Don’t suffer in silence.
Crohn’s Disease is an autoimmune disorder that causes long-term inflammation in the digestive tract, forming patches of damaged tissue. The symptoms — such as diarrhea, abdominal pain, fatigue and weight loss — may come and go, with times when they get worse (flare-ups) and times when they improve (remission). Other parts of the body may also be affected, such as the joints, skin, eyes or liver.
Having Crohn’s Disease can significantly interfere with your work, school and social life. You may feel anxious or fearful of the next flare-up, or very isolated due to the stigma associated with it.
The journey to getting a diagnosis can take several years with multiple doctor visits, tests and procedures. However, treatment can help reduce the symptoms and prevent future flare-ups. Inevitably, surgery may be needed to help manage the condition.
Although there is no known cure for Crohn’s Disease, clinical researchers are seeking to better understand and treat it. Read on to learn more.
If you have Crohn’s Disease, we would like to hear from you.
- Take our brief online survey to be considered for an upcoming clinical trial.*
- We also invite you to join our IBD Team online patient community to connect with others facing this condition.
*If you are eligible and choose to participate, you will receive all study-related care and study medication at no cost during your participation. Compensation for study-related travel costs may also be provided.
Thank you for sharing with us.
Symptoms & Complications
What are the symptoms of Crohn’s Disease?
No two people with Crohn’s Disease will have the same symptoms or severity. Any part of the digestive tract may be affected, but for most, the last part of the small intestine (called the ileum) and the colon are primarily affected.
The main symptoms include:
- Diarrhea, sometimes mixed with blood, mucus and pus.
- Cramping pains in the abdomen, which can be very severe and often occur before passing a stool.
- Tiredness and fatigue, either due to the illness itself, or from lack of sleep from pain or diarrhea at night, or as a side effect of medication used to treat it.
- Feeling generally unwell or feverish.
- Loss of appetite and weight loss, due to inflammation in the gut which affects the body’s ability to process nutrients.
- Anemia (a reduced number of red blood cells), which can result from loss of blood and not eating much.
- Mouth sores (ulcers).
What other signs and symptoms can Crohn’s Disease have?
Because Crohn’s Disease is an autoimmune disorder, it can cause inflammation in other parts of the body beyond just the gastrointestinal tract. These “extra-intestinal manifestations” of the disease may affect:
- Eyes (redness, pain, and itchiness)
- Mouth (sores)
- Joints (swelling and pain)
- Skin (tender bumps, painful ulcerations and other sores/rashes)
- Bones (osteoporosis)
- Kidney (stones)
- Liver [primary sclerosing cholangitis, hepatitis (inflammation) and cirrhosis (scarring)]
What are the possible complications of Crohn’s Disease?
Most people with Crohn’s Disease do not have any complications, but for some it may lead to problems such as bleeding, blockage or infection. Below are some of the potential complications:
- Bowel obstruction – Over time, parts of the bowel may thicken and narrow, causing it to become blocked. Passing bowel movements may become difficult and surgery may be necessary to remove the affected portion of the bowel.
- Malnutrition – Ongoing diarrhea, abdominal pain and cramping may make it difficult to eat or for the intestine to absorb enough nutrients. Crohn’s disease may cause low iron or vitamin B12, leading to anemia.
- Ulcers – Chronic inflammation can lead to open sores (ulcers) in the digestive tract, such as the mouth, anus, or genital area (perineum).
- Fistulas – when an ulcer extends completely through the intestinal wall, most commonly in the anal area (perianal). In some cases, a fistula may become infected and form an abscess.
- Anal fissure – a small tear in the tissue that lines the anus or in the skin around the anus, which often causes painful bowel movements and may lead to a fistula.
- Medication side effects – Certain medications for Crohn’s Disease may raise the risk of developing certain cancers. Corticosteroids can also raise the risk of osteoporosis, high blood pressure and other conditions.
- Other diseases – People with Crohn’s Disease are at a slightly greater risk for some other diseases, including colon cancer, blood clots, and primary sclerosing cholangitis (PSC) – where inflammation causes scars within the bile ducts, leading them to narrow, which can gradually lead to liver damage.
Sources: Mayo Clinic, CDC, Crohn’s and Colitis Foundation; and Crohn’s and Colitis UK
Causes & Risk Factors
What causes Crohn’s Disease?
The causes of Crohn’s Disease are not fully known, but a combination of factors is believed to be involved:
- Genetics – People with a close relative who has Crohn’s Disease are more likely to develop it. This suggests genes may make you more susceptible to it.
- Immune system – There are several theories about why the immune system malfunctions, either in response to a viral or bacterial infection, or due to an imbalance of bacteria in the gut, or mistakenly in response to “good” bacteria in the gut.
Who is at risk for developing Crohn’s?
- Age – People can develop Crohn’s Disease at any age, but it is usually diagnosed by around the age of 30.
- Ethnicity – Caucasians and Jews of European descent (Ashkenazi Jews) have the highest prevalence of Crohn’s Disease amongst ethnic groups. The incidence is also increasing among blacks who live in North America and the United Kingdom.
- Geography – People who live in Westernized countries are more likely to develop Crohn’s Disease, suggesting that certain environmental factors, such as a diet high in fat or refined foods, may play a role. People living in northern climates also seem to be at greater risk.
- Smoking – People who smoke are twice as likely to get Crohn’s Disease than those who don’t.
- Medication side effects – Some medications, known as nonsteroidal anti-inflammatory drugs (NSAIDS), may increase the risk of developing Crohn’s or worsen the disease in people who have it.
Sources: Mayo Clinic; Crohn’s and Colitis Foundation
Diagnosis & Treatment
How is Crohn’s Disease diagnosed?
Gastroenterologists (specialists in diseases of the digestive tract) use a variety of tests and procedures to diagnose Crohn’s Disease and rule out other potential causes of inflammation. These may include:
- Blood tests – to check for anemia or signs of infection.
- Stool (fecal) sample – to check for blood in the stool.
- Colonoscopy – a procedure used to view the entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, a biopsy (tissue sample) may also be taken for evaluation.
- Sigmoidoscopy – a procedure used to examine the rectum and sigmoid (the last portion of the colon) with a slender, flexible, lighted tube.
- Endoscopy – a procedure used to examine the esophagus, stomach and first part of the small intestine (duodenum) using a slender, flexible, lighted tube.
- Capsule endoscopy – a procedure sometimes used to examine the small intestine, in which a small capsule containing a camera is swallowed and the images are transmitted to a recorder. The capsule is passed painlessly through the urine.
- Balloon-assisted endoscopy – a procedure sometimes used to get a deeper view of the small intestine with a scope and balloon(s).
- X-ray – taken of the abdominal area to check for certain problems such as a perforated colon.
- Computerized tomography (CT) scan – to check for problems with any part of the entire bowel, or tissues outside the bowel, including the small intestines.
- Magnetic resonance imaging (MRI) – may be used for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography).
Sources: Mayo Clinic; NHS; American Society for Gastroenterological Endoscopy; Crohn’s and Colitis Foundation
How is Crohn’s Disease treated?
There is no known cure for Crohn’s Disease. Treatment is aimed at relieving the symptoms and preventing future flare-ups or complications, through a combination of diet, lifestyle changes, medicines and surgery.
Medicines used to treat Crohn’s Disease:
- Aminosalicylates or mesalazines (given by mouth, enemas or suppositories) – a group of medicines used to treat inflammation of the gut. They may be used as maintenance therapy in patients with mild inflammation.
- Immunosuppressants – such as steroids or azathioprine, used to “turn down” the immune system response.
- Biologics – specially developed medicines given as shots (injection) or as intravenous infusions (IV) that target a specific part of the immune system.
- Antibiotics – used to treat an infection.
- Steroids - a type of medication which may be used for a short time for active disease, but not generally used as maintenance treatment due to side effects.
Some people are treated with a combination of medicines.
- Surgery for Crohn’s Disease: Up to 70% of people with Crohn’s Disease will need surgery to remove the damaged areas of the gastrointestinal tract, and up to 60% of these people will need repeat surgery within 10 years.
- Nutrition Therapy: Your doctor may recommend a special diet given via a feeding tube (enteral nutrition) or nutrients injected into a vein (parenteral nutrition) to treat your Crohn’s Disease. This can improve your overall nutrition and allow the bowel to rest. Bowel rest can reduce inflammation in the short term, for example, prior to surgery or when medicines fail to control symptoms.
Diet: Your doctor may also recommend a low residue or low-fiber diet to reduce the risk of intestinal blockage if you have a narrowed bowel (stricture). A low residue diet is designed to reduce the size and number of stools.
In general, it is important to eat a healthy and balanced diet and it may be helpful to avoid foods that may irritate your gastrointestinal tract. Suggestions during flare-ups include:
- Eat smaller meals at more frequent intervals
- Reduce the amount of greasy or fried foods in your diet
- Limit consumption of milk or milk products
- Restrict your intake of certain high-fiber foods such as nuts, seeds, corn, and popcorn
Sources: Crohn’s & Colitis UK; Crohn’s and Colitis Foundation of America
- Exercise: Getting regular exercise can help with managing fatigue and keeping a positive outlook. Current research is looking into which types of exercise may have the greatest positive effect, such as high-intensity interval training, but it is best to speak with your doctor to determine which exercise, and amount, is right for you.
- Clinical Trials: Clinical trials are helping medical researchers better understand, diagnose and treat Crohn’s Disease in the future. Learn more.
The symptoms of Crohn’s Disease can make you feel awkward or distressed. There are several resources available to help provide helpful tips on how to handle certain situations, a few of which are listed below:
- For more about foods and diet, see the Crohn’s and Colitis UK’s leaflet, Food – Your Guide.
- Tips on Living With Crohn’s Disease are available from the Crohn’s and Colitis Foundation of America’s website.
- Crohn’s & Colitis UK offers an online tool called Crohn’s & IBD Companion to help anyone diagnosed with IBD explore a number of topics and find information, guidance and support.
- WebMD provides an article on “When Your Partner Has Crohn’s” with helpful information for partners of someone living with Crohn’s Disease, such as tips on what to/not to say.
- World IBD Day takes place on 19th May every year to help raise awareness about IBD and unite people worldwide in their fight against Crohn’s Disease and ulcerative colitis. The website provides links to national organizations and related events around the world.
Clinical Trials – Learn More
Clinical trials are investigating potential treatments for people with Crohn’s Disease. They are often seeking volunteers to take part.
If you are eligible and choose to participate, you will receive all study-related care and study medication at no cost during your participation.
Have you considered taking part in a clinical trial for people with Crohn’s Disease?
Potential benefits of participating in a clinical trial include:
- Close care and monitoring by a study doctor and staff throughout the study
- No cost for study treatment, related tests and procedures
- Contribute to our understanding of the treatment options for Crohn’s Disease in the future
If you would like to be considered for an upcoming clinical trial in Crohn’s Disease, take our survey.
Please take some time to answer a few questions and be considered for an upcoming clinical trial for people with Crohn’s Disease. We also invite you to join our IBD Team community to connect with others affected by the disease.
Thank you for sharing with us.
If you would like to be notified about an upcoming clinical trial, you may sign up at the end of our survey.