International Journal of Colorectal Disease

, Volume 22, Issue 12, pp 1437–1444 | Cite as

Crohn’s disease: a patient’s perspective

Original Article



As healthcare providers for Crohn’s disease, we assume that we have a good understanding of the disease progression and its symptoms. The aim of this study was to gather information about what patients with Crohn’s disease think are relevant to their symptoms and what helps them cope with this lifelong benign disease.

Materials and methods

A questionnaire was sent to all patients with a diagnosis of Crohn’s disease seen in the Digestive Disease Center in the last 5 years. The returned forms were downloaded into a database and sent for analysis.


Sixty-two percent of respondents were female. One third were between the ages of 35 and 50 years. Seventy percent were married. Thirty-eight percent had a graduate degree, 19% were unemployed. Fifty percent still smoked, half of them less than one pack a day. Sixty-eight percent said that their symptoms affected work, and one fourth changed jobs due to this. Foods worsened symptoms in 60%, with a decrease in symptoms while on low fiber foods and white meats. Lifestyle change worsened symptoms in 66%. A change in the caregiver was not a significant stressor. More than half used Remicade, with one third stating that it was helpful. Eight percent had never used steroids. Alcohol increased symptoms in 40%. Factors that did not cause a significant change were children at any age, pregnancy, menopause, and hormone replacement therapy. Surgery caused half the patients to improve for many years, although one third felt a lowered self-esteem postoperatively.


Patients with Crohn’s disease should be managed in a more comprehensive manner to provide optimal care. Thus, a team approach that includes a dietician and counselor should be considered as an integral part of this team. This will allow patients to have enhanced skills to cope with changes in their symptoms, whether they are due to the disease itself or the changes in their routine.


Crohn’ disease Lifestyle Diet Questionnaire Symptoms 


  1. 1.
    Mitchell A, Guyatt G, Singer J et al (1988) Quality of life in patients with inflammatory bowel disease. J Clin Gastroenterol 10:306–310CrossRefPubMedGoogle Scholar
  2. 2.
    Drossman DA, Patrick DL, Mitchell CM et al (1989) Health related quality of life in inflammatory bowel disease. Dig Dis Sci 34:1379–1386CrossRefPubMedGoogle Scholar
  3. 3.
    Bernkley T, Johnson J, Lygren I et al (2005) Health related quality of life in patients with inflammatory bowel disease measured with the Short Form-36: psychometric assessment and a comparison with general population norms. Inflamm Bowel Dis 11(10):909–918CrossRefGoogle Scholar
  4. 4.
    Cohen RD (2002) The quality of life in patients with Crohn’s disease. Aliment Pharmacol Ther 16:1603–1609CrossRefPubMedGoogle Scholar
  5. 5.
    Mussell M, Bocker U, Nagel N, Singer MV (2004) Predictors of disease related concerns and other aspects of health related quality of life in outpatients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 16(12):1273–1280CrossRefPubMedGoogle Scholar
  6. 6.
    Ringel Y, Drossman DA (2001) Psychosocial aspects of Crohn’s disease. Surg Clin North Am 81(1):231–252CrossRefPubMedGoogle Scholar
  7. 7.
    Garrett VD, Brantley PJ, Jones GN, McKnight GT (1991) The relation between daily stress and Crohn’s Disease. J Behav Med 14(1):87–96CrossRefPubMedGoogle Scholar
  8. 8.
    North CS, Alpers DH, Heltzer JE et al (1991) Do events or depression exacerbate inflammatory bowel disease? Ann Intern Med 114:381–386CrossRefPubMedGoogle Scholar
  9. 9.
    Bregenzer N, Lauge A, Furst A et al (2005) Patient education in inflammatory bowel disease does not influence patients knowledge and long term psychosocial well being. Gastroenterology 43(4):367–371Google Scholar
  10. 10.
    Blondel-Kucharski F, Chircop C, Marquis P et al (2001) Health related quality of life in Crohn’s disease: a prospective longitudinal study in 231 patients. Am J Gastroenterol 96(10):2915–2920CrossRefPubMedGoogle Scholar
  11. 11.
    Canavan C, Abrams KR, Hawthorne B et al (2006) Long-term prognosis in Crohn’s disease: factors that affect quality of life. Aliment Pharmacol Ther 23:377–385CrossRefPubMedGoogle Scholar
  12. 12.
    Russel MG, Nieman FH, Bergers JM et al (1996) Cigarette smoking and quality of life in patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 8:1075–1081CrossRefPubMedGoogle Scholar
  13. 13.
    Delaney CP, Kiran RP, Senagore AJ et al (2003) Quality of life improves within 30 days of surgery for Crohn’s disease. J Am Coll Surg 196(5):714–721CrossRefPubMedGoogle Scholar
  14. 14.
    Tillinger W, Mittermiller C, Lochs H, Moser G (1999) Health-related quality of life in patients with Crohn’s disease. Dig Dis Sci 44(5):932–938CrossRefPubMedGoogle Scholar
  15. 15.
    Wyke RJ, Edwards FC, Allan RN (1988) Employment problems and prospects for patients with inflammatory bowel disease. Gut 29(9):1229–1235CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Traue HC, Kosarz P (1999) Everyday stress and Crohn’s disease activity. A time series analysis of 20 single cases. Int J Behav Med 6(2):101–119CrossRefPubMedGoogle Scholar
  17. 17.
    Garcia-Vega E, Fernandez-Rodrigues C (2004) A stress management programme for Crohn’s disease. Behav Res Ther 42:367–383CrossRefPubMedGoogle Scholar
  18. 18.
    Jantschek G, Zeitz M, Pritsch M et al (1998) Effect of psychotherapy on the course of Crohn’s disease. Results of the German prospective multicenter psychotherapy treatment study on Crohn’s disease. Scand J Gastroenterol 33(12):1289–1296CrossRefPubMedGoogle Scholar
  19. 19.
    Schwarz SP, Blanchard EB (1991) Evaluation of a psychological treatment for inflammatory bowel disease. Behav Res Ther 29:167–177CrossRefPubMedGoogle Scholar
  20. 20.
    Mardini HE, Kip KE, Wilson JW (2004) Crohn’s disease: a two-year prospective study of the association between psychological distress and disease activity. Dig Dis Sci 49(3):492–497CrossRefPubMedGoogle Scholar
  21. 21.
    Cross RK, Wilson KT, Binion DG (2005) Narcotic use in patients with Crohn’s disease. Am J Gastroenterol 100:2225–2229CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryCleveland Clinic FoundationClevelandUSA
  2. 2.Department of Biostatistics and EpidemiologyCleveland Clinic FoundationClevelandUSA

Personalised recommendations