Division of Gastroenterology, Hepatology & Nutrition
The Division of Gastroenterology, Hepatology, and Nutrition, part of the Department of Medicine, offers world-class patient care, research programs, and education and training opportunities.
Crohn’s Disease Care
Expert care for chronic inflammation of the digestive tract
Take Control of Your Digestive Health
At Beth Israel Deaconess Medical Center’s nationally-recognized Center for Inflammatory Bowel Disease (IBD), we provide expert, multidisciplinary care for patients with Crohn’s disease. Our skilled gastroenterologists work closely with a dedicated team of colorectal surgeons, dietitians, pharmacists, nurses, psychologists, and social workers to deliver personalized treatment. We focus on controlling inflammation, preventing complications, and enhancing your quality of life.
Whether you're newly diagnosed or managing long-term symptoms, we offer a comprehensive range of advanced diagnostic tools, treatments, and ongoing support services—all in one place. Living with Crohn’s disease requires a long-term partnership with your care team, and at BIDMC, we provide the resources and expertise you need to manage your condition and live life to the fullest.
What is Crohn’s Disease?
Crohn’s disease is a chronic autoimmune condition where the immune system mistakenly attacks the gastrointestinal (GI) tract, leading to inflammation. It can affect any part of the digestive tract, from the mouth to the anus, but most often targets the end of the small intestine (ileum) and the beginning of the colon.
More About Crohn's Disease Care
Factors, Symptoms, & Types
Crohn’s Diseases Factors
While the cause of Crohn’s disease is unknown, several factors are believed to contribute, including:
- Genetics
- Environmental triggers
- An abnormal immune response to normal gut bacteria
Diets high in sugar, fat, and low in fiber may increase susceptibility, but no specific food causes Crohn’s.
Symptoms of Crohn’s Disease
Symptoms can range from mild to severe and may come and go in cycles. Common signs include:
- Persistent abdominal pain or cramping
- Diarrhea (sometimes with blood)
- Fatigue, fever, and weight loss
- Loss of appetite
- Rectal bleeding or drainage (due to fistulas or abscesses)
- Delayed growth in children
- Extraintestinal symptoms: joint pain, skin rashes, eye inflammation
Types & Patterns of Crohn’s Disease
Crohn's disease is not a one-size-fits-all condition. It varies widely between individuals, not only in severity but also in its location, behavior, and pattern of flare-ups. Understanding the different types and patterns of Crohn’s disease is crucial in tailoring effective treatments and managing symptoms.
By Location
- Ileocolitis: Most common; affects ileum and colon
- Ileitis: Affects only the ileum
- Gastroduodenal Crohn’s: Involves stomach and duodenum
- Jejunoileitis: Affects jejunum; less common
- Crohn’s Colitis: Involves only the colon
- Perianal Disease: Inflammation and complications around the anus
By Disease Behavior
- Inflammatory: Causes swelling and ulceration
- Fibrostenotic: Leads to scarring and bowel narrowing
- Fistulizing/Perforating: Causes abnormal tunnels and bowel wall perforations
Diagnosis Approach
There’s no single test for Crohn’s. At BIDMC, we use a comprehensive diagnostic approach that may include:
- Clinical history of your symptoms
- Endoscopy (upper endoscopy and colonoscopy)
- Laboratory tests of various blood and stool samples
- MRIs, CT scans and X-rays to identify the specific disease
- Special MRI of the small intestine, called MR enterography
- Physical exam
- Tissue biopsy evaluated by pathology experts
Treatment Options
There is no cure for Crohn’s, but with the right treatment, most people can achieve long-term remission and improved quality of life.
Our Treatment Goals
- Heal the intestinal lining
- Prevent hospitalizations and complications
- Minimize or delay the need for surgery
- Maintain remission and quality of life
Medical Therapies We Offer
- Biologic medications
- Anti-TNF therapies (infliximab, adalimumab, certolizumab pegol, vedolizumab, natalizumab, ustekinumab, infliximab biosimilars)
- Corticosteroids (steroids)
- Immunomodulators (mercaptopurine, azathioprine, methotrexate)
Surgical Expertise
When needed, our colorectal surgeons perform minimally invasive procedures such as:
- Ileocecectomy (removal of affected bowel segment)
- Stricturoplasty (widening narrowed bowel)
- Colectomy with or without stoma
- Seton placement for perianal fistulas
We offer both emergency and elective surgeries, with careful coordination between your gastroenterologist and surgical team.
Preventive Health & Vaccinations
We help you stay protected with preventive services, including:
- Recommended vaccinations for IBD patients on immunosuppressive therapy
- Smoking cessation support (smoking worsens disease progression)
- Bone health screening
- Regular cancer screenings
Managing Complications
At BIDMC, we closely monitor for complications and address them quickly:
- Bowel Obstructions
- Fistulas and Abscesses
- Bone Loss: DEXA scans, calcium & vitamin D therapy
- Colon Cancer Risk: Surveillance colonoscopies every 1–3 years
- Gallstones/Kidney Stones
- Small Intestinal Bacterial Overgrowth (SIBO): Diagnosed and treated with antibiotics
Specialized Services
We provide integrated, patient-centered care through specialized programs:
Nutrition Counseling
Our registered dietitians specialize in IBD-related nutrition. We offer individualized meal planning and strategies to manage deficiencies in:
- Vitamin B12, D, iron, calcium, and magnesium
- Fat-soluble vitamins (A, D, E, K)
- Calories and protein
Behavioral Health Support
Our IBD psychologists help patients manage the stress, anxiety, and depression that may accompany chronic illness.
Pregnancy
Our IBD team works closely with high-risk obstetricians to help you plan and manage a healthy pregnancy. If you’re considering pregnancy, we’ll help optimize disease control and medication safety.
Key Considerations
- Most Crohn’s medications are safe in pregnancy
- Disease remission before conception is ideal
- Some drugs (e.g., methotrexate) must be stopped beforehand
