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Symptoms
By Mayo Clinic staff
Inflammation of Crohn's disease may involve different areas in different people. In some people, just the small intestine is affected. In others, it's confined to the colon (part of the large intestine). The most common areas affected by Crohn's disease are the last part of the small intestine (ileum) and the colon. Inflammation may be confined to the bowel wall, which can lead to scarring (stenosis), or inflammation may spread through the bowel wall (fistula).
Signs and symptoms of Crohn's disease can range from mild to severe and may develop gradually or come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (remission). When the disease is active, signs and symptoms may include:
- Diarrhea. The inflammation that occurs in Crohn's disease causes cells in the affected areas of your intestine to secrete large amounts of water and salt. Because the colon can't completely absorb this excess fluid, you develop diarrhea. Intensified intestinal cramping also can contribute to loose stools. Diarrhea is a common problem for people with Crohn's.
- Abdominal pain and cramping. Inflammation and ulceration may cause the walls of portions of your bowel to swell and eventually thicken with scar tissue. This affects the normal movement of contents through your digestive tract and may lead to pain and cramping. Mild Crohn's disease usually causes slight to moderate intestinal discomfort, but in more-serious cases, the pain may be severe and include nausea and vomiting.
- Blood in your stool. Food moving through your digestive tract may cause inflamed tissue to bleed, or your bowel may also bleed on its own. You might notice bright red blood in the toilet bowl or darker blood mixed with your stool. You can also have bleeding you don't see (occult blood).
- Ulcers. Crohn's disease can cause small sores on the surface of the intestine that eventually become large ulcers that penetrate deep into — and sometimes through — the intestinal walls. You may also have ulcers in your mouth similar to canker sores.
- Reduced appetite and weight loss. Abdominal pain and cramping and the inflammatory reaction in the wall of your bowel can affect both your appetite and your ability to digest and absorb food.
Other signs and symptoms
People with severe Crohn's disease may also experience:
- Fever
- Fatigue
- Arthritis
- Eye inflammation
- Mouth sores
- Skin disorders
- Inflammation of the liver or bile ducts
- Delayed growth or sexual development, in children
When to see a doctor
See your doctor if you have persistent changes in your bowel habits or if you have any of the signs and symptoms of Crohn's disease, such as:
- Abdominal pain
- Blood in your stool
- Ongoing bouts of diarrhea that don't respond to over-the-counter (OTC) medications
- Unexplained fever lasting more than a day or two
References
- Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/Crohns.pdf. Accessed June 20, 2011.
- Management of Crohn's disease in adults. Bethesda, Md.:American College of Gastroenterology. http://www.acg.gi.org/physicians/guidelines/CrohnsDiseaseinAdults2009.pdf. Accessed June 20, 2011.
- Living with Crohn's disease. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/crohns2005.pdf. Accessed June 20, 2011.
- Crohn's disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec02/ch018/ch018b.html. Accessed June 20, 2011.
- Peppercorn MA. Clinical manifestations, diagnosis and natural history of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
- Smoking and your digestive system. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/smoking/DD-52.pdf. Accessed June 23, 2011.
- Burakoff R, et al. Inflammatory bowel disease. In: Greenberger NJ, et al. Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy. New York, N.Y.: The McGraw Hill Medical Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=6200149. Accessed June 20, 2011.
- Ford AC, et al. Glucocorticosteroid therapy in inflammatory bowel disease: Systematic review and meta-analysis. American Journal of Gastroenterology. 2011;106:590.
- Colombel JF, et al. Infliximab, azathioprine, or combination therapy for Crohn's disease. New England Journal of Medicine. 2010;362:1383.
- Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
- Farrell RJ, et al. Medical management of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
- Korzenik JR. Investigational therapies in the medical management of Crohn's disease. http://www.uptodate.com/home/index.html. Accessed June 20, 2011.
- Ford AC, et al. Efficacy of biological therapies in inflammatory bowel disease: Systematic review and meta-analysis. American Journal of Gastroenterology. 2011;106:644.
- Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
- Markowitz J, et al. Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease. Inflammatory Bowel Diseases. 2004;10:599.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. July 12, 2011.
- Colorectal cancer screening guidelines. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/colorectal/basic_info/screening/guidelines.htm. Accessed July 12, 2011.
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