It is usually thought to be due to an inability of the ileum to reabsorb bile acids after resection of the terminal ileum and was the first type of bile acid malabsorption recognized. Mental health
Crohns may result in anxiety or mood disorders, especially in young people who may have stunted growth or embarrassment from fecal incontinence. Counselling as well as antidepressant or anxiolytic medication may help some people manage.As of 2017 there is a small amount of research looking at mindfulness-based therapies, hypnotherapy, and cognitive behavioural therapy. Alternative medicine
It is common for people with Crohns disease to try complementary or alternative therapy. These include diets, probiotics, fish oil, and other herbal and nutritional supplements. Acupuncture is used to treat inflammatory bowel disease in China, and is being used more frequently in Western society. At this time, evidence is insufficient to recommend the use of acupuncture. A 2006 survey in Germany found that about half of people with IBD used some form of alternative medicine, with the most common being homeopathy, and a study in France found that about 30% used alternative medicine. Homeopathic preparations are not proven with this or any other condition, with large-scale studies finding them to be no more effective than a placebo. There are contradicting studies regarding the effect of medical cannabis on inflammatory bowel disease, and its effects on management are uncertain. Prognosis
Crohns disease is a chronic condition for which there is no known cure. It is characterised by periods of improvement followed by episodes when symptoms flare up.
Another study theorized that the human immune system traditionally evolved with the presence of parasites inside the body and that the lack thereof due to modern hygiene standards has weakened the immune system. Test subjects were reintroduced to harmless parasites, with positive responses. Microbes
It is hypothesized that maintenance of commensal microorganism growth in the GI tract is dysregulated, either as a result or cause of immune dysregulation.There is an apparent connection between Crohns disease, Mycobacterium, other pathogenic bacteria, and genetic markers. A number of studies have suggested a causal role for Mycobacterium avium subspecies paratuberculosis (MAP), which causes a similar disease, Johnes disease, in cattle. In many individuals, genetic factors predispose individuals to Mycobacterium avium subsp. paratuberculosis infection. This bacterium may produce certain compounds containing mannose, which may protect both itself and various other bacteria from phagocytosis, thereby possibly causing a variety of secondary infections.NOD2 is a gene involved in Crohns genetic susceptibility. It is associated with macrophages diminished ability to phagocytize MAP. This same gene may reduce innate and adaptive immunity in gastrointestinal tissue and impair the ability to resist infection by the MAP bacterium. Macrophages that ingest the MAP bacterium are associated with high production of TNF-α.Other studies have linked specific strains of enteroadherent E. coli to the disease.