Is Crohn’s Disease Fatal?

Amber J. Tresca
·8 min read

Medically reviewed by Robert Burakoff, MD, MPH

Crohn’s disease can be serious, but it is not considered a fatal condition. However, there is the potential for severe or even life-threatening complications. Crohn’s disease is a form of inflammatory bowel disease (IBD) which currently has no cure.

This condition can affect any part of the digestive system but is most common in the ileum (lower end of the small intestine) and the colon (large intestine). It can lead to signs and symptoms in many areas of the body.

This article will discuss the potential outcomes of Crohn’s disease and what people who live with the condition should know about life expectancy.

<p>shapecharge / Getty Images</p>

shapecharge / Getty Images

Can You Die From Crohn’s Disease?

Crohn’s disease isn’t usually thought of as being a fatal disease. It’s considered to be a chronic condition—one that lasts a long time and needs regular management.

However, Crohn’s disease can be quite serious in some people. It can cause complications that might be life-threatening. Plus, people with Crohn’s disease may need to have treatments like surgery, which carry their own risk. Whether or not Crohn’s played a small or a large role in a person’s death can be complicated to untangle.

The thought of having a disease that could be fatal can be upsetting and could lead to difficult emotions. People with chronic conditions like Crohn’s may want to take care to address their mental health as well as their physical health.

Currently, the best way to avoid potential complications is to see a healthcare provider regularly and to treat the inflammation caused by Crohn’s disease as well as possible.



Life Expectancy in IBD

IBD may have a small effect on shortening life expectancy. A study published in 2020 showed that life expectancy in people with IBD has been increasing in recent decades. However, it was still slightly lower than it is for people who don't live with a form of IBD.

A 2023 study showed that people with IBD are no more likely to die than people who don't live with the disease. However, it noted that people with Crohn's disease and their healthcare providers should be aware of risks such as cardiovascular disease and infections.



Factors That Affect Crohn’s Disease Life Expectancy

A 2022 study from Sweden found that, over 10 years, people with Crohn’s had the same mortality as the general population. However, some things affected mortality.

The study found:

  • Survival was lower for people diagnosed before 1985.

  • Older females had a greater mortality (especially when diagnosed before 1985).

  • Having disease in the colon and complications like stricture (narrowing of the colon) may also play a role, but the connection was not strong.



Do People With Crohn’s Disease Live Normal Lives?

With improvements in understanding and treating Crohn’s disease, people with this condition live a better quality of life than in previous decades. However, when the disease is active (causing a flare-up), quality of life might be lower for that time. It was also shown that quality of life improved over time, possibly because adjusting to the disease is helpful.



Life-Threatening Complications of Crohn’s

Some conditions that may happen along with Crohn’s disease increase the risk of a life-threatening complication. People concerned about these related conditions should discuss their risk with a healthcare provider because it is not the same for everyone with Crohn’s disease.

Colorectal Cancer

People with Crohn's disease affecting the colon are at an increased risk for colorectal cancer. It is a major cause of mortality in people with IBD. One study showed that it may be responsible for the deaths of 10% to 15% of people with IBD.

Everyone's risk of colorectal cancer is going to be different. The risk increases the longer a person has had Crohn's disease and if there is inflammation in the colon.

Intestinal Obstruction

An obstruction is when the bowel is blocked and stool can’t move through it. Obstructions are more common in people with IBD than in the general population. This can be because of inflammation, which causes the bowel tissue to swell. It can also happen when scar tissue forms from the inflammation, causing ulcers and then healing.

Obstruction might be treated with surgery, usually a resection to remove the narrowed part of the bowel. There is not a lot of good data about how often surgery for an obstruction can lead to a poor outcome. One study showed that 7% of people who had surgery for obstruction had a severe complication.

Older studies show that the mortality rate can be higher with emergency surgery, as opposed to scheduled one. However, there were no deaths in a study examining operations on 61 people from 2013 to 2017.

Fistulas

One of the complications that can lead to lowered quality of life and the need for more treatments in Crohn’s disease is a fistula. A fistula is an abnormal channel that forms between two organs or an organ and the skin. About 12% of people with Crohn’s live with a fistula.

Unfortunately, having a fistula may be associated with other conditions that have a higher risk of mortality. It’s rare, but one study showed that unmanaged Crohn’s disease was thought to be the biggest factor leading to a risk of death.

One study of people in the United States who were in the hospital to treat a fistula showed a decrease in deaths between 2009 and 2019. This was true even though there was an increase in people being admitted to the hospital in that time.

Perforated Colon

Perforations are a risk for every form of IBD. However, they are rare, occurring in 1% to 3% of people with Crohn’s disease. They are an emergency, and they can be life-threatening. However, there is no good data on how often there can be complications from perforation that lead to poor outcomes, including death.

Toxic Megacolon

Toxic megacolon is a complication of IBD in the large bowel. It is rare overall. In toxic megacolon, the colon expands rapidly, and rupture is a risk. Studies report different rates, but it is generally thought to occur more frequently in ulcerative colitis than Crohn’s disease.

Toxic megacolon is usually treated with surgery. Mortality after toxic megacolon was high decades ago but is now thought to be between 0% and 2%.

Adverse Effects of Medication

Some medications that are used to treat Crohn’s disease may also carry a risk of serious side effects. Steroids, which are commonly used for treating flare-ups, can put people at risk for infections.

Anti-tumor necrosis factor (TNF) medications, such as Humira (adalimumab) may be used for long-term maintenance and also may increase the risk of infection, especially tuberculosis. Asacol (mesalamine) and ant-TNF drugs may also contribute to a worsening of heart failure.

Thiopurines such as Azasan (azathioprine) can increase the risk of viral infections (including cytomegalovirus) and nonmelanoma skin cancers.

The risks of medications are going to be different for each person. There are a variety of treatments for IBD, so if one drug carries too much risk, there are other options. It is important that Crohn's disease be treated because the inflammation it causes could lead to serious complications.

When to See a Healthcare Provider for Complications

People who live with Crohn’s disease need regular management of the condition. This means seeing a healthcare provider (commonly a gastroenterologist) regularly for treatment and to stay ahead of potential problems.

Having an established relationship with a healthcare provider makes it easier to get help if new symptoms crop up. It’s important to get seen for any new symptoms or when existing symptoms get worse.

Here are some symptoms that are a reason to see a healthcare provider:

However, people with IBD should reach out to a healthcare provider whenever they have a concern. It’s better to find out symptoms are not serious rather than waiting until they become an emergency.



Stages of Crohn's Disease

Crohn's disease goes through periods of active disease and remission. It is generally considered a progressive disease, meaning that it may cause more complications over time. However, treating it soon after diagnosis with effective medications may help lower the risk of complications and improve long-term outcomes.



Summary

Crohn’s disease is currently a lifelong condition that can affect all parts of the body, but it's not considered fatal. People with any form of IBD may have a slightly shorter average lifespan than those with it. It’s important for people with Crohn’s disease to see a healthcare provider regularly.

Life-threatening complications from Crohn’s disease are not common. However, it’s important to understand what they are, how to potentially prevent them if possible, and what the personal risk looks like.

Read the original article on Verywell Health.