Crohn’s disease and ulcers: What you need to know
When you are diagnosed with IBD (Crohn’s disease or ulcerative colitis) it can feel a bit scary to hear that you have ulcers in your intestinal tract. When people talk about ulcers, they typically are referring to stomach ulcers. These kinds of ulcers can result from several causes, including medications and bacteria, and can lead to bleeding, pain, or even perforation. However, ulcers in Crohn’s disease or ulcerative colitis are different – they result from chronic inflammation.
People with ulcerative colitis may have ulcers in the mucosal layer – or inside lining – of the colon that often don’t go much deeper. With Crohn’s disease, the inflammation and ulceration extend beyond the mucosal layer into the full thickness of the bowel. As a result, untreated ulcers and inflammation can cause more damage and an increase in symptoms.
How ulcers can affect you
Strictures, fistulas, or perforations can form if ulcers and inflammation aren’t treated. A fistula is a small “leak” in the colon that then tunnels its way to another area of the body, like the surface of the skin, or another internal organ. Fistulas are often painful, and require antibiotics and or surgery to treat. A stricture is a narrowing in the intestinal tract that can form from the constant inflammation and repair taking place in the bowel. A stricture often leads to a bowel obstruction, which is painful and ultimately requires a surgical resection to remove the affected area. Perforations can also occur as a result of an ulcer that has gone deep enough to create a larger opening in the bowel, and also require surgery to repair.
How to treat and prevent ulcers
The best way to avoid ongoing uncontrolled ulcers in your GI tract is to work with your gastroenterologist. By starting and staying on a medication for your IBD, ulcers and inflammation will be limited or – more often – heal completely. To know if a medication is working, your GI provider will evaluate and treat until there are very few or no ulcers or inflammation at all. It is at that point that we know you are on the correct treatment at the correct dose.
Staying on your medication is key, so in addition to regularly seeing your gastroenterologist, you can also see a GI Health Coach. Health coaches help to make sure that you are taking your medications as prescribed and continuing healthy life habits to support your treatment. They can also help you make – and stick with – any lifestyle changes if needed. With this strategy, you can reclaim your health and avoid ulcers and the damage they cause.
Medically reviewed by Michael Currier, MSPAS, PA-C