As a doctor, I’ve always been aware of how unpredictable life can be, but I never thought I’d find myself diagnosing Crohn’s Disease and IBD (Inflammatory Bowel Disease) in the middle of a hike. Hiking is more than just an activity for me; it’s my escape—a way to clear my mind and refresh my spirit. Every month, I set out with friends and colleagues to explore Sri Lanka’s beautiful trails. Hiking offers a balance between the physical challenge and mental clarity I need to disconnect from the demands of hospital life.
One of our most unforgettable hikes was to Kirigalpoththa, Sri Lanka’s second-highest peak, located in the tranquil Horton Plains. It was a trip I had been eagerly anticipating for months. Among the group was Ravi, a close friend and fellow doctor, whose enthusiasm always kept our spirits high. But that day, something was different. Ravi, who usually led the pack, was struggling in silence—a struggle that would soon reveal a life-changing diagnosis.
The Unexpected Struggle
We started the climb early that morning. The air was crisp, and the mist rolled over the plains like a soft blanket. Our group, usually chatty and energetic, moved through the lush greenery with excitement. But Ravi, who was typically the heart and soul of every hike, was unusually quiet. Instead of leading, he stayed at the back, his face pale, wincing occasionally as if trying to hide something.
“You alright, Ravi?” I asked, falling back to walk beside him.
“Yeah, just a bit of stomach trouble,” he replied, forcing a smile. “Must’ve been that kottu roti I had last night.”
Kottu roti—Sri Lanka’s famous street food—was Ravi’s favorite. But this wasn’t just indigestion. His face was tense, and as a doctor, I could tell something deeper was happening. He was trying to tough it out, but by the time we reached the halfway point, Ravi was clearly in pain.
He finally admitted that he had been dealing with stomach cramps, diarrhea, and fatigue for weeks but had brushed it off as stress. That day, however, the symptoms were too severe to ignore. We turned back, and I insisted that he come in for a full check-up as soon as we returned to Colombo.
The Moment of Truth: Diagnosing Crohn’s Disease and IBD
Back in Colombo, we ran a series of tests—blood work, imaging, and finally, a colonoscopy. The results were clear: Ravi had Crohn’s Disease, a type of IBD (Inflammatory Bowel Disease).
For those unfamiliar, Crohn’s Disease and IBD are chronic conditions that cause inflammation in the gastrointestinal (GI) tract. This inflammation can lead to symptoms such as diarrhea, abdominal pain, fatigue, and weight loss. Ravi’s inflammation was concentrated in his small intestine, particularly the ileum—the last section of the small intestine—explaining his severe digestive issues.
The diagnosis was hard for Ravi to accept. He was used to being energetic and active, and now he faced a lifelong condition that would require significant changes to his lifestyle, from his diet to how he managed stress.
Unraveling Crohn’s Disease: Understanding the Condition
Crohn’s Disease is one of the two main types of IBD, the other being ulcerative colitis. While ulcerative colitis only affects the colon, Crohn’s Disease can affect any part of the GI tract, from the mouth to the anus. For Ravi, the inflammation was primarily in his ileum, which is a common area affected by Crohn’s Disease.
The disease is unpredictable and varies from person to person. Some people experience mild symptoms, while others suffer from severe flare-ups that can disrupt daily life. It’s a chronic condition, meaning there is no cure, but with the right management, many people can live full and active lives.
Symptoms and Early Warning Signs
Ravi had been living with symptoms for months, dismissing them as stress-related. This is common with Crohn’s Disease and IBD because the early signs often mimic other conditions, like irritable bowel syndrome (IBS) or food intolerance. The symptoms can develop gradually, making it difficult to pinpoint the disease early on.
Here are some of the common symptoms of Crohn’s Disease:
- Persistent diarrhea
- Abdominal pain and cramping
- Fatigue
- Blood in the stool
- Unexplained weight loss
- Loss of appetite
For Ravi, the stomach cramps were the most noticeable symptom, and he had also experienced significant weight loss. In Crohn’s Disease, these symptoms often come in waves, with periods of remission where the disease is less active, followed by flare-ups where symptoms become more severe.
If left untreated, Crohn’s Disease can lead to complications like ulcers, fistulas (abnormal connections between tissues), and even intestinal obstructions.
The Mystery of Causes: What Triggers Crohn’s Disease?
The exact cause of Crohn’s Disease and IBD remains a mystery, though researchers believe it’s a combination of genetic, environmental, and immune system factors. Some theories suggest that Crohn’s might be an autoimmune condition, where the immune system mistakenly attacks healthy tissues in the GI tract. Other factors that may contribute to the onset of Crohn’s Disease include:
- Genetics: A family history of Crohn’s Disease or IBD increases the risk.
- Environmental factors: Urban living, smoking, and certain diets are linked to a higher risk.
- Medication use: Long-term use of NSAIDs and antibiotics has been shown to increase gut inflammation.
For Ravi, the lack of a family history of IBD made his diagnosis all the more surprising. While lifestyle factors may have played a role, there wasn’t a clear cause. Crohn’s Disease remains a complex and unpredictable condition.
Diagnosing Crohn’s Disease: The Tests Involved
Diagnosing Crohn’s Disease often involves multiple tests to assess the extent of inflammation in the digestive tract. For Ravi, it began with blood tests and stool analysis to rule out infections and other causes. This was followed by a colonoscopy, during which a small camera was used to examine the lining of his intestines and detect any inflammation. Tissue samples, or biopsies, were also taken to confirm the diagnosis.
In some cases, additional imaging tests such as CT scans or MRIs may be necessary to get a clearer picture of the affected areas. These tests confirmed that Ravi’s Crohn’s Disease was concentrated in the ileum, a form of the disease known as ileitis.
Ravi’s Treatment Journey: Managing Crohn’s Disease and IBD
Managing Crohn’s Disease is a lifelong commitment. While there’s no cure, it can be controlled through medications, lifestyle changes, and sometimes surgery. Ravi’s treatment plan involved a combination of approaches:
- Anti-inflammatory medications: To reduce inflammation in the intestines.
- Immunosuppressants: To prevent the immune system from attacking healthy tissues.
- Dietary modifications: Ravi had to avoid certain foods that could trigger flare-ups, like high-fiber, fatty, and spicy foods.
The dietary changes were particularly tough for Ravi, as he had to give up many of his favorite dishes, including the spicy Sri Lankan street food he loved. However, with the help of a nutritionist, he learned to adapt his diet in a way that managed his symptoms without feeling deprived.
Despite these efforts, about a year after his diagnosis, Ravi experienced a severe flare-up that required surgery. The procedure involved removing a damaged section of his small intestine, a common intervention for patients with severe Crohn’s Disease. While surgery doesn’t cure the disease, it can provide significant relief and help manage symptoms for extended periods.
Life After Diagnosis: Ravi’s New Normal
Today, Ravi is managing his Crohn’s Disease and IBD well. His treatment plan includes regular medication, follow-up appointments, and ongoing adjustments to his diet. He’s also found emotional support through an online Crohn’s Disease community, where he connects with others who share similar experiences. This support network has been crucial for his mental and emotional well-being, helping him cope with the challenges of living with a chronic illness.
Ravi has even returned to hiking, though he now approaches it with more caution. He’s learned how to manage his symptoms, plan his hikes carefully, and avoid triggers that could lead to a flare-up. His journey with Crohn’s Disease has been difficult, but it hasn’t stopped him from living a full and active life.
Frequently Asked Questions About Crohn’s Disease and IBD
What causes Crohn’s Disease?
Crohn’s Disease is believed to result from a combination of factors, including genetics, an overactive immune response, and environmental triggers. While the exact cause remains unknown, researchers suggest that an abnormal immune response to gut bacteria plays a key role. Lifestyle factors like smoking can also increase the risk.
What are the symptoms of Crohn’s Disease?
Crohn’s Disease symptoms vary but often include persistent diarrhea, abdominal pain, fatigue, blood in the stool, and unintended weight loss. Other signs may include fever, mouth sores, and joint pain. The symptoms can range from mild to severe and may come in waves of flare-ups and remission.
How is Crohn’s Disease treated?
Treatment for Crohn’s Disease depends on the severity of the condition and may include anti-inflammatory drugs, immunosuppressants, and biologics that target specific parts of the immune system. In severe cases, surgery may be needed to remove damaged portions of the intestine. Lifestyle changes like dietary adjustments can also help manage symptoms.
Is there a cure for Crohn’s Disease?
Currently, there is no known cure for Crohn’s Disease. However, with effective treatment and ongoing medical care, many people achieve long periods of remission and maintain a good quality of life. Researchers are continuously exploring new therapies to improve outcomes for patients.
Can Crohn’s Disease affect life expectancy?
With proper treatment and management, most individuals with Crohn’s Disease can live a normal life expectancy. While complications like intestinal obstruction or malnutrition may arise, advancements in medical care have significantly improved the prognosis for people living with this condition.
Conclusion: A Life Reimagined
Ravi’s story is a powerful reminder that life can change in an instant. The diagnosis of Crohn’s Disease and IBD was a turning point for him, but it didn’t define his future. With the right treatment, support, and a positive outlook, Ravi continues to live a life full of adventure. He may face obstacles along the way, but he’s learned to navigate them with resilience and determination. Whether you’re hiking up a mountain or managing a chronic illness, persistence is key. Ravi’s journey shows that it’s possible to live fully, even with the challenges of Crohn’s Disease.