Initial Crohn’s disease symptoms are difficult to distinguish from other intestinal problems. Abdominal pain often occurs, especially in the lower right portion of the abdomen. Often, the pain is first mistaken for appendicitis. Abdominal cramps, spasms and diarrhea may also occur. Malnutrition and loss of appetite are frequent symptoms; some may experience sudden weight loss. Not all people experience the same symptoms, however. For instance, some might not experience diarrhea, and some patients don’t experience pain as a prominent symptom in the early stages of the disease.
Because Crohn’s disease often leads to malnutrition, which hinders the normal growth processes, children with Crohn’s may experience developmental delays, both physically and mentally.
Other Symptoms of Crohn’s Disease
These symptoms become more common as the disease progresses, but can vary widely among individuals:
- joint pain
- anal sores
- skin lesions or sores
- anal drainage.
See a medical professional as soon as possible if you experience any of the following symptoms, as they may indicate Crohn’s disease or other potentially serious health problems:
- blood in your feces
- severe abdominal pain
- chronic diarrhea
- unexplained fever
- sudden changes in bowel movements.
Crohn’s Fistulas and Other Complications
Intestinal blockage is the most common complication. Chronic inflammation can also result in scarring, which causes intestinal passages to narrow. If an obstruction forms, intestinal contents back up, resulting in constipation, vomiting and pain. In rare instances the intestinal wall may rupture, allowing bacteria from the intestine to infect other organs causing sepsis, the bacterial infection of an organ or the blood stream.
Severe diarrhea or constipation can result in a tear, or fissure, in the lining of the anus. These anal fissures can cause intense pain during and after a bowel movement, which stretches the fissure. While the majority of fissures will heal on their own some require surgical repair. Injections of botulinum toxin (BOTOXÂ®) may be considered in place of surgery.
Sores and ulcers caused by inflammation also occur. If the ulcer deepens and penetrates the intestinal wall itself, a fistula is formed. A fistula is an abnormal connection between two organs or body structures, which are not normally connected. A fistula often occurs in the colon or rectum, and may cause intestinal contents to seep into the bladder, the vagina or even drain through the skin. Fistulas are common causes of sepsis in Crohn’s disease. In some cases, sepsis can be life threatening.
Symptoms of Crohn’s fistulas that occur between sections of intestine are increased diarrhea, malabsorption and dehydration. A vaginal fistula causes intestinal gas and feces to leak into the vagina. Fecal contamination of the bladder in a bladder or vaginal fistula can cause urinary tract infections. The most common Crohn’s fistula, however, is the anal fistula – a connection between the rectum and skin around the anus. An anal fistula may or may not be associated with an abscess.
Infections of the intestine may also abscess, resulting in a pocket of infection that is sealed off from the rest of the intestine. Symptoms of a Crohn’s disease-associated abscess include fever and chills; an anal fistula abscess may also cause tenderness and swelling of the site.
The pain of the disease and recurrence of symptoms can often cause depression. According to a study published by the American Psychosomatic Society, depression, anxiety and personal perception of health-related quality of life can actually have a negative impact on the course of inflammatory bowel disease.
Less Common Crohn’s Complications
Crohn’s can cause a variety of secondary complications, including:
- skin disorders
- inflammation of the eyes
- mouth inflammation
- kidney stones
- liver problems.
American Society of Colon and Rectal Surgeons. (nd). Crohn’s disease.
Carson-Dewitt, R.S. (2002, December). Crohn’s disease. Gale Encyclopedia of Medicine.
Mittermaier, C., Dejaco, C., Waldhoer, T., Oefferlbauer-Ernst, A., Miehsler, W., Beier, M, Tillinger, W.