Does Crohn's Disease Weaken Your Immune System?

Studies show that Crohn's disease is the result of a weakened immune system.

Crohn's disease is an autoimmune disorder that primarily affects the gastrointestinal (GI) tract. In Crohn's patients, their immune system attacks healthy body cells due to abnormal regulation of the white blood cells in their bodies. The term weakened immune system or immune suppression often describes the lack of an appropriate response by the body to fight harmful germs.

Numerous studies conducted on people with Crohn's disease have presented the following findings:

• Individuals with Crohn's often exhibit granulomas throughout the gut wall, which reflect a defect in the clearance of foreign material from their intestines. This may be due to poor phagocyte (a type of white blood cell) function.
• The serum obtained from patients with Crohn's disease has shown that their neutrophils (white blood cells) have reduced chemotactic response (slower to move toward and attack a foreign body).
• Failure of phagocytes to respond optimally to an attack by a foreign body.

These studies consistently prove that individuals with Crohn's disease have an inadequate response to any kind of foreign (bacterial, viral, and fungal) invasion. Thus, Crohn's itself is a result of a weakened or inadequately trained immune system. Additionally, the corticosteroid medications, surgeries to treat the disease complications, and the immunosuppressant mediators all further weaken the immune system in a person with Crohn's disease.

However, each patient is different, and their immune status may ultimately depend upon the extent of disease severity, flares, type of medications as well as genetic predisposition.

A weakened immune system or immune suppression refers to the lack of the body's response to fight diseases and infections. Some of the reasons for a weakened immune system include:

• Medications (Steroids, disease-modifying antirheumatic drugs [DMARDs], antibiotic overuse, chemotherapy, etc.)
• Recent surgeries
• Extremes of age
• Genetics
• Chronic illness (diabetes, kidney disease, lupus, liver disease, etc.)

The most common sign of a weakened immune system is increased susceptibility to infections. Such a person may fall sick often and have repeated cases of flu and colds. Others may have repeated skin infections, especially fungal infections.

In the early phase of Crohn's disease, small erosions develop on the inner surface of the bowel. As the disease advances, these erosions turn into large ulcers that cause scarring and stiffness of the bowel, leading to a narrowed lumen.

When food content cannot pass through a narrow lumen, the person experiences intestinal obstruction. Sometimes, heavily fibrous food such as vegetables and fruits can worsen this obstruction. When the intestine is obstructed, food, fluid, and gas from the stomach and small intestine cannot pass further, which results in symptoms such as:

• Severe abdominal cramps
• Nausea
• Vomiting
• Abdominal distention

Obstruction of the small intestine is more common because it is narrower than the colon.

If untreated, deep ulcers tend to create perforations in the walls of the small intestine and the colon.

Also, a person with untreated Crohn's disease may have the following complications:

• Fistula (an ulcer creating a tunnel between the intestine and adjacent organs)
• Abdominal abscess (a collection of infected pus formed when the ulcer tunnel reaches an adjacent space inside the abdominal cavity)
• Urinary tract infections occur when a fistula develops between the intestine and the bladder
• Passage of gas and feces during urination
• Pus and mucus emerge from the skin of the abdomen when a fistula develops between the intestine and the skin
• Gas and feces coming from the vagina when a fistula develops between the colon and the vagina
• Discharge of mucous and pus from the anus when a fistula develops between the intestine and anus

Other complications include:

• Painful, red, raised spots on the legs
• Uveitis (painful eye conditions)
• Swelling, pain, and stiffness of the joints in the legs due to arthritis
• Sacroiliac joint arthritis (inflammation of the lower back)
• Ankylosing spondylitis (inflammation of the spine)
• Hepatitis (inflammation of the liver)
• Sclerosing cholangitis (inflammation of the bile ducts)
• Jaundice
• Increased risk for intestinal cancer

There isn't a permanent cure for Crohn's disease; however, scientists are seeking better ways to diagnose, treat, and perhaps even cure this debilitating and painful disease.

While there is no permanent cure, doctors can administer treatment that aims to:

• Induce remissions
• Maintain remissions
• Minimize any side effects from treatment
• Improve your quality of life

Treatment options may include anti-inflammatory agents, medications, and surgery (when necessary). Additionally, doctors could advise counsel from a dietitian to help implement dietary changes that avoid foods that trigger inflammation.