They sometimes go beyond the digestive system.
Crohn’s disease—a type of inflammatory bowel disease that can cause immune system attacks on the digestive tract—has a handful of telltale symptoms, but ultimately, it affects each patient a little differently.
In general, symptoms tend to come and go in flares (active symptoms) and remissions (a period of little to no disease activity). Flares can be dangerous since they imply increased inflammation in the body, which can result in damage over time or an increased risk of other inflammatory problems (more on this later).
You can’t always tell what the inflammation in your body is like, however. “How you feel might not be the same as how it looks inside during a colonoscopy,” says David P. Hudesman, MD, associate professor at the Department of Medicine and medical director of the IBD Center at NYU Langone Health. In other words, you can have terrible symptoms but only mild inflammation on the inside, or you could also have severe inflammation yet no symptoms.
The Textbook Symptoms of Crohn’s Disease
Crohn’s disease can affect anywhere in the digestive tract, which means symptoms can vary depending on where the body is inflamed. Is there inflammation in the stomach? Large intestine? Esophagus? All of the above? This can make a big difference in symptom presentation.
That said, here are the most common signs and symptoms of Crohn’s disease:
Diarrhea, or frequent and urgent bowel movements
Sensation of constipation (or incomplete bowel movement)
Less common symptoms include fever, distended belly, and an abscess or swelling in the area, according to Dr. Hudesman.
Symptoms Beyond the GI Tract
As previously mentioned, symptoms of Crohn’s disease sometimes spread beyond the gastrointestinal tract. That’s because chronic inflammation in one part of the body (in this case, the GI tract) can often create inflammation in other parts of the body.
“Other common symptoms patients get are joint pains, so pain or swelling in their knees, their elbows, their ankles,” says Dr. Hudesman. Additionally, some people with Crohn’s disease might experience skin rashes, pain and redness in the eyes, or mouth sores—all created from chronic inflammation in the body.
It’s “not uncommon,” says Dr. Hudesman, to see a patient who has “a little bit of pain and diarrhea and they don't think much of it, but they've also been having knee pain and can't run as much as they used to, or they have developed recurrent mouth sores or skin rashes.” These can all be signs of Crohn’s disease, even if the bowel symptoms are mild.
Think you may have Crohn’s disease? “It's important when talking to a physician … to talk about every symptom you're feeling, not just what's related to your intestines and stomach,” says Dr. Hudesman. Learn more tips for making the most of your appointments for Crohn’s disease.
If it is Crohn’s disease, there are many treatment options for Crohn’s that can help you feel better and live a normal life. Additionally, here are lifestyle changes that can help manage Crohn’s symptoms.
Dr. Hudesman is an associate professor in the Department of Medicine and medical director of the IBD Center at NYU Langone Health.
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So with Crohn's disease, I think the first
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important factor is that symptoms do not correlate
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with what's going on inside.
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And what I mean by that is that how you feel might not
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be the same as how it looks inside during a colonoscopy.
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So if we take a look inside,
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and we see a lot of inflammation, that person
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might feel great and have no symptoms at all.
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And some people that we know have Crohn's disease
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can feel very sick, and I can look inside
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and it doesn't look so bad.
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So common symptoms with Crohn's disease
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includes abdominal pain,
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frequent bowel movements and diarrhea,
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could have fevers,
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their belly could get bigger or distended.
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Some patients uncommonly may develop an abscess
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or a swelling in their anal area
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that they might not relate to Crohn's disease.
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Other common symptoms patients get are joint pains,
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so pain or swelling in their knees,
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their elbows, their ankles.
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They can develop different types of skin rashes.
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They can commonly develop eye pain
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where their eye gets red,
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or they can develop sores in their mouth.
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And it's not uncommon,
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I see somebody two, three years later,
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with maybe some mild abdominal pain,
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they're in college, they think they're eating unhealthy
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and they're out drinking and they might have a little bit
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of pain and diarrhea and they don't think much of it,
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but they've also been having knee pain and can't run
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as much as they used to, or they have developed
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recurrent mouth sores or skin rashes,
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and these are early signs of Crohn's disease,
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so it's important when talking to a physician,
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whether you have Crohn's or you think you may have Crohn's,
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to talk about every symptom you're feeling,
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not just what's related to your intestines and stomach.
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When symptoms worsen, it could be Crohn's flares
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or more inflammation on the inside, or it could be
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from a stomach bug or stomach infection.
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It could be something called bacterial overgrowth,
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or change in gut bacteria.
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There's a significant amount of patients that have
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both Crohn's disease and irritable bowel syndrome,
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so maybe their irritable bowel syndrome is worse
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and they have worsening cramping.
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So if symptoms do worsen, it's important to communicate
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with the provider, so then they can better help figure out
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what's driving those symptoms: Is it Crohn's,
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or is it something else?
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I wouldn't recommend rushing to taking something
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over-the-counter, or adjusting or increasing medications
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without getting a better sense of what's causing the symptoms.
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Patient education: Crohns disease (beyond the basics). Waltham, MA: UpToDate, 2019. (Accessed on January 31, 2020 at https://www.uptodate.com/contents/crohn-disease-beyond-the-basics.)
Signs and symptoms of Crohn’s disease. New York, NY: Crohn’s & Colitis Foundation. (Accessed on January 31, 2020 at https://www.crohnscolitisfoundation.org/what-is-crohns-disease/symptoms.)