What are the symptoms of Crohn's disease?

Written by Chen Rong
Gastroenterology
Updated on September 11, 2024
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Crohn's disease is a type of inflammatory bowel disease, primarily affecting the terminal ileum and adjacent colon, but can involve any digestive tract segment from mouth to anus, displaying either segmental or skip distribution. Clinically, it is characterized by abdominal pain, diarrhea, weight loss, abdominal mass, fistula formation, and intestinal obstruction. It may also present with fever and extraintestinal manifestations, including joint, skin, eye, and oral mucosa damage. This disease tends to recur throughout a person’s life, and severe cases can be prolonged and unhealing with poor prognosis. The onset age is mostly between 15-30 years, but initial attacks can occur at any age. The incidence rate is similar between genders. Abdominal pain is the most common symptom, often seen in the lower right abdomen or around the navel, presenting intermittently as cramp-like pain accompanied by bowel sounds, typically worsening after eating, and relieved by defecation or passing gas. Diarrhea is another common symptom, initially intermittent but can become persistent in later stages of the disease, with stools generally being pasty and containing mucus and pus-blood. If the lower part of the colon or anorectal area is involved, there may be mucus-bloody stools and a sensation of incomplete evacuation after bowel movements. Abdominal masses are often located in the lower right abdomen and around the navel, and fistula formation is a characteristic clinical manifestation of Crohn's disease.

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Differential Diagnosis between Intestinal Tuberculosis and Crohn's Disease

Intestinal tuberculosis often exhibits symptoms of extraintestinal tuberculosis, whereas Crohn's disease generally does not show signs of extraintestinal tuberculosis. Recurrence of intestinal tuberculosis is not common, whereas Crohn's disease has a longer duration and alternates between remission and relapse. Fistulas, abdominal abscesses, and perianal lesions are relatively rare in intestinal tuberculosis, but Crohn's disease may involve fistulas, abdominal masses, and perianal lesions. Tuberculin skin tests may be positive in patients with intestinal tuberculosis, while in Crohn's disease patients, the test may show a weakly positive result. After antituberculosis treatment, symptoms in patients with intestinal tuberculosis can significantly improve, whereas there is no significant improvement in symptoms in Crohn's disease patients following antituberculosis treatment. Furthermore, histopathological examination in patients with intestinal tuberculosis may reveal Mycobacterium tuberculosis and caseous necrosis. In contrast, Crohn's disease patients show negative results for Mycobacterium tuberculosis in pathologic testing and do not exhibit caseous necrosis.

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Can Crohn's disease be detected with an enhanced CT of the small intestine?

Crohn's disease cannot be accurately diagnosed through a CT scan of the small intestine; it only shows a general overview of the condition. To accurately diagnose specific conditions of Crohn's disease, it is necessary to perform a colonoscopy, combined with blood tests, routine stool tests, and pathological examinations for a definitive diagnosis. Then, further diagnoses can be made based on individual clinical symptoms. This disease generally has a definite connection with genetic and immune factors. If the condition is severe, surgery may be considered to remove the affected intestines.

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Written by Ren Zheng Xin
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How serious is Crohn's disease exactly?

Crohn's disease is an inflammatory bowel disease that can cause intestinal absorption disorders, malnutrition, and decreased body resistance leading to fever. The inflammation of the intestines can trigger abdominal pain, diarrhea, or bowel obstruction, and ischemic necrosis of the intestinal wall can lead to perforation and bloody stools. It can also affect other organs such as joints, liver, and skin, causing damage. Currently, the cause of Crohn's disease is not well understood, and it tends to have a long course, with frequent relapses and is difficult to cure completely. The current treatment methods combine pharmacotherapy with surgical techniques to treat complications and minimize damage to organs.

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Can people with Crohn's disease eat wontons?

Crohn's disease is a chronic inflammatory granulomatous disease of the digestive tract of unknown cause. It, along with ulcerative colitis, is classified as an inflammatory bowel disease. It can affect any part of the gastrointestinal tract from the mouth to the anus, but is most commonly found at the end of the ileum and the adjacent colon. The lesions are generally ulcers, which are typically longitudinal, large, and deep, appearing in a segmental or skipping pattern. The disease can involve all layers of the digestive tract, causing thickening of the intestinal wall, narrowing of the intestinal lumen, and bowel perforation. Additionally, this disease has a certain rate of malignant transformation. The disease is difficult to cure and has signs of lifelong recurrence. Therefore, in terms of diet, it is crucial for individuals with Crohn's disease to focus on easily digestible foods and avoid spicy, stimulating, fatty, greasy, and difficult-to-digest foods, as well as smoking and drinking alcohol. Wontons are relatively easy to digest; they should be chewed slowly and thoroughly. It is okay to eat them occasionally, but do not consume too much at one time, about 80% full is appropriate.

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Can Crohn's disease be seen on a CT scan?

Crohn's disease cannot be determined solely by CT scans. A CT scan can be used to assess the general situation, which should then be combined with personal clinical symptoms, routine stool tests, and ideally, colonoscopy and blood tests to make an accurate diagnosis. Crohn's disease is an idiopathic disease, currently thought to be related to genetic factors, and inevitably linked to individual immune factors and dietary habits. A definitive diagnosis can be made through colonoscopy and pathological examination. Care should be taken to avoid consuming raw, cold, hard, spicy, and irritating foods.