What are the signs and symptoms of Crohn's disease?

From the Guidelines

Crohn's disease typically presents with persistent diarrhea, abdominal pain, fatigue, weight loss, and reduced appetite, and can affect any part of the digestive tract, with symptoms varying depending on the section inflamed, as noted in the most recent guidelines 1. The disease can cause significant morbidity and impact on quality of life, and its symptoms often fluctuate with periods of flares and remission. Patients may also experience fever, blood in stool, mouth sores, perianal disease, and symptoms outside the digestive tract such as joint pain, eye inflammation, or skin rashes. Some key points to consider include:

• The disease can affect individuals of any age, from children to the elderly, and may cause significant morbidity and impact on quality of life 1.
• The precise aetiology of CD remains unknown, and a curative therapy is not yet available, with contemporary therapy focused on control of inflammation, using medications along with timely surgical interventions to alleviate the symptoms of bowel damage 1.
• Children with Crohn's may show delayed growth or sexual development, and the disease can affect any part of the digestive tract from mouth to anus, though it most commonly involves the end of the small intestine and beginning of the colon 2.
• The chronic inflammation occurs because the immune system mistakenly attacks the digestive tract, causing damage to the intestinal lining, and this autoimmune response can be triggered by genetic predisposition, environmental factors, and changes in gut bacteria 3. If you experience persistent digestive symptoms, especially diarrhea lasting more than a few weeks, unexplained weight loss, or blood in your stool, consult a healthcare provider promptly for proper diagnosis and treatment, as early intervention can improve outcomes and quality of life 1.

From the Research

Signs and Symptoms of Crohn's Disease

• Diarrhea, abdominal pain, weight loss, nausea, vomiting, and in certain cases fevers or chills are common presenting symptoms of Crohn's disease 4
• The disease can affect any part of the gastrointestinal tract, but the terminal ileum is the most frequent localization 5
• There are 3 main disease phenotypes: inflammatory, structuring, and penetrating, and up to a third of patients will develop perianal involvement of their disease 4
• Extraintestinal manifestations may also develop in some cases 4
• Patients with Crohn's disease may experience episodic flares of diarrhea, abdominal pain, fatigue, and unintentional weight loss 6

Disease Characteristics

• Crohn's disease is a chronic idiopathic inflammatory bowel disease condition characterized by skip lesions and transmural inflammation 4
• The cause of the disease remains unknown, but several factors have been implicated, including a dysregulated immune system, an altered microbiota, genetic susceptibility, and environmental factors 7
• Genetic defects, such as polymorphism of Caspase Associated Recruitment Domain (CARD15) and Carcinoembryonic Antigen-related Cell Adhesion Molecule 6 (CEACM6), may favor the colonization of terminal ileum by entero adherent-invasive Escherichia coli (AIEC) 5

Diagnosis and Differential Diagnosis

• Diagnosis of Crohn's disease typically relies on endoscopy and histological assessment of biopsy specimens 4, 7
• Terminal ileitis can be caused by other diseases, such as non-steroidal antiinflammatory drug (NSAID) intake, lymphoid hyperplasia, intestinal infections, lymphoma, and ulcerative colitis (UC), and should be considered in the differential diagnosis 8