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Chron disease (CD) is categorized as an inflammatory disorder of the gastrointestinal system (McCance & Huether, 2018). It can cause what is known as skip lesions or inflammatory spots mixed with noninflamed spots anywhere from the mouth to the anus (McCance & Huether, 2018). The inflamed lesions develop within intestinal submucosa, with the ascending and transverse colon being the most common sites (McCance & Huether, 2018). When the disease progresses, neutrophil infiltration occurs and can cause abscess formation and destruction of crypts (McCance & Huether, 2018). Fissures then develop resulting in inflammation of lymphoid tissue (McCance & Huether, 2018). Lesions have a cobble stone appearance with surrounding ulceration (McCance & Huether, 2018). There is then potential for fistula development in addition to strictures that increases the risk of obstruction (McCance & Huether, 2018).
It is important to educate patients on risk factors and identification of CD. Nonmodifiable risk factors of CD include family history, age (with diagnosis typically prior to age 40), being female, or being of Jewish ethnicity (McCance & Huether, 2018). A modifiable risk factor that causes CD is smoking (McCance & Huether, 2018). It is important to educate patients on the relationship between smoking and prevalence of CD, in addition to the increased potential to exacerbate CD if smoking with a confirmed diagnosed (Smoking and IBD, 2020). Smoking is a risk factor for developing CD due to the ability for cigarette smoke to alter gut bacteria leading to the development of CD (Smoking and IBD, 2020). Smoking with a CD diagnosis can cause fistulas, increase need for surgery, alter their immunosuppressant treatment, and leave themselves at risk for developing other disorders (Smoking and IBD, 2020). Diet is also an important factor when managing CD (Morton, Pedley, Stewart, & Coad, 2020). Foods identified to exacerbate symptoms include various fruit and vegetables, dairy, gluten, and foods that are considered to be high in fat (Morton et al., 2020). Having patients adhere to strict diets to prevent symptom exacerbation is imperative to achieving optimal quality of life.
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