Symptoms of Crohn’s Disease

Crohn’s disease is a chronic inflammatory condition that can affect any part of the digestive tract, most often the end of the small intestine (ileum) and the beginning of the large intestine (colon). It belongs to a group of conditions called inflammatory bowel disease (IBD). While the exact cause isn’t fully understood, the immune system, genetics and environmental factors all play roles. Understanding the common symptoms can help you recognize when to seek medical advice and manage your health effectively.

Common Intestinal Symptoms

People with Crohn’s often experience a range of gastrointestinal symptoms. These may come and go in “flare-ups,” or become persistent over time.

• Abdominal pain and cramping
  • Often in the lower right abdomen, but can occur anywhere
  • May worsen after eating or during flare-ups
• Chronic diarrhea
  • Loose, urgent stools that may occur several times a day
  • Can lead to dehydration and electrolyte imbalance
• Blood or mucus in the stool
  • Bright red blood or darker, tar-like stools
  • Indicates inflammation or ulceration in the digestive tract
• Bloating and gas
  • Feeling of fullness or excessive gas
  • Can be uncomfortable and embarrassing
• Urgent bowel movements
  • Sudden need to go, sometimes leading to accidents
  • Interferes with daily activities and sleep

Systemic and General Symptoms

Inflammation in Crohn’s isn’t confined to the gut. Many people experience symptoms that affect the whole body.

• Fatigue and low energy
  • Constant tiredness, even after plenty of rest
  • May result from inflammation, poor nutrition or anemia
• Unintentional weight loss
  • Due to reduced appetite, malabsorption of nutrients or avoiding foods that trigger symptoms
• Fever
  • Mild fever during active inflammation
  • Higher fever may suggest complications (abscesses, infections)
• Loss of appetite
  • Pain or nausea around mealtimes
  • Leads to missed meals and further weight loss

Extra-Intestinal Manifestations

Up to one-third of people with Crohn’s disease develop symptoms beyond the digestive tract. These “extra-intestinal” signs can affect the skin, eyes, joints and liver.

• Mouth sores (aphthous ulcers)
  • Small, painful ulcers on the inside of the cheeks or gums
  • Often accompany gut flare-ups
• Skin issues
  • Red bumps or nodules, especially on the shins (erythema nodosum)
  • Small pus-filled spots (pyoderma gangrenosum)
• Joint pain and swelling
  • Arthritis in large joints (knees, hips, ankles)
  • Can be migratory—moving from one joint to another
• Eye inflammation
  • Red, painful eyes (uveitis or episcleritis)
  • Sensitivity to light and blurred vision
• Liver and bile tract problems
  • Primary sclerosing cholangitis (PSC) – scarring of bile ducts
  • Gallstones and fatty liver are also more common

Complications and Severe Signs

When Crohn’s disease is left untreated or becomes severe, complications can arise in and around the intestines.

• Intestinal strictures
  • Scar tissue narrows segments of the bowel
  • Causes obstruction, leading to cramping, vomiting and constipation
• Fistulas
  • Abnormal tunnels between the intestine and other organs (bladder, skin)
  • May lead to infections, abscesses or persistent drainage
• Abscesses
  • Pockets of pus caused by infection
  • Present as tender, swollen areas, often near the anus or in the abdominal cavity
• Malnutrition and nutrient deficiencies
  • Poor absorption of vitamins (B12, D), iron and minerals
  • Can lead to anemia, bone thinning and other systemic issues
• Growth delays (in children)
  • Inflammation and poor nutrient uptake can slow growth and delay puberty

When to Seek Medical Help

While mild symptoms may come and go, certain signs always warrant prompt medical attention:

• High fever (>100.4°F or 38°C) that won’t subside
• Severe abdominal pain or rigidity
• Continuous vomiting or inability to keep fluids down
• Heavy bleeding or large amounts of blood in the stool
• Signs of dehydration: dizziness, dry mouth, reduced urination
• New lumps or areas of redness/swelling near the anus
• Sudden weight loss or persistent fatigue

If you experience any of the above, or if your usual symptoms suddenly worsen, speak to a doctor immediately.

Assessing Your Symptoms

If you’re unsure whether your symptoms could be related to Crohn’s disease, you might consider doing a free, online symptom check for Crohn’s disease. These tools can help you gather information before consulting a healthcare professional.

Next Steps and Talking to Your Doctor

1. Keep a symptom diary
   • Note what you eat, stress levels, medication, and how you feel each day.
2. List all your symptoms and their severity
   • Include extra-intestinal issues like skin or joint changes.
3. Prepare questions for your appointment
   • Ask about tests (colonoscopy, blood work, imaging), treatment options, and diet changes.
4. Discuss any life-threatening or serious concerns
   • Always let your provider know about severe pain, bleeding or other alarming signs.

No online resource can replace a personalized medical evaluation. If you suspect Crohn’s disease or experience any life-threatening symptoms, please speak to a doctor as soon as possible. Early diagnosis and treatment can help manage inflammation, relieve symptoms and reduce the risk of complications.