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Crohn’s Disease – Common Symptoms & Diagnosis

Crohns Posted by Crystal L.

Crohn’s disease symptom details

The symptoms of Crohn’s disease are explained based in the classification below:

– General/Typical symptoms: weakness, fever (in ≈30%), weight loss (due to malnutrition or malabsorption syndrome).

– Symptoms depending on the location, distribution, and severity of changes in the digestive tract:

  • The classic form with lesions of the distal ileum (terminal ileitis) (40-50% of patients) – the onset is usually latent, less often acute, simulating appendicitis. Sometimes the first symptoms are anemia, fever of unknown etiology, flexion contracture in the right hip joint, caused by an abscess of the ileocecal angle. Abdominal pain [4] and diarrhea usually dominate. Bloody stool is rare, but tarry stools may also occur. In ≈30% of patients, a node in the right lower quadrant of the abdomen is palpable. If the small intestine is too involved, it causes malabsorption syndrome – with steatorrhea, vitamin deficiency (especially B 12 ), hypoproteinemia, anemia, and electrolyte disturbances; over time, malnutrition and exhaustion develop, and edema in patients with hypoalbuminemia.
  • The large intestine (in 20% of cases, the changes are isolated. But the small intestine is simultaneously affected in 30–40% of cases) – sometimes the signs manifested may look like ulcerative colitis; the most frequent and in 50% of cases the first symptom is diarrhea (rarely with macroscopic admixture of blood), often abdominal pain, especially in the case of lesions of the blind and ileum;
  • oral cavity – pain, aphthae, and ulceration in the mouth;
  • esophagus – dysphagia, pain when swallowing;
  • stomach and duodenum – abdominal pain, vomiting (symptoms resembling peptic ulcer or pyloric stenosis);
  • the anal area – skin growths, ulcers, cracks, perianal abscesses and fistulas [5]; are observed in 50–80% of patients with lesions of the large intestine, may be the first symptom of the disease;

– Natural course: the disease has a chronic course, long-term, usually alternating periods of exacerbations and remissions, although often symptoms persist for a long time and lead to significant disability and the need for surgical intervention due to complications of the disease (in 60% of patients after 10 years); relapses after surgery up to 70%