Do I Have Symptoms Of Crohn’s Disease?

Crohn’s disease is an inflammatory bowel disease where the body starts attacking the gastrointestinal tract, resulting in inflammation.

“It's important to realize that our gut tract was designed to deal with bacteria, and there are a ton of immune cells around our gastrointestinal tract,” said Scott Dolejs, MD, a board-certified colon and rectal surgeon at Franciscan Health Mooresville. “So if this immune system gets overstimulated and cannot turn itself off appropriately, that's when we get inflammation and Crohn's disease can develop.”

Dr. Dolejs explains common symptoms of Crohn’s disease in men and women, how they differ from symptoms of IBS and colitis, and how Crohn’s disease is diagnosed.

What Are Early Symptoms Of Crohn’s Disease?

Early symptoms of Crohn’s disease include:

• Abdominal pain
• Diarrhea
• Weight loss
• Fatigue
• Nutritional deficiencies
• Feeling anxious or depressed.

“Symptoms from Crohn's are based on the part of the gastrointestinal tract impacted,” Dr. Dolejs said. “The most common symptoms include diarrhea, abdominal pain, rectal bleeding, feeling tired, weight loss and fever. Some people develop painful abscesses or sores around their anus, and people can also get mouth sores, joint pain, eye redness, irritation, and skin rashes.

“But really the diarrhea, abdominal pain and rectal bleeding are the three things that really trigger us into thinking, ‘Is this Crohn's disease or not?’”

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Crohn's disease may affect any part of your digestive tract, including your mouth, esophagus, small intestine, large intestine and rectum.

Even though both men and women experience the common symptoms of Crohn's disease — like diarrhea, stomach pain, weight loss and blood in the stool — certain symptoms can show up more in one sex than the other.

Crohn's Disease Symptoms In Women

Crohn's disease symptoms in women include:

• Anemia
• Osteoporosis and bone loss
• Menstrual pain
• Potential increase in pregnancy complications

Crohn's Disease Symptoms In Men

Crohn's disease symptoms in men include:

• Decrease in sexual desire
• Erectile dysfunction
• Higher risk for colorectal cancer
• Higher risk for primary sclerosing cholangitis, a rare liver disease

Are Crohn’s And IBS Symptoms The Same?

“Sometimes we as doctors will use the phrase when we're describing someone who we're worried about having Crohn's disease or ulcerative colitis as inflammatory bowel disease, which of course sounds very, very similar to irritable bowel syndrome,” Dr. Dolejs said. “But Crohn's disease, ulcerative colitis, are very different from irritable bowel syndrome. The key difference is that in irritable bowel syndrome, there's no inflammation of the gastrointestinal tract and biopsies that we take are normal.

“Irritable bowel syndrome is considered a functional gastrointestinal disorder, which just means that we do not have a particular test or finding when we look at tissue under the microscope that say whether you have irritable bowel syndrome or not. In comparison, Crohn's disease patients will usually have characteristic findings on biopsies and other imaging studies.”

Are Crohn’s And Colitis Symptoms The Same?

Crohn’s disease differs from ulcerative colitis, another common type of inflammatory bowel disease, in that it can develop anywhere along digestive tract from the mouth to the anus. In comparison, ulcerative colitis stay in the colon and rectal areas.

“The most common location Crohn’s patients have problems with is the last part of the small intestine where the small intestine enters into the colon or large intestine,” Dr. Dolejs said. “This area is called the terminal ileum. The next most common location is actually around the anus, and patients can get abscesses or other sores around their anus.”

Who Is At Risk For Crohn's Disease?

Nearly one in 100 Americans are diagnosed with Crohn’s disease or ulcerative colitis, and it typically is diagnosed in teens and young adults, ages 15 to 30, although Crohn’s symptoms can occur at any age.

“Unfortunately, the rate of Crohn's disease seems to be increasing,” Dr. Dolejs said. “It'd be great if we could say, ‘Hey, this is the exact cause of Crohn's disease,’ but we don't know that.”

Genetics can play a role, however.

“There is some genetic or familial component to Crohn's disease that we're still figuring out,” Dr. Dolejs said. “If someone in your family has Crohn's disease, you have at least a three times higher chance of having Crohn's disease, and it might be as high as a 25 times higher chance.”

Other risk factors for Crohn's disease include:

• Smoking, which can more than double your risk
• Less physical activity
• Diets poor in fiber
• Poor sleep habits.
• An autoimmune reaction caused by digestive tract bacteria
• Taking some medicines like ibuprofen and other NSAIDs, which may slightly increase the risk of Crohn's disease.

“Unfortunately, even people who do not smoke, exercise regularly and have an excellent diet with good fiber can and do still get Crohn's disease,” Dr. Dolejs said. “So those are factors. None of them actually cause the disease itself.”

Diagnosing Crohn's Disease Symptoms

According to National Institute of Diabetes and Digestive and Kidney Diseases, Crohn's disease tests include looking for:

• Bloating, pain or inflammation of the abdomen
• Enlargement of the liver or spleen
• There are also lab tests used to help diagnose the condition, including:
  • White blood cell tests for signs of inflammation
  • Red blood cell tests for anemia
  • Stool tests to rule out other digestive problems
• Upper GI tract endoscopy to examine your esophagus, stomach and duodenum
• Enteroscopy to examine your small intestine
• Colonoscopy to examine your ileum, colon and rectum
• Upper GI series
• CT scans

“Laboratory studies and imaging studies, like a CT scan, can help us determine the severity of Crohn's disease and likelihood of having Crohn's disease,” Dr. Dolejs said. “We can make a solid diagnosis with a colonoscopy, with biopsies or an upper endoscopy with biopsies. Getting some kind of tissue that we can say, ‘Yes, there's some inflammation there,’ really helps us solidifying the diagnosis of Crohn's disease.”

Treatment for Crohn’s disease often includes medications and surgery, along with diet and lifestyle changes.

“The first thing to understand is that it certainly is tricky because the presentation of Crohn's disease can be so variable,” Dr. Dolejs said. “In fact, about one in five patients, who is treated for an initial flare of Crohn’s disease, never has problems with it again.”