Complications You May Experience If You Have Crohn's Disease
dragana991 / Getty Images
Medically reviewed by Robert Burakoff, MD
Crohn's disease (CD) is an inflammatory bowel disease (IBD) that causes swelling and irritation of the gastrointestinal (GI) tract. Common symptoms include diarrhea, abdominal pain, fatigue, and unintentional weight loss. Crohn’s disease can cause GI complications like intestinal obstructions, fistulas (abnormal tunnels), abscesses (pockets of infection), and perianal complications, among others.
The gastrointestinal tract refers to the structures within the digestive system, which is the part of your body that breaks down food and absorbs nutrients. Structures of the GI tract begin with the mouth and continue to the anus (where stool exits the body).
Crohn's disease can also lead to extraintestinal (outside the GI tract) complications such as arthritis, gynecologic problems, kidney stones, malnutrition, and skin sores.
Here at Health, we know how important it is to share the experiences of those with chronic conditions. We asked Health's Crohn's disease advocate Gaylyn Henderson to share some topics frequently discussed by those within the Crohn's disease community, which led to the creation of this article.
Symptoms of CD
Your immune system uses inflammation to fend off harmful substances like viruses and bacteria. This inflammation can cause swelling, fever, irritation, redness, sores, or pain.
With Crohn’s, inflammation is likely due to an abnormal immune response to normal gut flora (good bacteria in your intestines), making it an autoimmune disorder. While Crohn’s can affect any part of the GI tract, it most commonly affects the small and large intestines.
The Small and Large Intestines
The small and large intestines (bowels) are the long tubes in your abdomen that transport food and stool from the stomach to the anus. Other terms concerning the intestines include:
Ileum: A section of the small intestine
Colon: A term for the large intestine
Rectum: The last section of the large intestine
The most common symptoms of Crohn's disease include:
Abdominal pain and cramping
Diarrhea (loose or runny stool)
Fatigue (extreme over-tiredness)
Unintentional weight loss
Other symptoms may include:
Fever
Joint pain
Loss of appetite
Skin nodules (red, tender bumps under the skin) or skin sores
Ulcers (open sores in your mouth, intestines, or perianal area)
Eye problems (eye pain, redness, or sensitivity to light)
Possible Complications of Crohn’s Disease
Crohn’s related inflammation can lead to complications within the GI tract and outside of the digestive tract (extraintestinal manifestations). These complications include bowel obstruction, fistulas, abscesses, and malnutrition, amongst others.
Frequently Asked Questions
Crohn's Can Affect Your Whole Body
A common misconception is that Crohn's disease only impacts the gastrointestinal system. That is false. Crohn's disease is an inflammatory autoimmune disease that can impact your entire body. Crohn's disease can impact your joints, skin, and eyes, cause incredible fatigue, and more. It is important to pay attention to new symptoms and alert your medical care team of any alarming symptoms.
Bowel Obstruction
Ongoing intestinal (bowel) inflammation can cause scar tissue and strictures (thickening and narrowing). This creates an obstruction or blockage, making it difficult for food, stool, or fluids to pass. Bowel obstructions can cause:
Bloating (stomach swelling)
Constipation (not being able to pass poop)
Lack of flatus (not being able to pass gas)
Nausea and vomiting
People at higher risk include those with long-standing Crohn’s and frequent flare-ups—especially when it affects the small intestines—or those who have had multiple intestinal surgeries.
Fistulas
Fistulas are abnormal tunnels that develop between different organs. With Crohn’s, they connect between the intestine and the skin, vagina, bladder, or other parts of the bowel. They are most common for those with deep, chronic inflammation that affects all three layers of the intestinal wall.
Abscesses
Fistulas can cause pain, infection, or abscesses. Abscesses are pockets of infection that collect pus and cause a fever, pain, and swelling. People with active Crohn’s—especially those with a history of fistulas—are at higher risk of developing abscesses.
Perianal Complications
Perianal (anus and surrounding skin) complications affect 25% of those with CD and can occur with any amount of inflammation. Anal fissures are an example. They cause tearing of the anal lining, leading to itching, pain, or bleeding.
Malnutrition
Those with long-term intestinal inflammation and diarrhea have more difficulty absorbing nutrients from their food. This can lead to malnutrition, which causes weakness, weight loss, and delayed growth and development.
Anemia
When a person with Crohn’s has chronic GI bleeding or excessive menstrual (period) bleeding, they may experience anemia (having fewer red blood cells than usual). Symptoms include fatigue, weakness, and pale skin.
Arthritis
Crohn’s related arthritis is the most common form of extraintestinal inflammation (complications that occur outside of the intestinal inflammation caused by CD). It causes joint pain and stiffness of the large joints, such as the knees, ankles, wrists, and elbows. Arthritis is more common in those whose large intestine (colon) is more affected by CD inflammation.
Crohn’s-related arthritis occurs along with flare-ups and resolves with Crohn’s treatment. It typically affects less than six joints and does not cause long-term damage.
Other types of arthritis can cause long-term damage. However, their symptoms typically occur independently of CD flare-ups and do not resolve with CD treatment. A rheumatologist (a doctor who specializes in inflammatory conditions) can help determine the type of arthritis you have and suggest medications that reduce your risk of long-term damage.
Rheumatoid Arthritis (RA) and Crohn's
Rheumatoid arthritis (RA) is an autoimmune disease affecting many joints, including the hands, wrist, and feet. While RA is not directly caused by Crohn's, those with IBD are at a slightly higher risk of developing it.
Gynecological Concerns
For people with Crohn's who have female reproductive organs, complications that may affect the reproductive system include:
Menstrual irregularities: This includes more premenstrual symptoms (PMS), irregular or missed periods, heavy or prolonged menstrual bleeding, and heavy cramping.
Worsening Crohn’s symptoms: CD symptoms may worsen with hormone changes throughout the menstrual cycle and period (menstrual bleeding).
Infertility: While CD doesn't cause infertility, many people with uteruses who have IBD have more difficulty getting pregnant.
Vaginal fistulas: Fistulas can cause diarrhea to pass through the vagina, which is next to the urethra (where pee exits the body). Diarrhea can easily transmit bacteria into the urinary tract, causing an infection (UTI).
Pregnancy complications: This includes a higher risk of gestational diabetes, miscarriage, preterm delivery, and low birth weight.
Decreased sexual health: CD can lead to painful sex, pelvic pain, difficulty achieving orgasm, and skin sores in the genital area.
Endometriosis: Endometriosis is when the endometrium (tissue that is similar to the lining of the uterus) grows outside the uterus (womb). It causes symptoms similar to CD, like abdominal pain, pain with sex, and diarrhea. Those with endometriosis have a 50% higher risk of IBD.
Kidney Stones
Kidney stones are tiny, hard particles or crystals that form in your kidneys and cause severe pain as they travel to the bladder. They are more common when Crohn’s affects the small intestine. Kidney stones are more common with CD due to the malabsorption of bile salts, fatty acids, and certain minerals such as calcium.
Medication Side Effects
Crohn's disease treatment, such as corticosteroids and immunosuppressants, can contribute to complications such as:
Osteoporosis (bone-thinning)
Adrenal insufficiency (when your adrenal glands don't create enough of the hormone cortisol)
Weight gain
Eye disease (e.g. cataracts, glaucoma)
High blood pressure
Diabetes
Infection
Mental Health Concerns
Living with IBD can lead to mental health complications like anxiety or depression. It can also negatively impact one's social life and romantic relationships, leading to isolation and loneliness.
Skin Conditions
After arthritis, the most common extraintestinal symptoms people with Crohn's experience are skin concerns. The most common skin conditions that occur with Crohn’s are:
Erythema nodusum: Painful, red, nodules (bumps on the skin) that occur with CD flare-ups
Pyoderma gangrenosusm: A rare disorder that causes painful skin sores that arise independently of CD flare-ups
Skin tags: These small flaps of extra skin are especially common around the anus
Toxic Megacolon
Toxic megacolon is a rare, life-threatening complication that can cause a ruptured colon, sepsis (severe blood infection), and shock. The risk is higher for those with extensive colon involvement or those who don't respond well to treatment.
Toxic megacolon is a medical emergency. Symptoms include:
Abdominal pain and distention (stomach sticking out)
Dehydration (not having enough fluid in the body)
Decrease in bowel movements
Fever (over 100.4 degrees)
Rapid heart rate (more than 120 beats per minute)
Colon Cancer
While colon cancer is not a complication of Crohn's, those with CD are at a higher risk. This is especially true when the disease affects the large intestine (colon).
Primary Sclerosing Cholangitis
Those with IBD are at a higher risk of primary sclerosing cholangitis (PSC), a rare, autoimmune liver disease. PSC causes inflammation and strictures in the liver and bile ducts (tubes that carry digestive fluid). While PSC is more common in people with ulcerative colitis (UC) (the other type of inflammatory bowel disease, or IBD), it can occur with Crohn's, especially when it heavily affects the colon.
How to Prevent Crohn’s Disease Complications
Creating a self-care routine can help prevent flare-ups and minimize symptoms, which decreases your risk of complications. Here are some strategies to help minimize your risk.
Medications: Following your medication plan can help control inflammation and reduce the risk of flare-ups. Discuss any of your medication concerns with your prescribing healthcare provider as soon as they arise.
Regular checkups: Attending regular healthcare checkups allows for early detection and treatment of new symptoms or changes in your condition.
Healthy food: While no one diet causes or cures Crohn’s, it’s important to eat healthy, nutritious foods that do not trigger a flare-up. If you are unsure which foods are best for you, consider consulting a nutritionist or dietitian specializing in gastrointestinal disorders.
Consider multivitamins and supplements: Common supplements for those with Crohn’s include multivitamins, vitamin B12, folic acid, vitamin D, calcium, probiotics, and iron. Consult with your healthcare providers to decide which may be necessary and safe for you.
Drink plenty of water: This helps cushion your joints and eliminate waste from your body (which decreases inflammation).
Avoid triggers: Triggers may include certain foods, medications, stress, or sleep deprivation (lack of sleep). While not everyone’s triggers are the same, some common trigger foods include greasy or fried foods, dairy, high fiber, spicy foods, and alcohol.
Smoking cessation: Smoking cigarettes can cause inflammation and trigger flare-ups. If you smoke, quitting can help you feel better and decrease your risk of complications.
Prioritize sleep: Sleep boosts your immune system, helps you manage stress, and improves your mood (making you more likely to practice self-care).
Stress management: Stress reduction techniques such as deep breathing exercises, yoga, tai chi, meditation, or practicing a hobby can help reduce your risk of flare-ups.
Physical activity: Regular, mild-to-moderate physical activity helps reduce stress, improve bone strength, increase energy, and boost your immune system. If you are a beginner or are experiencing fatigue, start slowly.
Support system: A strong network of friends, family, and support groups can help provide emotional and practical support, strengthening your ability to follow a self-care routine.
When to Contact a Healthcare Provider
Contact your healthcare provider before changing medications or taking over-the-counter medications or supplements. You can also help reduce your risk of complications by contacting them if you experience:
The inability to hold down fluids
Fever (over 100.4 degrees)
Worsening or unusually severe symptoms
Persistent symptoms that don’t resolve with treatment
New symptoms
Unexplained weight loss
Mental health changes
Signs of dehydration (thirst, dry skin or lips, less or dark pee, lightheadedness, headache, dizziness)
A Quick Review
Crohn's disease (CD) causes swelling and irritation of the gastrointestinal (GI) tract. Common symptoms include diarrhea, abdominal pain, fatigue, and weight loss. Crohn’s can cause GI complications like bowel obstructions, fistulas, infection, and anal fissures. It can also cause complications such as arthritis, gynecologic problems, kidney stones, malnutrition, and skin conditions. Practicing self-care can help minimize inflammation, reducing your risk of complications.
For more Health.com news, make sure to sign up for our newsletter!
Read the original article on Health.com.
