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Complications

By Mayo Clinic staff

Crohn's disease may lead to one or more of the following complications:

  • Bowel obstruction. Crohn's disease affects the entire thickness of the intestinal wall. Over time, parts of the bowel can thicken and narrow, which may block the flow of digestive contents through the affected part of your intestine. Some cases require surgery to remove the diseased portion of your bowel.
  • Ulcers. Chronic inflammation can lead to open sores (ulcers) anywhere in your digestive tract, including your mouth and anus, and in the genital area (perineum) and anus.
  • Fistulas. Sometimes ulcers can extend completely through the intestinal wall, creating a fistula — an abnormal connection between different parts of your intestine, between your intestine and skin, or between your intestine and another organ, such as the bladder or vagina. When internal fistulas develop, food may bypass areas of the bowel that are necessary for absorption. An external fistula can cause continuous drainage of bowel contents to your skin, and in some cases, a fistula may become infected and form an abscess, a problem that can be life-threatening if left untreated.
  • Anal fissure. This is a crack, or cleft, in the anus or in the skin around the anus where infections can occur. It's often associated with painful bowel movements.
  • Malnutrition. Diarrhea, abdominal pain and cramping may make it difficult for you to eat or for your intestine to absorb enough nutrients to keep you nourished. Additionally, anemia is common in people with Crohn's disease.
  • Other health problems. In addition to inflammation and ulcers in the digestive tract, Crohn's disease can cause problems in other parts of the body, such as arthritis, inflammation of the eyes or skin, clubbing of the fingernails, kidney stones, gallstones and, occasionally, inflammation of the bile ducts. People with long-standing Crohn's disease also may develop osteoporosis, a condition that causes weak, brittle bones.

IBD and colon cancer
Having Crohn's disease increases your risk of colon cancer. Despite this increased risk, more than 90 percent of people with inflammatory bowel disease never develop cancer.

Your risk is greatest if you've had inflammatory bowel disease for at least eight years and if it has spread through your entire colon. The longer you've had the disease and the larger the area affected, the greater your risk of colon cancer. The risk of other cancers also is increased, including cancer of the anus.

Medications and cancer risk
Immune system suppressors also are associated with a small risk of cancer development. These include azathioprine, mercaptopurine, methotrexate, infliximab and others. The risk may be due to the immune system suppression that these medications cause. While these medications do increase risk, they may be necessary for people with Crohn's disease to improve quality of life and avoid surgery or hospitalization. Work with your doctor to determine which medications are right for you.

Preparing for your appointment Risk factors
References
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  2. Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/. Accessed June 21, 2009.
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  6. Werman HA, et al. Ileitis, colitis, and diverticulitis. In: Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, N.Y.: McGraw Hill; 2004. http://www.accessmedicine.com/content.aspx?aID=592744. Accessed June 21, 2009.
  7. Learning about Crohn's disease. National Human Genome Research Institute. http://www.genome.gov/pfv.cfm?pageID=25521854. Accessed June 17, 2009.
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  16. FDA approves Cimzia to treat Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
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Aug. 8, 2009

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