Crohn's Disease Symptoms - WebMD

Crohn's disease causes inflammation in part of your digestive system. Crohn's can affect any part of it, but it most often involves your ... MenuNewsReferenceSlideshowsVideosFindaGastroenterologistAnemiaColonCancerColonoscopyConstipationDiarrheaInflammatoryBowelDiseaseOstomyRectalBleedingUlcerativeColitisInflammatoryBowelDiseaseCrohn'sDiseaseMenuMedicallyReviewedbyMineshKhatri, MDonJune27,2020ArticlesOnCrohn'sDiseaseWhatIsCrohn'sDisease?CausesSymptomsDiagnosisWhattoExpectTreatmentsAvoidFlaresKnowtheRightDoctorRemissionWhatIsCrohn'sDisease?Crohn’sdiseasecausesinflammationinpartofyourdigestivesystem.Crohn'scanaffectanypartofit,butitmostofteninvolvesyoursmallintestineandcolon.Crohn'sandanotherdisease,ulcerativecolitis,arepartofagroupofconditionscalledinflammatoryboweldisease.There’snocureforCrohn’s,buttreatmentcaneaseyoursymptomsandhelpyouenjoyafull,activelife.Crohn'sDiseaseSymptomsPeoplewithCrohn'sdiseasecanhaveseveresymptoms,followedbyperiodsofnosymptomsthatmaylastforweeksoryears.Thesymptomsdependonwherethediseasehappensandhowsevereitis.Youmightnotice:Long-lastingdiarrhea,oftenbloodyandwithmucusorpusWeightlossFeverBellypainandtendernessRectalbleedingCrohn’sDiseaseComplicationsCrohn’scausestwotypesofcomplications:Local,whichaffectjustyourintestinesSystemic,whichaffectyourwholebody.Youmighthearthemcalledextraintestinalcomplications.LocalcomplicationsofCrohn’sinclude:Abscess.Thispocketofpushappensbecauseofbacterialinfections.Itcanformonthewallsofyourintestinesandbulgeout.Oryoumightgetonenearyouranusthatlookslikeaboil.You’dnoticeswelling,tenderness,pain,andfever.Bilesaltdiarrhea.Crohn’sdiseasemostoftenaffectstheileum,thelowerendofyourintestine.Thispartusuallyabsorbsbileacids,whichyourbodymakestohelpitabsorbfat.Ifyourbodycan’tprocessthefat,youcouldgetthistypeofdiarrhea.Fissure.Thisisapainfultearintheliningoftheanus.Itcancausebleedingduringbowelmovements.Fistula.Soresorulcerscanturnintoopeningscalledfistulasthatconnecttwopartsofyourintestine.Theycanalsotunnelintonearbytissues,likethebladder,vagina,andskin.Malabsorptionandmalnutrition.Crohn'saffectsyoursmallintestine,thepartofyourbodythatabsorbsnutrientsfromfood.Afteryou’vehaditforalongtime,yourbodymaynolongerbeablemakethemostofwhatyoudoeat.Smallintestinalbacterialovergrowth(SIBO).Yourgutisfullofbacteriathathelpyoubreakdownfood.Whenthishappenshigherupinyourdigestivetractthanusual,youcangetgas,bloating,bellypain,anddiarrhea.Strictures.Thesenarrowed,thickenedareasofyourintestinesresultfromtheinflammationthatcomeswithCrohn’s.Theycanbemildorsevere,dependingonhowmuchofyourintestineisblocked.Symptomsincludecramping,abdominalpain,andbloating.Systemiccomplicationsinclude:Arthritis.Jointinflammation,whichleadstopain,swelling,andalackofflexibility,isthemostcommonsystemiccomplication.ThreetypesofarthritissometimescomewithCrohn’s:Peripheral.Thistypeaffectslargejointsinyourarmsandlegs,likeyourelbows,knees,wrists,andankles.Axial.Thistypeaffectsyourspineorlowerback(thedoctormaycallityoursacroiliacjoint).Ankylosingspondylitis.ThismoreserioustypeofspinalarthritisisrareamongpeoplewithCrohn’s,butitcanhappen.Itcanalsoleadtoinflammationinyoureyes,lungs,andheartvalves.Skinproblems.Thesearethesecondmostcommonsystemiccomplication.ThosemostoftenlinkedtoCrohn’sdiseaseinclude:Erythemanodosum.Thesesmall,tender,rednodulesusuallyshowuponyourshins,ankles,andsometimesarms.Pyodermagangrenosum.Thesepus-filledsoresoftenfollowaninjuryorotherskintrauma.Theyoftenappearonyourlegsbutcanshowupanywhere.Skintags.ThesesmallflapsofskinarecommoninpeoplewithCrohn’s,especiallyaroundtheanus.Mouthulcers.Youmighthearthemcalledcankersores.Theyformbetweenyourgumandlowerliporalongthesidesandbottomofyourtongue.Boneloss.Medicationslikesteroidscanleadtoboneloss,aconditionknownasosteoporosis.Theycan:Stopyourbodyfromabsorbingcalcium,whichitneedstobuildboneMakeyourbodygetridofcalciumwhenyoupeeBoostproductionofcellsthatbreakdownboneLowerthenumberofcellsthathelpformbonesLoweryourbody’soutputofestrogen.Estrogenalsohelpsbuildbone.Theproteinsthatcauseinflammationcanalsochangethespeedatwhichyourbodyremovesandmakesbone.LackofvitaminD.Ifyourbodycan’tabsorbvitaminDbecauseofCrohn’sdamagetothesmallintestine,orifpartofyoursmallintestinehasbeenremoved,you’relesslikelytobeabletoabsorbcalciumandmakebone.Eyeproblems.InflammationassociatedwithCrohn’scanaffecttheeyesinseveralways.Commonconditionsinclude:Episcleritis.Inflammationoftheareajustbelowtheconjunctiva(thecleartissuethatcoverstheinsideofyoureyelidsandthewhiteofyoureye)isthemostcommoncomplicationofCrohn’s.Itcanaffectoneeyeorboth.You’llnoticepain,itching,burning,andsevereredness,butitwon’ttypicallyhurtyourvision.Scleritis.Thisconditioncausesconstantpainthatgetsworsewhenyoumoveyoureyes.Uveitis.Thisisapainfulinflammationoftheuvea,themiddlelayerofyoureye.Itcancauseblurryvision,lightsensitivity,andredness.Kidneyproblems.TheseorganscanbeaffectedbyCrohn’sbecausetheyplayaroleinprocessingwasteandarenearyourintestines.Potentialissuesinclude:Kidneystones.They’reacommonproblemwithCrohn’s.Onetypeoccurswhenasaltcalledoxalategetsabsorbedintoyourkidneysandturnsintostones.Anothertype,calleduricacidstones,formsifyourbodycannotabsorballtheuricacidthatitmakes.Hydronephrosis.Thishappenswhentheileum(wherethesmallintestinemeetsthelarge)swellsfromCrohn’sandputspressureonaureter,thetubethatcarriesurinefromyourkidneytoyourbladder.Whenurinecan’tdrainasitshould,yourkidneyswells,andscartissuecanform.Fistulas.Inadditiontoformingwithinyourintestines,fistulascanformbetweentheintestineandotherorgans,likethebladderorureter.Liverproblems.Yourliverprocesseseverythingyoueatanddrink.ItcangetinflamedasaresultofCrohn’streatmentorthediseaseitself.You’relikelytohaveonlylowenergyandfatigueunlessyougetamoreseriousproblem.Amongthemostcommonissuesare:Fattyliverdisease.Whenyourbodydoesn’tprocessfatsaswell,theycanbuildupinyourliver.Steroidscanhelp.Gallstones.WhenCrohn’saffectstheileum,itcan’tprocessbilesalts,whichhelpcholesteroldissolve.Thecholesterolcanformstonesthatblocktheopeningbetweenyourliverandthebileduct.Hepatitis.Long-termliverinflammationcanresultfromCrohn’sdiseaseitself.Pancreatitis.Inflammationofthepancreascanresultfrombothgallstonesandmedications.Itcancausepain,nausea,vomiting,andfever.Physicaldevelopmentproblems.Crohn’scanstartatanyage.WhenkidsgetCrohn’s,parentsarelikelytonotice:Growthfailure.KidswhohaveCrohn’sarelikelytobeshorterandweighlessthanthosewhodon’t.Theymaystopgettingtallerbeforesymptomsstart.Delayedpuberty.KidswithCrohn’sarelikelytostartpubertylater.MoststudieslinkCrohn’sdiseasetoaverysmallbutrealincreaseinthechanceofdeath.Usually,thecausesarenotjustCrohn’sdiseaseitself,butrelatedcomplications.Theyincludeinfections,aperforationortearinthebowels,anddeadlyreactionstosteroidsandothertreatments.CausesofCrohn'sDiseaseDoctorsaren’tsurewhatcausesCrohn'sdisease.Somepeoplethinkofitasanautoimmunedisease.Researchsuggeststhatthelong-terminflammationmaynothappenbecauseyourimmunesystemattacksyourbody,butinsteadbecauseitattacksaharmlessvirus,bacteria,orfoodinyourgut.Crohn'sDiseaseRiskFactorsAfewthingscanmakeyoumorelikelytogetCrohn’sdisease:Genes.Crohn'sdiseaseisofteninherited.About20%ofpeoplewhohaveitmayhaveacloserelativewitheitherCrohn'sorulcerativecolitis.Inaddition,AshkenaziJewshaveahigherriskforthedisease.Age.WhileCrohn'sdiseasecanaffectpeopleofallages,it’sprimarilyanillnessoftheyoung.Mostpeoplearediagnosedbeforeage30,butthediseasecanhappeninpeopleintheir50s,60s,70s,orevenlaterinlife.Smoking.Thisistheoneriskfactorthat’seasytocontrol.SmokingcanmakeCrohn’smoresevereandraisetheoddsthatyou’llneedsurgery.Medications.Nonsteroidalanti-inflammatorydrugs(NSAIDs)likeibuprofen,naproxen,andsimilarmedicationsdon’tcauseCrohn’sdisease,buttheycanleadtoinflammationofthebowelsthatmakesitworse.Theworldaroundyou.PeoplewholiveinurbanareasorindustrializedcountriesaremorelikelytogetCrohn’s.Diet.Ifyoueatalotofhigh-fatorprocessedfoods,youroddsofCrohn’scouldgoup.Infection.BacterialinkedtoCrohn’sincludeMycobacteriumaviumparatuberculosis,whichcausesasimilarconditionincattle,andatypeofE.coli.Crohn’sDiseaseVariationsTherearefivetypesofCrohn’sdisease,basedonwhatpartofyourdigestivetractisaffected.Ileocolitis,themostcommonformofCrohn’s,involvesyourcolonandthelastpartofyoursmallintestine(calledtheterminalileum).Crohn’scolitisorgranulomatouscolitisaffectsonlyyourcolon.GastroduodenalCrohn’sdiseaseisinyourstomachandthefirstpartofyoursmallintestine(calledtheduodenum).Ileitisaffectsyourileum.Jejunoileitiscausessmallareasofinflammationintheupperhalfofyoursmallintestine(calledthejejunum).Crohn'sDiseaseDiagnosisDoctorsusemanyteststodistinguishCrohn'sdiseasefromotherconditionslikeulcerativecolitis.First,yourdoctorwillreviewyourmedicalhistoryandtalkaboutyoursymptoms.Theymightwanttoordersomelabtests,like:Bloodtests,includingbloodcountsStoolsamplestoruleoutinfectionsasthecauseofdiarrheaImagingtests:MRI.Thisshowsyourdoctoraclearpictureoftheinsideofyourbodywithoutusingradiation.CTscan.ThistestusesX-raystomakedetailedimagesofyourinternalorgans.Endoscopy.Yourdoctormightsendyoutoaspecialistcalledagastroenterologisttogetoneofthese:Balloon-assistedenteroscopy.Thistestusesballoonsthatinflateanddeflatetopullaflexibletubecalledanendoscopethroughyoursmallintestine.Atinycameraononeendgivesaviewoftheinsideofyourguts.Capsuleendoscopy.You’llswallowatiny,pill-sizedcameratogivethedoctoracloserlookatyoursmallintestine.Upperendoscopy.Thedoctordoesthistoseeyouresophagus,stomach,andduodenum.Colonoscopyorsigmoidoscopy.Thesegivethedoctoraclearpictureofyourintestinesandletthemtakeatissuesampletostudy.Crohn'sDiseaseTriggersWithCrohn'sdisease,youhaveperiodsofsymptomsthatcanlastdays,weeks,ormonths,followedbyperiodsofremissionwhenyouhavenosymptoms.Remissionscanlastdays,weeks,oryears.ThingsthatcanworsenCrohn'sdiseaseinclude:Infections(includingthecommoncold)CigarettesmokingSomeanti-inflammatorydrugs(suchasaspirinandibuprofen)Crohn'sDiseaseTreatmentTreatmentscan’tcureCrohn'sdisease,buttheycanhelpmostpeopleleadregularlives.MedicationCrohn'sdiseaseismostlytreatedwithmedications,including:Corticosteroids,amorepowerfultypeofanti-inflammatorydrug.Examplesincludebudesonide(Entocort)andprednisoneormethylprednisolone(Solu-Medrol).Ifyoutaketheseforalongtime,sideeffectscanbesevereandmayincludebonethinning,muscleloss,skinproblems,andahigherriskofinfection.Entocorthasfewersideeffects.Anti-inflammatorydrugs.Examplesincludemesalamine(Asacol,Lialda,Pentasa),olsalazine(Dipentum),andsulfasalazine(Azulfidine).Sideeffectsincludeupsetstomach,headache,nausea,diarrhea,andrash.Thesemedicinesareusedonlyincertaincases.Immunesystemmodifierssuchasazathioprine(Imuran,Azasan)andmethotrexate(Rheumatrex,Trexall).Itcantakeupto6monthsforthesedrugstowork.Theyalsohaveahigherriskofinfectionsthatcanbelife-threatening.Antibioticssuchasciprofloxacin(Cipro)andmetronidazole(Flagyl).Flagylcancauseametallictasteinyourmouth,nausea,andtinglingornumbnessofyourhandsandfeet.CiprocancausenauseaandtearsinyourAchillestendon.DrugsfordiarrheaBiologicmedicines,suchasadalimumab(Humira),adalimumab-atto(Amjevita),adalimumab-abdn(Cyltezo),certolizumabpegol(Cimzia),infliximab(Remicade),infliximab-abda(Renflexis),infliximab-dyyb(Inflectra),infliximab-axxq(Avsola),Infliximab-qbtx(IXIFI),natalizumab(Tysabri),ustekinumab(Stelara),andvedolizumab(Entyvio)Onceyoustarttreatment,yourdoctorwillcheckbackinseveralweekstoseehowwellitworks.You’llcontinueuntilyoureachremission.Whenthathappens,yourdoctormayprescribe"maintenancetherapy"tokeepyoursymptomsatbay.Ifyoudon’tgetbetter,you’llneedstrongertreatment.Yourdoctormaysuggestnutritionalsupplements,too.SurgeryAbout66%to75%ofpeoplewithCrohn'sdiseasewillneedsurgery.Itcanhelpwithcomplicationsorwhenmedicationsdon'twork.Commonproceduresinclude:Anastomosis.Yoursurgeonremovesthediseasedpartofthebowelandjoinsthetwohealthyendstogether.Manypeoplearesymptom-freeforyearsafter,butitisn’tacure.Crohn'sdiseaseoftencomesbackatthesiteoftheanastomosis.Ileostomy.Youmightneedthisifyourrectumisdiseasedandthedoctorcan’tuseitforananastomosis.Thisprocedureconnectsyourintestinetotheskinofyourtorso.Theresultisanopeningintheskinthatcancollectwasteproductsinaspecialpouchthatyouempty.ComplementaryandalternativetreatmentsWhenyouusenonmedicaltreatmentsinsteadofmedicalones,they’recalledalternativetherapies.Thoseusedalongwithmedicaltreatmentsarecalledcomplementarytherapies.MedicationisthemaintreatmentforCrohn’s,butmanypeopleusecomplementarytherapiestohelpeasesymptoms.Theyinclude:Mind-bodytherapiessuchasrelaxation,meditation,hypnosis,acupuncture,yoga,andexerciseDietarysupplementslikeomega-3fattyacidsandcurcuminProbioticsMedicalcannabisResearchonmanyofthesetreatmentsisongoing.Talkwithyourdoctorbeforetryinganyofthem.LifestylechangesandhomeremediesSomelifestylechangesmayalsorelieveyourCrohn’ssymptoms.AvoidNSAIDs.Useacetaminopheninstead.Quitsmoking.Thismayhelpreduceflare-ups,lessentheamountofmedicationyouneed,andloweryourchancesofsurgery.Managestress.Stressdoesn’tcauseCrohn’s,butitcanmakesymptomsworse.Trysomeofthemind-bodytherapiesabove,suchasmeditationoryoga.Crohn'sdiseasedietFoodsdon'tseemtocauseCrohn'sdisease,butsoft,blandthingsmaycausefewersymptomsthanspicyorhigh-fiberfoodswhenthediseaseisactive.MostdoctorstrytobeflexibleinplanningthedietsoftheirCrohn'sdiseasepatients.Youmightalsotryaneliminationdiet,whichcanhelpyoufigureoutwhichfoodstriggerCrohn’ssymptoms.You’llremovethingsfromyourdietoneatatimetoandseewhathappens.Workwithyourdoctororadietitiantomakesureyoudon’tmissoutonanynutrientswhileyou’redoingit.Seehowyoufeelaftercuttingbackon:GreasyorfriedfoodsDairyproductsCarbonateddrinksCaffeineHigh-fiberfoodslikenuts,seeds,andrawvegetablesFoodsthatcancausegas,suchasbeansandcruciferousveggies  NextInCrohn'sDiseaseCausesWhat'saLow-ResidueDiet?HowtoTreataCrohn'sFlareCopingWithCrohn'sDisease?Crohn'sDisease:FoodstoAvoidManagingCrohn'sWhenPregnantBiologicsforCrohn'sandIBDUlcerativeColitisSurgery--WhattoExpectTheIntestines(HumanAnatomy):Picture,Function,Location,Parts,Definition,andConditionsOnlinePuzzle:PlaytheGame!TestYourColitisIQUlcerativeColitisTreatments&SurgeryReasonforMyStomachCrampsandDiarrheaCrohn'sDiseaseandInflammatoryBowelDisease:54TipsColitisTopicsCrohn’sandYourDietFoodstoavoid.ChallengedbyCrohn’s?Getpersonalizedtips.CausesofCrohn'sIsitgenetics,yourimmunesystem,orsomethingelse?WhatIsIBD?LearnaboutCrohn’s,colitis,andmore.ArticleTreatmentOptionsforCrohn'sDiseaseArticleCrohn'sandYourDietToolHowWellAreYouCopingWithCrohn's?ArticleMedicationsforUlcerativeColitisArticleTriggerFoodstoAvoidWithCrohn'sArticleExercisingWithCrohn'sArticleNewlyDiagnosedWithCrohn's?ArticleWhenCrohn'sSurgeryMightBeNeededTool:YourHealth&Crohn'sCausesofBloodinStoolPicturesoftheIntestinesWhatIsaLow-ResidueDiet?DeliciousDietTipsforIBDHealthSolutionsPenisCurvedWhenErect?CouldIhaveCAD?TreatBentFingersTreatHR+,HER2-MBCTiredofDandruff?BenefitsofCBDRethinkMSTreatmentAFib-RelatedStrokesRiskofaFutureDVT/PEIsMyPenisNormal?RelapsingMSOptionsLiverTransplantsSaveLivesFinancePlasticSurgeryBentFingerCausesLivingWithPsoriasis?MissingTeeth?MorefromWebMD5TipstoHelpWithRelapsingMSHowtoThriveWithNarcolepsyReliefforBlockedHairFolliclesPsoriaticArthritisandYourSleepWhatPsoriasisFeelsLikeFirstPsoriaticArthritisFlareTalkingtoYourDoctorAboutRACrohn's: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