Crohn's Disease and the Small Bowel

Crohn’s Disease is an inflammatory bowel disease, which involves the small bowel in most patients who have the disease. About a third of Crohn’s patients have inflammation exclusively in the ileum, the deepest part of the small bowel. Inflammation, ulcerations, strictures (a narrowing that can cause blockage in the bowel), and bleeding are some of the serious clinical problems patients may experience.

At the Small Bowel Program, part of the University of Michigan’s Gastroenterology Division, our multidisciplinary team collaborates with the Inflammatory Bowel Disease Program to diagnose and treat conditions in the small bowel that relate to Crohn’s disease.

Symptoms of Crohn’s Disease Affecting the Small Bowel

When Crohn’s disease affects the small bowel, symptoms can include:

  • Pain that can be severe
  • Diarrhea
  • Anemia (not enough healthy red blood cells to get oxygen through the body, making you feel weak and cold)
  • Weight loss
  • Bloating

Diagnosing Crohn’s Disease in the Small Bowel

To diagnose, we start with a comprehensive examination and obtain a thorough history.

Sometimes a capsule endoscopy is a recommended diagnostic exam. Capsule endoscopy is a study that allows us to see all the way through the small bowel and find things we wouldn’t be able to see any other way. The procedure involves swallowing a small capsule, which is the size of a large vitamin pill. Inside the capsule is a tiny wireless camera that takes more than 50,000 digital pictures as it passes through the small intestine. Images are transmitted to a recording device worn on a belt around your waist. This recording device saves the pictures for a specialist to look at and interpret at a later time. Our experienced doctors have performed more than 3,500 capsule endoscopies.

If we are concerned that there is a narrowing in the small bowel, we won’t use capsule endoscopy as the device could become stuck in the narrowing. Instead we can use a special type of CT scan, or we can perform a double balloon enteroscopy to view the small bowel.

Double balloon enteroscopy is a specialty endoscopy, or scope test, which allows doctors to go deep into the small bowel. The technology includes the use of balloon attachments on a scope, which help move the scope through the small bowel to the affected area. Through the scope we can biopsy abnormalities or dilate strictures, if required. Though in the state of Michigan, this minimally invasive procedure is available only through our Small Bowel Program, our doctors have performed over 1,000 double balloon enteroscopies.

Treatment for Crohn’s Disease Issues in the Small Bowel

The typical treatment for Crohn’s disease issues in the small bowel is medication. A wide variety of medical therapies are available depending on the individual need.

The need for surgery is rare, however it is sometimes necessary if medication is not working and/or the patient has strictures in the small bowel. A number of surgical options are available.

Multidisciplinary Care for Small Bowel Disease

As members of the Gastroenterology Division of the University of Michigan, we have the resources of our entire medical center, and work in collaboration with other divisions to provide the most complete care. Our surgeons specialize in small bowel diseases and our pathologists, who review unusual findings on biopsies, have extensive small bowel experience.

Other Information About Digestive and Liver Health

To see related medical services we offer, visit our Digestive and Liver Health overview page.

Make an Appointment

To schedule an appointment to discuss small bowel bleeding or other digestive or liver health concerns, call us at 877-462-6935.