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Symptoms
By Mayo Clinic staffSigns 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 the most 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
- 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: Clinical features. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Saunders Elsevier; Philadelphia, Pa.: 2006. http://www.mdconsult.com/das/book/body/144932667-3/0/1389/810.html?tocnode=51643270&fromURL=810.html#4-u1.0-B1-4160-0245-6..50113-X--cesec14_5163. Accessed June 21, 2009.
- Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/. Accessed June 21, 2009.
- Crohn's disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec02/ch018/ch018b.html. Accessed June 17, 2009.
- Peppercorn MA. Clinical manifestations, diagnosis and natural history of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
- 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 17, 2009.
- 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.
- Learning about Crohn's disease. National Human Genome Research Institute. http://www.genome.gov/pfv.cfm?pageID=25521854. Accessed June 17, 2009.
- Inflammatory bowel disease. In: Rakel RE, et al. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/144932667-4/854785995/1621/261.html#4-u1.0-B978-1-4160-4435-2..50133-3--cesec17_2085. Accessed June 21, 2009.
- Accutane (prescribing information). Nutley, N.J.: Roche. 2008. http://www.rocheusa.com/products/accutane/pi.pdf. Accessed June 23, 2009.
- Draganov PV. Colorectal cancer surveillance in inflammatory bowel disease: The search continues. World Journal of Gastroenterology. 2009;15:61.
- Ingle SB, et al. The natural history of perianal Crohn's disease. Digestive and Liver Disease. 2007; 39:963.
- Piton G, et al. Big risk, small risk: Small bowel cancer in Crohn's disease. Inflammatory Bowel Diseases. In press. Accessed June 23, 2009.
- Crohn's disease: Treatment. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/144932667-3/0/1389/813.html?tocnode=51643292&fromURL=813.html#4-u1.0-B1-4160-0245-6..50113-X--cesec36_5185. Accessed June 21, 2009.
- Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
- FDA approves new treatment for Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
- FDA approves Cimzia to treat Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
- FDA approves Tysabri to treat moderate-to-severe Crohn's disease: Drug currently approved for use in treating some forms of multiple sclerosis. Accessed June 23, 2004.
- Diet and nutrition. Crohn's and Colitis Foundation of America. http://www.ccfa.org/info/diet. Accessed June 23, 2009.
- 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.
- Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
- Korzenik JR. Investigational therapies in the medical management of Crohn's disease. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
- Picco MF (expert opinion). Mayo Clinic. Jacksonville, Fla. July 9, 2009.
- Follow-up to the June 4, 2008, early communication about the ongoing safety review of tumor necrosis factor (TNF) blockers (marketed as Remicade, Enbrel, Humira, Cimzia and Simponi). Food and Drug Administration. Accesed August 4, 2009.
