What is Crohn’s disease?

Crohn’s disease, a form of inflammatory bowel disease (IBD), is a chronic disease of the gastrointestinal tract in which parts of the digestive system get inflamed. The inflammation causes swelling, which leads to symptoms such as pain and debilitating.

It affects men and women equally, it can occur at any age, but usually starts in adolescents and young adults (between 20 and 30 years of age), and it is more common in Caucasians. The exact cause of the disease is unknown, but many factors are involved, including genetics, having first-degree relative increases the risk of developing it, and immune system issues that attack healthy parts of the digestive tract. ^1,2,3

Symptoms

Crohn's disease can affect any part of the digestive tract, causing different symptoms in each individual. The symptoms vary between mild to severe and usually appear gradually; however, they can also appear suddenly. The main symptoms include the following:

• Persistent diarrhea.
• Constipation.
• Abdominal pain and cramps.
• Urgent need to evacuate.
• The sensation of incomplete bowel evacuation.
• Blood in the stool.

It can also cause other symptoms such as mouth sores, fever, loss of appetite, fatigue, weight loss, and night sweats. ^1,2,3 If you have any of these symptoms visit your doctor and share your concerns. 

Chronic diseases may take a toll on mental health

There are many reasons why chronic diseases such as Crohn’s disease may take a toll on people’s mental health. The symptoms of the disease may lead to a worse quality of health and decreased social functioning, which can have an important impact on mental health. Additionally, in the case of Crohn’s disease, there is a bidirectional connection between the gut and the brain, that is still not fully understood, but involves inflammation processes and alterations to the gut microbiota, which can have a deleterious effect on mental health. Furthermore, genetics and the drugs used in the treatment of Crohn’s disease can also influence people’s mental states. ^1,2,3

For all those reasons, anxiety and depression are more common in Crohn’s disease patients than in the general population. People with Crohn's disease have a 2-4 times higher risk of developing depression and a 3-5 times higher risk of developing anxiety, and the risk is even greater when the disease is active. ^1,2,3

Stress may worsen Crohn’s disease symptoms

Stress can worsen the symptoms of Crohn’s disease and cause relapse through several mechanisms. These include changes to the gut microbiota, dysmotility of the intestines, impairment of internal barriers, and changes in the immune and neuroendocrine systems. In general, the body’s response to stress releases proinflammatory substances that can worsen the disease’s symptoms. ⁴

How to manage anxiety about worsening disease?

Living with a lifelong condition such as Crohn’s disease often comes with great struggles, such as the fear of symptoms getting worse, fear of needing surgery, low energy levels, and side effects of the treatment, which can lead to anxiety or depression. These emotional needs are unfortunately not often fully met by healthcare workers, and it can worsen Crohn’s symptoms. 5 Therefore, it is important that the patient works actively with the doctor to meet their needs properly, which can be done in many effective ways, such as through psychotherapy and relaxation techniques. 

Additionally, lifestyle habits have an important role in Crohn’s disease and mental health. Being physically active and avoiding alcohol consumption can improve emotional well-being and decrease anxiety and depression in people who have Crohn’s disease. ^1,2,3

If you or someone close to you is struggling with mental health

If you or someone close to you has Crohn’s disease and is struggling with mental health, there are many ways that you can seek support. Importantly, many treatments can help to control the disease, allowing people to carry on a normal life, so work together with your doctor to optimize your treatment. Additionally, share your concerns with your doctor and seek psychological support if necessary.

There are many organizations in the United Kingdom and abroad that provide support to people living with this condition that you might benefit greatly from their help. 

Conclusion

Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract that can cause a range of symptoms, including persistent diarrhea, constipation, and abdominal pain. People with this condition might experience a worse quality of life and physiological changes in their bodies that can have a negative effect on their mental health. Importantly, stress can worsen Crohn's disease symptoms, and therefore decreasing stress is an important part of the management of the disease, which can be done through several ways, such as psychotherapy and relaxation techniques. If you or someone close to you are struggling with mental health, contact your doctor and discuss what is the best way to get support.