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.
00:00.267 --> 00:02.366
00:02.367 --> 00:03.966
So with Crohn's disease, I think the first
00:03.967 --> 00:07.932
important factor is that symptoms do not correlate
00:07.933 --> 00:09.832
with what's going on inside.
00:09.833 --> 00:13.066
And what I mean by that is that how you feel might not
00:13.067 --> 00:16.632
be the same as how it looks inside during a colonoscopy.
00:16.633 --> 00:18.366
So if we take a look inside,
00:18.367 --> 00:20.932
and we see a lot of inflammation, that person
00:20.933 --> 00:24.266
might feel great and have no symptoms at all.
00:24.267 --> 00:26.166
And some people that we know have Crohn's disease
00:26.167 --> 00:28.099
can feel very sick, and I can look inside
00:28.100 --> 00:30.232
and it doesn't look so bad.
00:30.233 --> 00:34.332
00:34.333 --> 00:36.699
So common symptoms with Crohn's disease
00:36.700 --> 00:38.266
includes abdominal pain,
00:38.267 --> 00:40.332
frequent bowel movements and diarrhea,
00:40.333 --> 00:41.632
00:41.633 --> 00:43.299
could have fevers,
00:43.300 --> 00:45.932
their belly could get bigger or distended.
00:45.933 --> 00:49.132
Some patients uncommonly may develop an abscess
00:49.133 --> 00:51.032
or a swelling in their anal area
00:51.033 --> 00:53.132
that they might not relate to Crohn's disease.
00:53.133 --> 00:56.799
Other common symptoms patients get are joint pains,
00:56.800 --> 00:59.166
so pain or swelling in their knees,
00:59.167 --> 01:00.932
their elbows, their ankles.
01:00.933 --> 01:03.666
They can develop different types of skin rashes.
01:03.667 --> 01:05.432
They can commonly develop eye pain
01:05.433 --> 01:07.099
where their eye gets red,
01:07.100 --> 01:09.232
or they can develop sores in their mouth.
01:09.233 --> 01:10.432
And it's not uncommon,
01:10.433 --> 01:13.032
I see somebody two, three years later,
01:13.033 --> 01:15.166
with maybe some mild abdominal pain,
01:15.167 --> 01:17.432
they're in college, they think they're eating unhealthy
01:17.433 --> 01:19.432
and they're out drinking and they might have a little bit
01:19.433 --> 01:21.499
of pain and diarrhea and they don't think much of it,
01:21.500 --> 01:23.932
but they've also been having knee pain and can't run
01:23.933 --> 01:25.966
as much as they used to, or they have developed
01:25.967 --> 01:28.332
recurrent mouth sores or skin rashes,
01:28.333 --> 01:30.199
and these are early signs of Crohn's disease,
01:30.200 --> 01:33.399
so it's important when talking to a physician,
01:33.400 --> 01:36.232
whether you have Crohn's or you think you may have Crohn's,
01:36.233 --> 01:38.099
to talk about every symptom you're feeling,
01:38.100 --> 01:40.832
not just what's related to your intestines and stomach.
01:40.833 --> 01:44.366
When symptoms worsen, it could be Crohn's flares
01:44.367 --> 01:47.832
or more inflammation on the inside, or it could be
01:47.833 --> 01:50.566
from a stomach bug or stomach infection.
01:50.567 --> 01:52.699
It could be something called bacterial overgrowth,
01:52.700 --> 01:54.332
or change in gut bacteria.
01:54.333 --> 01:56.866
There's a significant amount of patients that have
01:56.867 --> 01:59.932
both Crohn's disease and irritable bowel syndrome,
01:59.933 --> 02:02.532
so maybe their irritable bowel syndrome is worse
02:02.533 --> 02:03.966
and they have worsening cramping.
02:03.967 --> 02:07.032
So if symptoms do worsen, it's important to communicate
02:07.033 --> 02:10.266
with the provider, so then they can better help figure out
02:10.267 --> 02:12.732
what's driving those symptoms: Is it Crohn's,
02:12.733 --> 02:13.932
or is it something else?
02:13.933 --> 02:16.066
I wouldn't recommend rushing to taking something
02:16.067 --> 02:19.466
over-the-counter, or adjusting or increasing medications
02:19.467 --> 02:23.032
without getting a better sense of what's causing the symptoms.
02:23.033 --> 02:29.033
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.)