...I find it very interesting that there are so many different genes tagged as being responsible for causing the disease...The article just mentions the possibility of how the disease affects the intestine may be related to how the gene involved in a particular person expresses itself not necessarily where geographically the disease occurs throughout the digestive system.....

 

[pb4]

Yes, it's strange why some are more prone to getting fistulas while others are not but from everything I've ever read...Ileitis and Ileitisis are more common areas that have relation to fistulas...I've also read that crohn's colitis patients can also be more prone to anal disease including abcesses, fistulas and anal skin tags...so much more needs to be learned of course...I'm just glad that I'm not (or at least so far) prone to those nasty abcesses/fistulas.

•Ileitisis Crohn's disease of the jejunum (the longest portion of the small intestine), which is located between the duodenum and the ileum. Symptoms include mild to intense abdominal pain and cramps after meals, diarrhea, and malnutrition caused by malabsorption of nutrients. (The majority of nutrients are absorbed in the jejunum.) Fistulas (abnormal openings in the intestinal tract) may form. These can link a diseased area of the small intestine to another area of the intestine or another organ, such as the bladder. Fistulas may increase the risk of developing infections outside of the GI tract.

•Ileitis - Ileitis affects the ileum (the lowest, or last, part of the small intestine). Symptoms include diarrhea and cramping or pain in the right lower quadrant and periumbilical (around the bellybutton) area, especially after meals. Malabsorption of vitamin B12 can lead to tingling in the fingers or toes (peripheral neuropathy). Folate deficiency can hinder the development of red blood cells, putting the patient at higher risk of developing anemia. Fistulas can develop, as can inflammatory masses.

 

[Chinook]

Appears that I have the fun version of Crohn's. I three of the types, mucosa, stricturing, and perianal. But the good news is that I have dealt with it pretty well since 1986. With only two resects (88 and 03) to my case and all primarily terminal illeum and early colon area.

But alas, I guess all good things come to an end.... My most recent bout was a GI bleed that nearly cost me my life. Lost over three units of blood and did not realize I was bleeding until it was too late. 2AM telling my wife we have to go the the ER is not fun, esp when she loathes the hospitals... 5 days in the hospital, and a myriad of tests they could not find where I had bled from. We can only ascertain that I had inflammation that had tore into a vessel which caused the bleeding. Endoscopy and colonoscopy both unrevealing.

I was started on Remicade back in Oct, but due to a Pilonidal Cyst I had to go off. I am going back on Remi come Wednesday. The GI I saw back at the beginning of the month said that my case is good for the Remi treatment.

We shall see!

 

[fenway1971]

Crohn's Colitis (Granulomatous Colitis):
Crohn’s disease affecting the colon is called Crohn’s Colitis or Granulomatous Colitis. It differs from ulcerative colitis in two ways:

Ulcerative colitis is always continuous whereas in Crohn’s colitis, areas of healthy tissue are interspersed between areas of diseased tissue.
Ulcerative colitis always affects the rectum and areas of colon beyond rectum, whereas Crohn’s colitis appears only in the colon, but can still affect the rectom.
Diarrhea, rectal bleeding and disease around the anus (such as abscess, fistulas and ulcers) are the symptoms of this type. Skin lesions and joint pains are common in this type, perianal crohn's skin tags are often common as well with those that suffer with crohn's colitis.

I have crohn's colitis, have never had an abcess or fistula in the entire 18 yrs I've had crohn's colitis (flaring to some degree, usually severe/moderate) so of course nothing is written in stone, thank goodness cuz I do have the perianal crohn's skin tag issues and dealing with those has been bad enough. Perianal crohn's skin tags look a little bit like a hemmie but are not at all the same, nor should they be treated the same, many are unaware of these skin tags/have never heard of them.

This is me!

 

[Peaches]

Appears that I have the fun version of Crohn's. I three of the types, mucosa, stricturing, and perianal. But the good news is that I have dealt with it pretty well since 1986. With only two resects (88 and 03) to my case and all primarily terminal illeum and early colon area.

But alas, I guess all good things come to an end.... My most recent bout was a GI bleed that nearly cost me my life. Lost over three units of blood and did not realize I was bleeding until it was too late. 2AM telling my wife we have to go the the ER is not fun, esp when she loathes the hospitals... 5 days in the hospital, and a myriad of tests they could not find where I had bled from. We can only ascertain that I had inflammation that had tore into a vessel which caused the bleeding. Endoscopy and colonoscopy both unrevealing.

I was started on Remicade back in Oct, but due to a Pilonidal Cyst I had to go off. I am going back on Remi come Wednesday. The GI I saw back at the beginning of the month said that my case is good for the Remi treatment.

We shall see!

War scars!! Hope the Remi works for you....welcome to the forum!

 

[Agent X20]

Woohoo... I'm a fistuliser!
Didn't realise I had so much choice, but I have been told I have "multiple" internal fistulas.
... and welcome, Chinook.

 

[Chinook]

War scars!! Hope the Remi works for you....welcome to the forum!

LOL - never thought of them as "war scars" - thank you Peaches!

Thank you, it is most interesting to be able to communicate so readily with other people who suffer from the same condition. I have been dealing with Crohn's now for over 23 years. I too hope that the Remi works as I am very tired of prednisone and all its ill effects.

 

[farm]

Mucosal & stricturing for me.

 

[dayng1016]

Stricturing for me.

 

[Peaches]

Mucosal & stricturing for me.

ditto for me.....hmmm, checking the family tree once again

 

[pb4]

Mine is inflammatory.

 

[kenny]

good thread! I never even knew this forum was here. what else have I missed

I went with the third "stricture" due to all the mess with scarring and such that required the removal of some of my plumbing parts. But I have some fistulizing issues. There was one running all the way from my terminal illieum way way up to the transverse colon. It was tugging on the colon and they simply sniped it and sewed the side of the colon like you would for strictureplasty.

I guess the reason I am on the Imuran is to close up the couple of fistulas that are still present/developed post surgery and prevent new ones from forming.

 

[katiesue1506]

I actually finally found out what kind I have. His words on the letter are "severe ileocolonic crohn's disease with severely inflamed and ulcerated mucosa in the sigmoid colon including the descending and tranverse colon in a skip pattern"

Translation: I'm screwed.

 

[Crohn's 35]

That was my initial dx, looping they also called it, surgery was a month or so later, nothing would work.

 

[Peaches]

Mine kinda sounded like that too Katie - except my ileum wasn't involved at the beginning. I also found out that I had LUNG involvement in the beginning. They blamed this mass in the lower lobe of my lung on Crohn's. Luckily it resolved, but WTH? Never heard of that before! After reading my medical records - I read in three different places (points in time) that I was in remission. I was pretty darn surprised by this, they don't tell you things they put in your records. Point is......hopefully you aren't screwed....hopefully.

 

[shazamataz]

I think we can all agree that we have the kind of Crohn's that makes you feel like crap!

 

[Pirate]

Agreed.

I was first dx as Gastroduodenal and have since had it in pretty much all of my small intestine. No matter where it shows up it still sucks.

 

[Samantha]

oooh I'm not sure, because of the surgery I've just had I think it's Crohns colitis, but there is also some present in the small intestine. I'll ask the doc when I see him again on the 1st Feb.

 

[MikeinBklyn]

Both fistulizing and stricture.

Lucky me!

 

[Nyx]

Mine's Peri-anal....oh how I love the skin tags! I've actually named mine 'the Peanut' lol Going to get that removed when I get the rest of my intestine and rectum sewed up and removed. What a joy this disease is!!

 

[mwb3779]

I'd say I have a crappy one... lol

 

[Astra]

Do you know what!
I don't know!
I've never asked!
I know it hurts!
down the right side, where it joins the small bowel, near appendix, and it swells up
so what's that called then?