The most common symptom of Crohn's disease is abdominal pain, often situated in the right lower abdomen. It can easily be confused with appendicitis. However, the pain pattern often can be very non-specific, occurring in any part of the abdomen and varying in intensity.
Abdominal bloating due to obstruction is a relatively late symptom. The stools might be normal, but diarrhoea is often present.
Rectal bleeding is much less common compared to ulcerative colitis. The course of the disease might be sub acute and relapsing over a long period of time, often wrongly diagnosed as an irritable bowel syndrome.
Extra-intestinal features of Crohn's are often valuable pointers towards making the correct diagnosis. Peri-anal disease affects up to 15% of patients, including abscesses and fistulae around or near the anus. The presence of peri anal disease implies the disease is more severe.
Inflammation of the eyes, skin rashes and arthritis can sometimes even precede the development of intestinal symptoms, and are interestingly enough more often associated with disease of the large bowel.
As Crohn's is a systemic disease, patients tend to feel generally unwell and tired. Fever, weight loss and growth retardation in children are not uncommon.
What is Crohn's disease?
Reviewed by Dr Ismail Moola MBCHB (UCT) FCP (SA) Cert Gastro Phys (SA) Specialist Physician / Gastroenterologist Netcare Sunninghill Hospital and part time Lecturer Department of Internal Medicine, Division of Gastroenterology, Wits University. (February 2015)
Previously reviewed by Prof Don du Toit (M.B.Ch.B) (D.Phil.) (Ph.D) (FCS) (FRCS)