13 Crohn’s Disease Symptoms, From Diarrhea to Beyond

The signs of IBD can go beyond digestive troubles.
Image representing the GI tract in Crohn's disease
Crohn's disease symptoms can be hard to distinguish from other GI conditions. istetiana / Getty Images

Crohn’s disease symptoms can be more than just a little uncomfortable. In addition to managing pain, living with the chronic condition can make you feel really anxious about going somewhere new—or even going anywhere at all—if you don’t know what the bathroom situation will be like.

If you go undiagnosed or without necessary treatment, Crohn’s disease can cause lasting damage to your digestive tract, leading to even more pain and discomfort in the long run. For those reasons and more (which we’ll dig into below), it’s important to keep an eye out for the signs of Crohn’s disease and take action if you’re experiencing them, even though they can be tough to talk about.

But rest assured you’re not alone: An estimated half a million people in the U.S. have Crohn’s disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This 2013 estimate is the latest available, so the exact figure is likely much higher than this.

Not sure what your stomach woes could be pointing to? Read on to learn about the most common Crohn’s disease symptoms and the steps you can take if something similar is happening to you.

What is Crohn’s disease, exactly?

Crohn’s disease is one form of inflammatory bowel disease (IBD), which includes other conditions such as ulcerative colitis, according to the U.S. National Library of Medicine (NLM). IBD happens when your immune system mistakenly attacks healthy cells in your digestive tract and causes chronic inflammation, setting off a slew of symptoms, as well as possible complications if the disease isn’t treated.

Researchers believe this autoimmune reaction occurs when your immune system has an abnormal response to bacteria in your digestive tract, but why this happens isn’t entirely understood. Over time, chronic inflammation can cause visible damage to the digestive tract, which can be seen on scans, Benjamin Lebwohl, M.D., gastroenterologist and associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, tells SELF.

Crohn’s in particular causes inflammation anywhere in your digestive tract (which begins at the mouth and ends at the anus). However, it most commonly affects the small intestine (the longest portion of your GI tract) and the large intestine (which includes your colon, rectum, and anus).

It’s not clear why some people get Crohn’s disease and others don’t, but experts suspect genetics might be involved since the condition can run in families, according to the NLM. In fact, scientists have found more than 100 genes that are associated with having IBD, but more research is needed to understand the link1.

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What are the most common Crohn’s disease symptoms?

Crohn’s disease can manifest in different ways depending on the severity of your condition and where the inflammation has taken hold, so not everyone has the exact same experience. Ahead, read about the most common Crohn’s symptoms, according to the NIDDK and Mayo Clinic.

1. Diarrhea

We’re talking persistent, unexpected, and urgent diarrhea that doesn’t respond well to over-the-counter medications. Though the timeline varies, diarrhea can last anywhere from a few days to a few months during Crohn’s disease flare-ups, Ashkan Farhadi, M.D., gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, California.

Diarrhea happens because of the gut inflammation inherent to Crohn’s, Dr. Farhadi says. Even though Crohn’s can impact any part of your digestive system, it typically affects the last part of the small intestine (where most of the digestive process happens) and the colon (the longest part of the large intestine, which moves stool so it can exit your body), according to the Mayo Clinic. It makes perfect, painful sense that when these parts of your digestive tract are irritated, they can’t do their jobs properly—and you can get some pretty severe diarrhea as a result. What’s more, Crohn’s-induced inflammation can also cause the affected parts of your digestive tract to become hyperactive and spasm too much, which can force food to move through your system far too quickly, resulting in those really loose, watery stools.

2. Bloody stool

No one likes looking into the toilet bowl and seeing blood but, unfortunately, this can be a common Crohn’s disease symptom. The illness can cause open sores (ulcers) anywhere in your digestive tract. Unfortunately, those ulcers can bleed, causing bloody poop, Dr. Farhadi says. Noticing blood in your poop is always something to bring up to your doctor, even though it’s not always a sign of something as serious as Crohn’s disease.

3. Severe abdominal pain and cramping

Inflammation can make your intestines go way overboard with cramping, and that can contribute to Crohn’s disease pain. Also, people with Crohn’s disease may have scarring and narrowing of their intestinal walls (known as intestinal strictures). “This causes pain and bloating because the stool has a hard time getting through,” Jessica Philpott, M.D., Ph.D., a gastroenterologist who specializes in treating inflammatory bowel disease at the Cleveland Clinic, tells SELF. For some people, Crohn’s disease pain can make it hard to even get out of bed.

4. Mouth sores

You may not usually think of your mouth as being part of your digestive system, but it is. Given that it’s part of your bigger digestive operation, your mouth can develop sores just like other parts of your system that Crohn’s disease can compromise, Dr. Farhadi says. In some cases, people develop mouth sores before other Crohn’s symptoms2.

5. Dehydration

Chronic diarrhea can cause you to lose more liquids and electrolytes than you take in, leading to an increased risk of dehydration, according to the Cleveland Clinic. Chronic dehydration can become serious because your heart (and other vital organs) need water to function. Some common signs of dehydration include feeling really thirsty, having a dry mouth, or getting a headache. Some less obvious signs include feeling fatigued, moody, or nauseous. If you develop additional symptoms, such as a fever, muscle twitching, or a rapid heart rate, then you may be severely dehydrated and need urgent medical care.

6. Fever

This doesn’t necessarily mean you’re burning up 24/7, but your temperature might spike when your digestive tract is under siege during a Crohn’s disease flare-up. Fever is one sign that your body’s immune system has activated in response to a threat, per the NLM, and this can happen because of inflammation tied to Crohn’s disease, Dr. Farhadi says.

7. Fatigue­­

It’s pretty much a given that when you’re dealing with Crohn’s disease symptoms like diarrhea and a fever, it’s hard to feel energetic. All that inflammation and your body’s resulting immune response can contribute to low energy and fatigue, according to Dr. Farhadi.

Diarrhea and its effects can also be a culprit, Dr. Philpott says. When you have diarrhea, your body doesn’t absorb the nutrients you eat as well as it should, and that can affect your overall health, she explains. In addition to dehydration, this can possibly lead to issues like anemia, which can make you feel tired. Finally, to round it out, symptoms of Crohn’s can keep you up at night, making things even worse, Dr. Philpott says.

8. Decreased appetite

It’s no wonder that you won’t necessarily have a raging appetite if you’re dealing with things like diarrhea, stomach pain, and bloating. “Some people may even be scared that eating will increase the pain,” Dr. Farhadi says. Plus, many people experience nausea or even vomit, which can make food seem really unappetizing.

9. Unintentional weight loss

“This can be the consequence of not properly absorbing dietary calories because the gut is damaged, but can also be a manifestation of inflammation,” Dr. Lebwohl says.3 “When the body has ongoing inflammation, it is in a state where it’s expending energy and calories and that can cause weight loss.”

Additionally, a lack of appetite can also lead to weight loss because you simply may not be eating enough. Combine that with the fact that Crohn’s can make it hard to fully absorb nutrients when you do manage to eat, and it’s easy to see why people with this illness may grapple with unintended weight loss.

10. Anal fissures

Chronic inflammation can make the lining of your anal canal sensitive and prone to tears, known as anal fissures. These tears can happen for numerous reasons, but they’re generally caused by prolonged diarrhea in the case of Crohn’s disease, according to the Mayo Clinic. Anal fissures can be identified as a visible break in the skin around your anus—but that can be hard to spot on your own. Other signs of an anal fissure include seeing blood on your toilet paper or in your stool or having severe pain during and after your bowel movements. If this happens, schedule an appointment with your doctor.

11. Anal fistula

People with Crohn’s can have severe ulcers that create tunnels through their intestinal walls, creating abnormal openings between different body parts. This is known as a fistula, per the Mayo Clinic. They’re commonly located near the anal area, but they can develop between the intestines and skin or intestines and another organ. Fistulas can be horrendously painful, and if you have one near your anus, you might experience intense aching in that area, in addition to drainage.

12. Skin, joint, and, eye inflammation

People who have severe Crohn’s disease may also experience symptoms beyond their GI tract, which are side effects caused by chronic inflammation in the body, Peter D.R. Higgins, M.D., Ph.D., professor of gastroenterology and director of the IBD Program at the University of Michigan, tells SELF. In some cases, you could develop arthritis and have very swollen and painful sore joints, the Mayo Clinic says. You might also have inflammatory eye problems, like conjunctivitis (the medical term for pink eye)4, or inflammatory skin issues, like erythema nodosum5, which causes painful round lumps commonly on the front of your legs.

13. Itchy skin on large areas

You have little tubes called ducts that move bile, an essential digestive fluid, from your liver to your gallbladder and small intestine, according to NLM. Sometimes, inflammation causes scarring, which blocks these ducts in a condition called primary sclerosing cholangitis, according to the Mayo Clinic. This reduced bile flow can cause serious itching all over your body.

The majority of people with primary sclerosing cholangitis also have an inflammatory bowel disease like Crohn’s disease, according to the Mayo Clinic. It’s not necessarily a cause-and-effect link and experts aren’t totally sure why this connection exists. Still, it’s worth flagging this to your doctor, especially if you have other Crohn’s disease symptoms.

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Do different types of Crohn’s disease cause different symptoms?

Here’s where things get a bit more complex. There are different types of Crohn’s disease, and they’re categorized by which part of your GI tract the condition is targeting. Although there are commonalities among all forms of Crohn’s disease, you may be prone to certain symptoms depending on the type you have, says Dr. Higgins.

According to the Cleveland Clinic, the types of Crohn’s disease include:

  • Ileocolitis involves the small intestine and part of the large intestine. This is the most common type of Crohn’s disease, affecting about 40% of people with the condition3. Blood in the stool is more likely when Crohn’s impacts the large intestine, usually as a result of ulcers (sores) that form on the inner lining of the organ.
  • Ileitis means your small intestine (ileum) becomes inflamed. People with ileitis can have typical Crohn’s disease symptoms, but inflammation in the small intestine generally leads to cramps and diarrhea after meals as well as increases your risk of developing fistulas6. You may also be more likely to experience B12 deficiency because the ileum is where this nutrient is absorbed6.
  • Gastroduodenal occurs when your stomach and the top of the small intestine (your duodenum) are inflamed. You can have any Crohn’s symptoms, but you may be more likely to experience abdominal pain, nausea, and vomiting from the stomach inflammation, according to the Crohn’s & Colitis Foundation. Persistent symptoms can be a sign that you have an obstruction in this area7.
  • Jejunoileitis is when you have patches of inflammation in the middle part of your small intestine, or the jejunum. Similar to the other types of Crohn’s disease affecting the small intestine, your main symptoms may be cramping and diarrhea after meals. The primary function of the jejunum is to absorb water and nutrients from food—specifically, sugars, amino acids, and fatty acids—so damage in this area can lead to nutrient deficiencies and diarrhea.
  • Crohn’s (granulomatous) colitis affects your colon (large intestine) and frequently causes fistulas, scar tissue, and bowel obstructions if the inflammation isn’t treated6.

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Wait, what’s the difference between Crohn’s disease vs. ulcerative colitis symptoms? And what about IBS?

If you’re dealing with ongoing digestive distress such as diarrhea and abdominal pain, it can be tough to nail down the actual cause. For one, those symptoms can also be a sign of irritable bowel syndrome (IBS), which is characterized by a collection of repeated GI symptoms because the gut and brain don’t communicate well, according to the NIDDK. “Many of the symptoms of Crohn’s disease and IBS can overlap, and it can be a real challenge to distinguish between the two,” Dr. Lebwohl says. However, IBS doesn’t damage your digestive tract in the way IBD does, he adds.

To complicate things further, there is a significant overlap between Crohn’s disease symptoms and ulcerative colitis symptoms, the other common form of IBD, according to Dr. Lebwohl. But there are a few subtleties to watch for and report to your doctor to help guide you toward the most accurate diagnosis.

“Blood in stool is a much more common symptom in ulcerative colitis, whereas people with Crohn’s might not see any blood in their stool depending on where in the intestinal tract the Crohn’s is active,” Dr. Lebwohl says. Another small difference between Crohn’s and ulcerative colitis is that generally Crohn’s disease pain and discomfort happens in between bowel movements whereas ulcerative colitis pain typically happens right around the time of bowel movements, Dr. Higgins says.

What’s more, ulcerative colitis affects the colon in one continuous inflamed area and Crohn’s disease can occur in patches anywhere in the digestive tract, according to UCLA Health, which helps explain some of the variations in symptoms.

The only way to know for sure whether you're dealing with Crohn’s disease or ulcerative colitis is by seeing a doctor for an exam and testing.

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How do you get a Crohn’s disease diagnosis?

“Any time you have blood in your stool, that’s not normal,” Dr. Higgins says. That’s a red flag on its own and should prompt a call to your doctor. Otherwise, having a random bout of abdominal pain and diarrhea that goes on for two or three days might be just a fluke, but if it persists for longer than that or you experience multiple bouts of a few days of symptoms at a time, see your doctor, Dr. Higgins says. Additionally, having an unexplained fever lasting more than two days and sudden weight loss are also reasons to make an appointment.

Diagnosing Crohn’s disease is a detailed process that often requires a few steps involving tests and potential procedures. At your first appointment, you’ll have a physical exam so your doctor can check for stomach bloating, tenderness, and signs of Crohn’s disease pain. It’s worth preparing a list of your Crohn's disease symptoms and how often they happen, in addition to thinking about your personal and family medical history, since your doctor should discuss those with you as well.

If necessary, your doctor may recommend doing lab tests (such as blood or stool tests), imaging (such as a CT scan or MRI), or procedures like a colonoscopy (in which a long bendy tube is inserted into the digestive tract), to help look for signs of Crohn’s disease. However, it’s important to note that there is no single test to identify Crohn’s disease or other forms of IBD, so you may need to undergo several of these before your doctor lands on a final diagnosis.

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Are there Crohn’s disease complications that can make your symptoms worse?

If Crohn’s disease goes untreated and the inflammation progresses, it can lead to a handful of complications that can make your symptoms worse. According to the NIDDK, potential Crohn’s disease complications include:

  • Bowel obstructions can be caused by thickened scar tissue in the GI tract, which can lead to narrowed intestines, blocking food or stool from traveling through them.
  • Abscesses are infected pockets of tissue containing pus in the abdominal, pelvic, or anal area.
  • Ulcers are open sores caused by inflammation that can appear in your mouth, intestines, anus, or perineum.
  • Malnutrition happens when your intestines are damaged and can’t absorb nutrients as well or if you lose your appetite and don’t eat.
  • Enteropathic arthritis is inflammatory arthritis that develops when your chronic inflammation moves outside of your GI tract6. When this happens, you may feel pain in your knees, ankles, or hips, for example.
  • Kidney stones are lumps of minerals and salts that can develop when Crohn’s disease makes it harder for your body to absorb fat7. These hard deposits can be very painful when passed through the urinary tract.
  • Urinary tract issues, such as ureteral obstruction (blockage of the tubes that transport urine from the kidney to the bladder), are also a possibility if you develop fistulas8.
  • Primary sclerosing cholangitis, a type of chronic inflammatory liver disease, can happen when your bile ducts become inflamed.