Mummy's Tummy (Crohn's Disease Awareness Month)

This question has come up from both Beans and Bunny a lot because it is a part of our daily life, as chronic diseases tend to be, and while I answer as best I can, it is one of the few things there isn't a good answer for.  But it also comes up from a lot of other people too. Why doesn't my tummy work right? (OK, maybe the grown-ups don't say "tummy")

November is Crohn's and Colitis Awareness Month, so I thought it was a good time to make people aware - I have Crohn's Disease. I was diagnosed 13 years ago and I do my very best to lead a "normal" life with it. Day to day life with Crohn's doesn't get talked about a lot because the symptoms themselves are a bit awkward to talk about - pain, nausea, vomiting, diarrhea, blood, mucus - not to mention the scramble for bathrooms. There's no good way to put that stuff in a casual water-cooler conversation. So, in honour of the month here's a bit about what it is, what it does and why my tummy doesn't work quite right. 

Let's start from the very beginning, a very good place to start. When we sing we begin with Do Re Mi. When we talk Crohn's we begin with the digestive system (Yeah ok, it's hard to rhyme "digestive system", my apologies to Julie Andrews). Digestive systems are pretty important, and also pretty long. There are a bunch of sections that all do a specific job:

from: http://www.ccfc.ca 

Mouth

It eats stuff. Like, say, chocolate. Nom nom nom.

Esophagus

The tube that connects your mouth to your stomach. Yup, pretty much just a tube that contracts.

Stomach

The food gets together with stomach acid and enzymes and breaks down into smaller pieces. Bet it's higher up in your body than you thought it was! The stomach actually does very little absorption of nutrients.

Small Bowel (Small Intestine)

It has three parts and digests the food and absorbs the nutrients. This is pretty much the most important bit there is because without it you can't get the nutrition out of food. 

    - Duodenum (about 8 cm in length) 

    - Jejunum (can be around 3 metres long)

    - Ileum (can also be approximately 3 metres in length)

Large Bowel (Large Intestine/Colon)

It's called "large" because of it's diameter, not length and is usually about 1.5 metres long. It includes the rectum and anus, which we have probably all heard of (and giggled about). It's job is to get the water and salt out of stuff and then store the waste until it is time to get rid of it.

So, in your average person these all work together and process your food efficiently and everything moves through according to schedule (except maybe for that sketchy taco...). But in those of us with Crohn's disease, the body's immune system attacks the gastrointestinal tract resulting in a chronic inflammatory disorder. This is the part that is tricky answering - WHY? I don't know. No one knows. There isn't an answer yet - research shows interactions between environmental, immunological and bacterial factors in genetically susceptible individuals (which is the science equivalent of "we're not quite sure yet"). 

The inflammation can occur in any part of the digestive system and in all layers of the tissues. The intestines become inflamed and ulcerous, and leaves behind scar tissue, which causes narrowing of the intestines, blockages and all kinds of other super fun things. As well, because the immune system is involved it is a whole body experience - arthritis and other random inflammation is par for the course. 

This is an awesome video that explains it better than I ever could:

And this comic is quite possibly one of the best explanations of living with Crohn's I've ever read, particularly the part about pretending to listen while in pain and finding random bathrooms. 

The part that is hardest to answer to the girls is "will you get better". Bluntly - no, I won't. But with meds, diet and a bit of luck I can live with it, so that's alright then. The most important part of living with Crohn's is a sense of humour, and online support groups are full of funny pictures and "bathroom humour" because to live with something like this requires laughing at it, otherwise it has too much power. Especially during colonoscopy prep. So, while I often make separate meals and carry toilet paper wherever I go - I go everywhere and do everything and I hope that that is the part they remember.

Thanks for listening. Feel free to ask questions!

If you'd like to learn more about Crohn's, this is a very good place to start: