Crohn’s
Symptoms

Crohn’s disease symptoms range from mild to severe. They may vary over time and from person to person, depending on what part of the gastrointestinal (GI) tractCollectively referring to the mouth, esophagus, stomach, small and large intestines, and anus. is inflamed. And because symptoms vary from person to person, the way to gauge what you consider a flare-up of symptoms is relative to what is “normal” for you.

Common Crohn’s disease symptoms include:

• Frequent, recurring diarrhea
• RectalLowest portion of the large intestine that connects to the anus. bleeding
• Unexplained weight loss
• Fever
• Abdominal pain and cramping
• Fatigue and a feeling of low energy
• Reduced appetite

Crohn’s can affect the entire GI tract — from the mouth to the anus — and can be progressiveIncreasing in extent or severity., so over time, your symptoms could get worse. That's why it's important that you have an open and honest conversation about your symptoms, since your doctor will use that information to help determine what treatment plan is best for you.

It might be helpful to refer to the chart below to help you understand the differences between mild, moderate and severe symptoms, since your doctor may use similar measures.

Crohn’s Disease Symptom Severity

Once you and your doctor have discussed your symptoms and created a treatment plan, it’s important to follow directions and take your treatment as prescribed. If you ever have any questions or concerns about your treatment, you should contact your doctor before making any changes or adjustments.

Crohn’s disease is unpredictable. Over time, your symptoms may change in severity, or change altogether. You may go through periods of remission—when you have few or no symptoms. Or your symptoms may come on suddenly, without warning.

Millie Long, M.D., M.P.H., is an Associate Professor at the University of North Carolina Chapel Hill School of Medicine.

The location of your disease may determine what kind of symptoms you have

The five types of Crohn’s disease and their symptoms:

• Ileocolitis

  Affects the end of the small intestine (the ileum) and the large intestine (the colon). Symptoms include weight loss, diarrhea and cramping or pain in the middle or right lower abdomen.

• Ileitis

  Affects the ileum. Symptoms include weight loss, diarrhea and cramping or pain in the middle or right lower abdomen.

• Jejunoileitis

  Characterized by patchy areas of inflammation in the upper half of the small intestine (the jejunum). Symptoms include mild to strong abdominal pain and cramps following meals, as well as diarrhea.

• Gastroduodenal Crohn’s disease

  Affects the stomach and the beginning of the small intestine (the duodenum). Symptoms include loss of appetite, weight loss, nausea, and vomiting.

• Crohn’s colitis

  Affects the colon. Symptoms include diarrhea, rectal bleeding, and disease around the anus (abscess, fistulas, ulcers).

Complications of Crohn’s disease

Along with painful symptoms, Crohn’s disease can lead to complications in your intestines such as:

• Obstruction (blockage) of the intestines
• Formation of scar tissue
• Fissures (small cuts or tears in the anal canal, which may bleed)
• Abscesses (localized infection or collection of pus)
• Fistulas (abnormal tunnels that form between two structures of the body)

Your doctor may recommend surgery to remove a damaged portion of your digestive tract to close fistulas, remove scar tissue, or to repair damage caused by Crohn’s disease.

In addition to the symptoms listed above, Crohn’s disease complications may include:

• Increased risk of colon cancer, due to chronic inflammation of the colon
• Vitamin and mineral deficiencies:
  • Chronic inflammation of the small intestine, or patients who have had damaged portion of their intestines removed, may have issues with malabsorption of the vitamin B-12.
  • Over time, blood loss from inflammation and ulceration of the intestines can lead to iron-deficiency anemia.
  • People with Crohn’s disease can have decreased vitamin D, which can lead to bone loss (osteopeniaReduction in bone volume to below normal levels. and/or osteoporosisA condition that is characterized by the decrease in bone mass with decreased bone density causing brittle bones, usually occurs in older women.). Corticosteroid use can make bone loss worse.
• Kidney stones can be a complication if you have Crohn’s in the small intestine.

Crohn’s can affect more than the GI tract

Sometimes, Crohn’s disease causes inflammation outside of the GI tract, in areas such as:

These symptoms are called extra-intestinalSituated or occurring outside the intestines. symptoms and can also be linked to inflammation. You should talk to your doctor if you experience any symptoms—even if they seem to have nothing to do with your gastrointestinal tract.

Inflammation can lead to Crohn’s disease symptoms

Painful flare-upsThe sudden intensification of disease symptoms or the return of symptoms suddenly. occur when the lining of your intestines swells and thickens, obstructing normal movement of food through your digestive tract. Learn more about your Crohn’s symptoms and how they could be linked to damaging inflammation with Expert Advice.