Crohn's Disease

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Signs and Symptoms

Symptoms of Crohn's disease vary from patient to patient in type and severity. The most common symptoms are chronic diarrhea, fever, rectal bleeding, and abdominal pain.

Other symptoms include the following:

• Abscesses
• Bloating
• Bloody stools
• Constipation
• Diminished appetite (often causes weight loss)
• Fatigue
• Nausea
• Ulcers
• Vaginal or urinary tract infections

Some patients experience related problems in the joints, eyes, liver, and skin. Children may exhibit stunted growth.

Complications
Crohn's disease can cause extensive complications. One of the most common is intestinal obstruction. The disorder often causes the intestinal walls to thicken with scar tissue and swell, making it difficult for stool to travel through the intestines.

Inflammation can cause ulcers, or open sores, to develop in the digestive tract. Ulcers often occur in the rectum, colon, or lower part of the small intestine. They can cause bleeding, which may lead to anemia.

In severe cases, these sores tunnel through the rectum or anus into surrounding tissue (e.g., bladder, vagina, skin). These tunnels, which may become infected, are called fistulas. Medications, such as infliximab (Remicade), can be used to treat fistulas, but they may require surgery.

Small tears or cracks in the anal skin or mucous membrane also may develop. These tears, which are called fissures, may cause painful bowel movements.

Malnutrition is common in patients who have Crohn's disease. Eating often is unpleasant because of chronic digestive discomfort, and the disease damages the lining of the intestines, preventing proper digestion of nutrients.

Depression and anxiety are also common in patients who have Crohn's disease. In addition to feeling unwell, they often must deal with the unpredictable nature of the disease, not knowing when it may flare up again. Other health problems associated with Crohn's disease include osteoporosis, arthritis, kidney stones, gallstones, and liver disease. Some studies have shown that women who have Crohn's disease are at increased risk for complications during pregnancy.

Patients who have Crohn's disease for many years (usually eight years or more) are at increased risk for developing cancer of the colon, anus, or small intestine. Some of the medications used to treat the disorder (e.g., infliximab [Remicade]) also may increase the risk for cancer.

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