Diseases » Crohn's disease » Causes

Causes of Crohn's disease

List of causes of Crohn's disease

Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Crohn's disease) that could possibly cause Crohn's disease includes:

• The exact cause of Crohn disease remains unknown. Current theories implicate the role of genetic, microbial, immunologic, environmental, dietary, vascular, and even psychosocial factors as potential causative agents
• Imbalance between proinflammatory and anti-inflammatory mediators
• Research shows that the inflammation seen in the GI tract of people with Crohn's disease involves several factors: the genes the patient has inherited, the immune system itself, and the environment. Foreign substances, also referred to as antigens, are found in the environment. One possible cause for inflammation may be the body's reaction to these antigens, or that the antigens themselves are the cause for the inflammation. Some scientists think that a protein produced by the immune system, called anti-tumor necrosis factor (TNF), may be a possible cause for the inflammation associated with Crohn's disease

Crohn's disease Causes: Book Excerpts

• Medical causes - Bowel sounds, hyperactive
• Causes and incidence - Crohn's disease
• Medical causes - Bowel sounds, hyperactive
• Differential Overview - Gastrointestinal Bleeding
• Causes - Intestinal obstruction
• Causes - Crohn's disease
• Medical causes - Bowel sounds, hyperactive
• Medical causes - Bowel sounds, hyperactive
• Principal Causes of Gastrointestinal Bleeding - Gastrointestinal Bleeding
• Medical causes - Bowel sounds, hyperactive

Crohn's disease as a symptom:

Conditions listing Crohn's disease as a symptom may also be potential underlying causes of Crohn's disease. Our database lists the following as having Crohn's disease as a symptom of that condition:

• Behcet's Disease
• Spondylometaphyseal dysplasia with combined immunodeficiency

What causes Crohn's disease?

Causes: Crohn's disease: Researchers have not yet determined the cause of Crohn's disease. One theory is that it is the result of an over-reactive immune response to food and other substances in the GI tract. Normally the body's immune response is a protective reaction to foreign potentially dangerous substances in the body, such as viruses. In Crohn's disease, an over-reactive immune response may result in symptoms, such as diarrhea and abdominal pain. There may also be a familial connection with Crohn's disease. About 20% of people with the condition have blood relatives with Crohn's disease or some other form of inflammatory bowel disease, such as ulcerative colitis, and irritable bowel syndrome.

Genes and Disease by the National Center for Biotechnology (Excerpt)

Inflammatory bowel disease (IBD) is a group of chronic disorders that causes inflammation or ulceration in the small and large intestines. Most often, IBD is classified either as ulcerative colitis or Crohn's disease. While ulcerative colitis affects the inner lining of the colon and rectum, Crohn's disease extends into the deeper layers of the intestinal wall. It is a chronic condition and may recur at various times over a lifetime. (Source: Genes and Disease by the National Center for Biotechnology)

Crohn's Disease: NIDDK (Excerpt)

Theories about what causes Crohn's disease abound, but none has been proven. The most popular theory is that the body's immune system reacts to a virus or a bacterium by causing ongoing inflammation in the intestine.

People with Crohn's disease tend to have abnormalities of the immune system, but doctors do not know whether these abnormalities are a cause or result of the disease. Crohn's disease is not caused by emotional distress. (Source: excerpt from Crohn's Disease: NIDDK)

Related information on causes of Crohn's disease:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Crohn's disease may be found in:

• Risk factors for Crohn's disease
• Genetics of Crohn's disease
• Hidden causes of Crohn's disease

Causes of Crohn's disease: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Crohn's disease.

Bowel sounds, hyperactive: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

❑ Crohn's disease. Hyperactive bowel sounds usually arise insidiously. Associated signs and symptoms include diarrhea, cramping abdominal pain that may be relieved by defecation, anorexia, a low-grade fever, abdominal distention and tenderness and, in many cases, a fixed mass in the right lower quadrant. Perianal and vaginal lesions are common. Muscle wasting, weight loss, and signs of dehydration may occur as Crohn's disease progresses.

❑ Food hypersensitivity. Malabsorption — typically lactose intolerance — may cause hyperactive bowel sounds. Associated signs and symptoms include diarrhea and, possibly, nausea and vomiting, angioedema, and urticaria.

❑ Gastroenteritis. Hyperactive bowel sounds follow sudden nausea and vomiting and accompany “explosive” diarrhea. Abdominal cramping or pain is common, usually after a peristaltic wave. Fever may occur, depending on the causative organism.

❑ GI hemorrhage. Hyperactive bowel sounds provide the most immediate indication of persistent upper GI bleeding. Other findings include hematemesis, coffee-ground vomitus, abdominal distention, bloody diarrhea, rectal passage of bright red clots and jellylike material or melena, and pain during bleeding. Decreased urine output, tachycardia, and hypotension accompany blood loss.

❑ Mechanical intestinal obstruction. Hyperactive bowel sounds occur simultaneously with cramping abdominal pain every few minutes in patients with mechanical intestinal obstruction, a potentially life-threatening disorder; bowel sounds may later become hypoactive and then disappear. With small-bowel obstruction, nausea and vomiting occur earlier and with greater severity than in large-bowel obstruction. With complete bowel obstruction, hyperactive sounds are also accompanied by abdominal distention and constipation, although the part of the bowel distal to the obstruction may continue to empty for up to 3 days.

❑ Ulcerative colitis (acute). Hyperactive bowel sounds arise abruptly in patients with ulcerative colitis and are accompanied by bloody diarrhea, anorexia, abdominal pain, nausea and vomiting, fever, and tenesmus. Weight loss, arthralgias, and arthritis may occur.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Crohn's disease: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

In Crohn’s disease, lacteal blockage in the intestinal wall leads to edema and, eventually, inflammation, ulceration, and stenosis. Abscesses and fistulas may also occur.

Although the exact cause of Crohn’s disease is unknown, autoimmune and genetic factors are thought to play a role. Up to 5% of those with the disease have one or more affected relatives; Jewish ancestry is also a risk factor. However, a pattern of Mendelian inheritance hasn’t been identified.

The incidence of Crohn’s disease has risen steadily over the past 50 years; it now affects 7 out of every 100,000 people. Crohn’s disease is most prevalent in adults ages 20 to 40. It’s two to three times more common in those of Jewish ancestry and least common in blacks.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Bowel sounds, hyperactive: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Crohn’s disease

Hyperactive bowel sounds usually arise insidiously in Crohn’s disease. Associated signs and symptoms include diarrhea, cramping abdominal pain that may be relieved by defecation, anorexia, low-grade fever, abdominal distention and tenderness and, in many cases, a fixed mass in the right lower quadrant. Perianal and vaginal lesions are common. Muscle wasting, weight loss, and signs of dehydration may occur as Crohn’s disease progresses.

Food hypersensitivity

Malabsorption—typically lactose intolerance—may cause hyperactive bowel sounds. Associated signs and symptoms include diarrhea and, possibly, nausea and vomiting, angioedema, and urticaria.

Gastroenteritis

Hyperactive bowel sounds follow sudden nausea and vomiting and accompany “explosive” diarrhea. Abdominal cramping or pain is common, often after a peristaltic wave. Fever may occur, depending on the causative organism.

GI hemorrhage

Hyperactive bowel sounds provide the most immediate indication of persistent upper GI bleeding. Other findings include hematemesis, coffee-ground vomitus, abdominal distention, bloody diarrhea, rectal passage of bright red clots and jellylike material or melena, and pain during bleeding. Decreased urine output, tachycardia, and hypotension accompany blood loss.

Mechanical intestinal obstruction

Hyperactive bowel sounds occur simultaneously with cramping abdominal pain every few minutes in patients with mechanical intestinal obstruction—a potentially life-threatening disorder. Bowel sounds may later become hypoactive and then disappear. Nausea and vomiting occur earlier and with greater severity in small-bowel obstruction than in large-bowel obstruction. In complete bowel obstruction, hyperactive sounds are also accompanied by abdominal distention and constipation, although the part of the bowel distal to the obstruction may continue to empty for up to 3 days.

Ulcerative colitis (acute)

Hyperactive bowel sounds arise abruptly in patients with ulcerative colitis and are accompanied by bloody diarrhea, anorexia, abdominal pain, nausea and vomiting, fever, and tenesmus. Weight loss, arthralgia, and arthritis may occur.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Gastrointestinal Bleeding: Differential Overview
(Field Guide to Bedside Diagnosis)

Upper GI

❑ Peptic ulcer disease

❑ Gastritis

❑ Mallory-Weiss tear

❑ Esophageal varices

❑ Esophagitis

❑ Epistaxis

❑ Esophageal cancer

❑ Gastric cancer

Lower GI

❑ Infectious diarrhea

❑ Diverticular bleeding

❑ Hemorrhoids

❑ Anal fissure

❑ Inflammatory bowel disease

❑ Angiodysplasia

❑ Colon cancer

❑ Mesenteric ischemia

❑ Aortoenteric fistula

» READ BOOK EXCERPT ONLINE »

Source: Field Guide to Bedside Diagnosis, 2007

Intestinal obstruction: Causes
(Handbook of Diseases)

Adhesions and strangulated hernias usually cause small-bowel obstructions; carcinomas usually cause large-bowel obstructions. A mechanical intestinal obstruction results from a foreign body (fruit pits, gallstones, or worms) or compression of the bowel wall due to stenosis, intussusception, volvulus of the sigmoid or cecum, tumors, or atresia.

A nonmechanical obstruction results from a physiologic disturbance, such as paralytic ileus (see Paralytic ileus), electrolyte imbalance, toxicity (uremia or generalized infection), a neurogenic abnormality (spinal cord lesions), or thrombosis or embolism of mesenteric vessels.

The three forms of intestinal obstruction are:

❑ simple — blockage prevents intestinal contents from passing with no other complications

❑ strangulated — blood supply to part or all of the obstructed section is cut off in addition to blockage of the lumen

❑ close looped — both ends of a bowel section are occluded, isolating it from the rest of the intestine.

In all three forms, the physiologic effects are similar. When intestinal obstruction occurs, fluid, air, and gas collect near the site. Peristalsis increases temporarily as the bowel tries to force its contents through the obstruction, injuring intestinal mucosa and causing distention at and above the site of the obstruction. This distention blocks the flow of venous blood and halts normal absorptive processes. As a result, the bowel begins to secrete water, sodium, and potassium into the fluid pooled in the lumen. This results in distention and enormous amounts of fluid in the gut.

An obstruction in the upper intestine results in metabolic alkalosis from dehydration and loss of gastric hydrochloric acid; a lower obstruction causes slower dehydration and loss of intestinal alkaline fluids, resulting in metabolic acidosis. Ultimately, an intestinal obstruction may lead to ischemia, necrosis, and death.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Crohn's disease: Causes
(Handbook of Diseases)

Although the exact cause of Crohn’s disease is unknown, possible causes include allergies and other immune disorders and infection. However, no infecting organism has been isolated. A genetic cause has also been implicated in some cases.

As the disease progresses, deep ulcers and fissures extend into muscle layers of the wall. These lesions give rise to characteristic “cobblestone” appearance.

Whatever the cause of Crohn’s disease, lacteal blockage in the intestinal wall leads to edema and, eventually, to mucosal inflammation, ulceration, stricturing, and fistula and abscess formation. Absorption is impaired and small bowel obstruction may result.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Bowel sounds, hyperactive: Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

See Hyperactive bowel sounds: Causes and associated findings.

Crohn’s disease

Hyperactive bowel sounds usually arise insidiously. Associated signs and symptoms of Crohn’s disease include diarrhea, cramping abdominal pain that may be relieved by defecation, anorexia, low-grade fever, abdominal distention and tenderness and, in many cases, a fixed mass in the right lower quadrant. Perianal and vaginal lesions are common. Muscle wasting, weight loss, and signs of dehydration may occur as the disease progresses.

Food hypersensitivity

Malabsorption — typically lactose intolerance — may cause hyperactive bowel sounds. Associated signs and symptoms of food hypersensitivity include diarrhea and, possibly, nausea and vomiting, angioedema, and urticaria.

Gastroenteritis

Hyperactive bowel sounds follow sudden nausea and vomiting and accompany “explosive” diarrhea. Abdominal cramping or pain is common, typically after a peristaltic wave. Fever may occur, depending on the causative organism.

GI hemorrhage

Hyperactive bowel sounds provide the most immediate indication of persistent upper GI bleeding. Other findings include hematemesis, coffee-ground vomitus, abdominal distention, bloody diarrhea, rectal passage of bright red clots and jellylike material or melena, and pain during bleeding. Decreased urine output, tachycardia, and hypotension accompany blood loss.

Mechanical intestinal obstruction

Hyperactive bowel sounds occur simultaneously with cramping abdominal pain every few minutes in patients with intestinal obstruction, a potentially life-threatening disorder. Bowel sounds may later become hypoactive and then disappear. With small-bowel obstruction, nausea and vomiting occur earlier and with greater severity than in large-bowel obstruction. With complete bowel obstruction, hyperactive sounds are also accompanied by abdominal distention and constipation, although the part of the bowel distal to the obstruction may continue to empty for up to 3 days.

Ulcerative colitis (acute)

Hyperactive bowel sounds arise abruptly in patients with ulcerative colitis and are accompanied by bloody diarrhea, anorexia, abdominal pain, nausea and vomiting, fever, and tenesmus. Weight loss, arthralgia, and arthritis may occur.

» READ BOOK EXCERPT ONLINE »

Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

Bowel sounds, hyperactive: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Crohn’s disease

Hyperactive bowel sounds usually arise insidiously in those with Crohn’s disease. Associated signs and symptoms include diarrhea, cramping abdominal pain that may be relieved by defecation, anorexia, low-grade fever, abdominal distention and tenderness and, in many cases, a fixed mass in the right lower quadrant. Muscle wasting, weight loss, and signs of dehydration may occur as Crohn’s disease progresses.

Gastroenteritis

With gastroenteritis, hyperactive bowel sounds follow sudden nausea and vomiting and accompany “explosive” diarrhea. Abdominal cramping or pain is common, typically after a peristaltic wave. Fever may occur, depending on the causative organism.

GI hemorrhage

Hyperactive bowel sounds provide the most immediate indication of persistent upper GI bleeding. Other findings include hematemesis, coffee-ground vomitus, abdominal distention, bloody diarrhea, rectal passage of bright red clots and jellylike material or melena, and pain during bleeding. Decreased urine output, tachycardia, and hypotension accompany blood loss.

Malabsorption

Malabsorption — typically lactose intolerance — may cause hyperactive bowel sounds. Associated signs and symptoms include diarrhea and, possibly, nausea and vomiting, angioedema, and urticaria.

Mechanical intestinal obstruction

Mechanical intestinal obstruction — a potentially life-threatening disorder — causes hyperactive bowel sounds to occur simultaneously with cramping abdominal pain every few minutes; bowel sounds may later become hypoactive and then disappear. With small-bowel obstruction, nausea and vomiting occur earlier and with greater severity than in large-bowel obstruction. With complete bowel obstruction, hyperactive sounds are also accompanied by abdominal distention and constipation, although the part of the bowel distal to the obstruction may continue to empty for up to 3 days.

Ulcerative colitis (acute)

Hyperactive bowel sounds arise abruptly in patients with acute ulcerative colitis. The hallmark of this disorder is recurrent bloody diarrhea (usually containing pus and mucus) accompanied by anorexia, abdominal pain, nausea and vomiting, fever, and tenesmus. Weight loss, arthralgia, and arthritis may occur.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Gastrointestinal Bleeding: Principal Causes of Gastrointestinal Bleeding
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)

1. Uppergastrointestinal bleeding
   1. Nose
   2. Mouth and pharynx
   3. Esophagus
      1. Esophagitis
         1. Gastroesophageal reflux
         2. Caustic ingestion
         3. Infection
      2. Foreign body
      3. Varices
      4. Duplication
   4. Gastroesophageal junction
      1. Mallory-Weisstear
   5. Stomach
      1. Gastritis
      2. Ulcer
      3. Duplication
      4. Vascular malformation
      5. Neoplasm
   6. Duodenum
      1. Ulcer
      2. Foreign body
      3. Varices
      4. Duplication
      5. Vascular malformation
      6. Hemobilia
   7. Other
      1. Swallowed blood
      2. Coagulopathy
         1. Hemorrhagic disease of the newborn(vitamin K deficiency)
         2. Disseminated intravascular coagulation
      3. Drugs
2. Lower gastrointestinal bleeding
   1. Intestine
      1. Cow milk/soyprotein sensitivity
      2. Necrotizing enterocolitis
      3. Infectious colitis
      4. Henoch-Schönlein purpura
      5. Intussusception
      6. Congenital aganglionic megacolon (Hirschsprungdisease)
      7. Meckel diverticulum
      8. Volvulus with malrotation
      9. Inflammatory bowel disease
      10. Intestinal polyps
          1. Solitaryjuvenile polyps/juvenile intestinal polyposis
          2. Adenomatous polyposis of the colon
          3. Peutz-Jeghers syndrome
          4. Benign lymphoid hyperplasia
          5. Duplication
          6. Vascular malformation
          7. Neoplasm
   2. Rectum and anus
      1. Anal fissure
      2. Trauma
      3. Sexual abuse
      4. Hemorrhoids
      5. Other
   3. Swallowed blood
   4. Coagulopathy
   5. Drugs
3. Factitious bleeding

» READ BOOK EXCERPT ONLINE »

Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006

Bowel sounds, hyperactive: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Crohn's disease.Hyperactive bowel sounds usually arise insidiously. Associated signs and symptoms include diarrhea, cramping abdominal pain that may be relieved by defecation, anorexia, a low-grade fever, abdominal distention and tenderness and, in many cases, a fixed mass in the right lower quadrant. Perianal and vaginal lesions are common. Muscle wasting, weight loss, and signs of dehydration may occur as Crohn's disease progresses.

Food hypersensitivity.Malabsorption—typically lactose intolerance—may cause hyperactive bowel sounds. Associated signs and symptoms include diarrhea and, possibly, nausea and vomiting, angioedema, and urticaria.

Gastroenteritis.Hyperactive bowel sounds follow sudden nausea and vomiting and accompany “explosive” diarrhea. Abdominal cramping or pain is common, usually after a peristaltic wave. Fever may occur, depending on the causative organism.

GI hemorrhage.Hyperactive bowel sounds provide the most immediate indication of persistent upper GI bleeding. Other findings include hematemesis, coffee-ground vomitus, abdominal distention, bloody diarrhea, rectal passage of bright red clots and jellylike material or melena, and pain during bleeding. Decreased urine output, tachycardia, and hypotension accompany significant blood loss.

Mechanical intestinal obstruction.Hyperactive bowel sounds occur simultaneously with cramping abdominal pain every few minutes in patients with mechanical intestinal obstruction, a potentially life-threatening disorder; bowel sounds may later become hypoactive and then disappear. With small-bowel obstruction, nausea and vomiting occur earlier and with greater severity than in large-bowel obstruction. With complete bowel obstruction, hyperactive sounds are also accompanied by abdominal distention and constipation, although the part of the bowel distal to the obstruction may continue to empty for up to 3 days.

Ulcerative colitis (acute).Hyperactive bowel sounds arise abruptly in patients with acute ulcerative colitis and are accompanied by bloody diarrhea, anorexia, abdominal pain, nausea and vomiting, fever, and tenesmus. Weight loss, arthralgias, and arthritis may occur.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

 » Next page: Risk Factors for Crohn's disease

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