Crohn's / IBD

What are the signs of Crohn’s disease?

Crohn’s disease is a long-term inflammatory disease of the digestive tract, and its symptoms tend to relate to the gut and digestion. These symptoms often appear gradually and can get worse over time.

An estimated 565,000 people in the United States have Crohn’s disease. The disease is difficult to diagnose, and its exact cause remains unknown. Experts believe that an autoimmune reaction, in which the body’s immune cells attack healthy cells in the body, may be a primary cause of the condition.

In this article, we examine the signs and symptoms of Crohn’s disease and explain how the symptoms can differ depending on the part of the gut that the disease affects. We also take a look at possible complications and other conditions that can cause similar symptoms to Crohn’s disease.

Signs and symptoms of Crohn’s disease

woman with hands on stomach
Stomach pain and diarrhea are common symptoms of Crohn’s disease.

Crohn’s disease is most likely to present in people between the ages of 20 and 29. However, around one-sixth of people develop symptoms before the age of 15, and the disease can affect people of any age.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the most common symptoms of Crohn’s disease are:

  • diarrhea
  • unexplained weight loss
  • stomach pain or cramping

Other early signs and symptoms of Crohn’s disease include:

  • loss of appetite
  • fever
  • tiredness
  • nausea
  • eye pain or redness
  • aching or painful joints
  • bloody stool
  • tender, red bumps on the skin

People with Crohn’s disease may find that their symptoms worsen with stress or after eating certain foods.


Types of Crohn’s disease

There are five types of Crohn’s disease, which differ according to the part of the digestive tract that they affect. They also have slightly different symptoms, which helps doctors diagnose them correctly.

Below is a quick overview of each of the five types of Crohn’s disease and their symptoms:

Ileocolitis

This is the most common form of Crohn’s disease, and it affects both the large intestine and the end of the small intestine. As many as 40 percent of people with Crohn’s disease have ileocolitis.

Symptoms often include pain or cramping in the central or lower right region of the abdomen. This pain often accompanies diarrhea and sudden, unexplained weight loss.

Ileitis

This type of Crohn’s disease causes inflammation of the ileum, which is the narrowest and final section of the small intestine.

Its symptoms are similar to those of ileocolitis, but some people may develop complications, such as fistulas or abscesses in the lower right of the abdomen. A fistula in the gut is an abnormal connection between the digestive tract and another part of the body.

Crohn’s colitis

Crohn’s colitis, which doctors may also refer to as granulomatous colitis, only affects the large intestine. The technical name for the large intestine is the colon.

Common symptoms include:

  • ulcers, lesions, and abscesses in the anal region
  • joint pain
  • diarrhea
  • bloody stools

Gastroduodenal Crohn’s disease

The stomach and the first part of the small intestine become severely inflamed as a result of this type of Crohn’s disease.

According to Johns Hopkins Medicine, around one-third of young people with Crohn’s disease develop ulcers in this part of the digestive tract. Symptoms include loss of appetite, weight loss, nausea, and vomiting.

Jejunoileitis

This less common type of Crohn’s disease affects the upper half of the small intestine, called the jejunum.

Symptoms typically include diarrhea and stomach cramping or discomfort after eating. In severe cases, fistulas may also form.


Possible complications

The complications of Crohn’s disease can involve parts of the body external to the digestive tract. For example, inflammation may occur in the eyes, joints, skin, and liver due to the disease.

Other complications may include:

  • ulcers
  • abscesses
  • fistulas
  • blockage of the digestive tract
  • anemia
  • joint problems
  • nutritional difficulties
  • a tear in the bowel


When to see a doctor

People should visit a doctor if they experience any of the following symptoms:

  • diarrhea that lasts for 7 days or longer
  • frequent stomach pain, cramping, and discomfort
  • blood in the stool
  • unexplained weight loss

Diagnosis

doctor examining female patients stomach
People with frequent stomach pain and diarrhea should consult a doctor.

The most common symptoms of Crohn’s disease also occur with several other disorders. As a result, doctors need to carry out a combination of physical and laboratory tests to confirm whether or not someone has Crohn’s disease.

The doctor may measure body temperature and blood pressure, ask about pain in the abdomen, and carry out a rectal exam.

They will also often use some of the following tests to diagnose Crohn’s disease:

  • CT or MRI scan of the abdominal area
  • stool sample to check for an infection
  • routine blood tests
  • colonoscopy, to check the entire colon
  • sigmoidoscopy, to examine the lower part of the colon

A colonoscopy or sigmoidoscopy involves inserting a thin, flexible tube into the digestive tract through the anus. The tube has a light and camera on it that enable the doctor to have a look inside the gut to see what might be causing problems.


Other conditions that cause similar symptoms

People may often mistake the early signs and symptoms of Crohn’s disease for those of other conditions, such as:

It is best to visit a doctor if the symptoms persist for longer than a couple of weeks so that they can recommend the best course of treatment. The treatments for Crohn’s disease and the conditions listed above are quite different.

Treatment and prevention

selection of food with high fat content
Having a high-fat diet may raise the risk of Crohn’s disease.

There is not yet a cure for Crohn’s disease, but people can make certain lifestyle changes and take medicines to relieve symptoms and manage the condition.

Depending on the type of Crohn’s disease and the person’s medical history, doctors may recommend one or more of the following treatment options:

  • steroids or other medicines that reduce inflammation in the digestive system
  • biologic drugs that help the body’s immune system alleviate symptoms
  • surgery to remove a part of the stomach or intestine
  • antibiotics that destroy certain bacteria in the gut that cause infection symptoms

The NIDDK suggest that some dietary changes can help reduce the symptoms of Crohn’s disease. Their tips include:

  • avoiding fizzy drinks
  • avoiding high-fiber foods
  • drinking more liquid
  • eating small, frequent meals

As experts do not fully understand the cause of Crohn’s disease, there is no guaranteed way to prevent it.

However, smoking and eating a high-fat diet may increase the risk of Crohn’s disease. As a result, avoiding smoking and moderating fat intake could help people reduce their risk of getting the disease.


Outlook

Many of the early signs and symptoms of Crohn’s disease are similar to those resulting from other conditions. It is important for people who have these symptoms to see a doctor to get an accurate diagnosis.

Although there is no cure for Crohn’s disease, treatment can help relieve symptoms and reduce the impact that the disease has on quality of life.

In most cases, Crohn’s disease requires life-long management. It is essential to maintain regular contact with a medical team and take any prescribed medicines as directed. People with Crohn’s disease may benefit from working with their doctor to create an ongoing management plan.

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