Symptoms of Crohn’s Disease

Crohn’s disease is a form of chronic inflammatory bowel disease. There is ulceration of mucosal lining of the intestinal lumen. These ulcerations can occur anywhere in the gastrointestinal tract, from mouth to anal opening. Most commonly, Crohn’s Disease (CD) affect the small and large intestine leading to chronic colitis. Ileum, the last part of the small intestine, is the commonest site. The cause of CD is thought to be autoimmune, where body’s own immune system hits the GI tract leading to chronic inflammation. The symptoms of Crohn’s disease vary according to the extent and severity of the ulceration.

• Diarrhea – this is the most consistent symptom of CD. As the mucosal lining is ulcerated, the intestine cannot absorb all the liquid material that is ingested. Moreover, the inflamed cells secrete salt, water and other serous discharges. All these lead to diarrhea.

• Pain abdomen – this occurs due to ulceration of the mucosal lining. Chronic inflammation of the lining of the small and large intestine can lead to scar formation which hinders normal movement of the GI tract. Thus, digested food materials blocks the lumen of the intestine making it swelled up. Abdominal cramps are more serious in nature in advanced stages of the CD. Spasm in the intestine increases the chance of diarrhea. Patient may complain of increased flatulence.

Crohn's Disease

Source – slapjack

• Nausea and vomiting – abdominal cramps and diarrhea can produce nausea and vomiting. Nausea is often experienced after taking a meal as the GI tract tries to push the food material down through the ulcerated part of the intestine.

• Stool mixed with blood – it is also commonly seen in later stages of CD. Ulcers in the mucosal lining bleeds as the food materials get rubbed over it. In addition, the blood vessels of the intestine become friable after years of chronic inflammatory process.

• Intestinal perforation – usually ulcers in the GI tract are small. But sometimes, they become aggregated producing a large confluent ulcer. If the ulcer gets perforated, the contents of the intestine comes inside the abdominal cavity (peritoneal cavity) leading to a condition called Peritonitis. There is severe pain abdomen, muscle guard and vomiting. The patient cannot move from a posture to another as change of posture makes the pain intense. Perforation may lead to shock and the patient may collapse.

• Fever – sometimes the ulcers get infected by bacteria present in the intestine. This may lead to mild to moderate degree fever.

• Loss of appetite – in chronic stage, the patient feels less carving for food. There may be weight loss as well.

• Incontinence – CD of the anal canal can lead to fecal incontinence. Involuntary passing of stool becomes a highly annoying feature of CD of anal canal.

• Symptoms due to extra intestinal CD – as this is an autoimmune disease, CD can affect anywhere in our body. There may be a fungating growth in the arms of legs (pyoderma gangrenosum), difficulty or loss of vision, anemia, ankylosing spondylitis and brittle bone are other common symptoms of CD.

Crohn’s Disease is a relatively common disorder which can affect both the genders equally. It is imperative to catch the symptoms of Crohn’s Disease at an early stage to keep it under control.

Author – Dr. Anupam Biswas