What is Crohn’s disease?

Crohn’s disease is a type of inflammatory bowel disease. It causes inflammation (swelling and redness) inside your digestive tract. This can lead to symptoms such as abdominal (tummy) pain and diarrhoea.

Crohn’s disease can develop at any age, but usually first appears in people aged in their 20s and 30s.

Crohn's disease is more common in people living in the Western world, but it’s also becoming more common in developing countries. Australia has one of the highest rates of inflammatory bowel disease in the world.

What are the symptoms of Crohn’s disease?

Common symptoms of Crohn’s disease include:

• diarrhoea
• abdominal pain and cramping
• fatigue (tiredness)
• reduced appetite
• weight loss

Other symptoms may include:

• blood and/or mucous in your stools (poo)
• mouth ulcers
• fever
• pain or swelling around your anus (back passage)

Symptoms tend to come and go over time, as the inflammation flares up then eases again (known as ‘remission’).

Symptoms also depend on which area of your gut is affected.

Not all people with Crohn’s disease will have the same symptoms.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes Crohn’s disease?

The exact cause of Crohn’s disease isn’t known. But it is known that genetics, infections and other environmental factors are important.

While stress and some foods can trigger symptoms, Crohn’s disease is not caused by diet or stress alone.

What is the difference between Crohn’s disease and ulcerative colitis?

Ulcerative colitis is another type of inflammatory bowel disease (IBD).

These 2 diseases affect the digestive tract in different ways:

• Crohn’s disease can affect any part of your digestive tract, from your mouth to your anus (back passage). It usually affects the last section of your small bowel (the ileum) and/or your colon. Inflammation can extend into the entire thickness of the bowel wall. Inflammation caused by Crohn’s disease may also affect other parts of your body, such as your eyes or joints.
• Ulcerative colitis only affects your large bowel (colon or rectum), and inflammation is only in the surface layers of your bowel lining. It causes ulcers (tiny, open sores) in the lining of your bowel.

When should I see my doctor?

See your doctor if you have any symptoms of Crohn’s disease. Your doctor may refer you to a gastroenterologist (specialist doctor) for diagnosis and treatment.

If you have Crohn’s disease, it’s recommended to see your doctor for a checkup at least every 6 months.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is Crohn’s disease diagnosed?

Your doctor will ask about your symptoms and general health. They will also examine you. Your doctor or specialist may recommend some of the following tests to help diagnose Crohn’s disease.

• Blood tests can show inflammation, any vitamin or mineral deficiencies and rule out other potential causes of your symptoms, such as coeliac disease.
• A stool sample may be used to test for faecal calprotectin. This shows if there is inflammation in your bowel. Stool samples are often tested for infection as well.
• A colonoscopy (or sigmoidoscopy) uses a thin, flexible tube containing a tiny camera looks inside your bowel for inflammation. A similar test can also be used to look inside your stomach (gastroscopy).
• Biopsies are small samples of tissue may be taken from inside your bowel during a colonoscopy. These are examined under a microscope to look for signs of disease.
• Imaging tests such as x-ray, CT scan or MRI scan may also be recommended.

How is Crohn’s disease treated?

Although there is no cure for Crohn’s disease, there are several treatments to help control the inflammation and improve your quality of life.

Medicines

Medicines that may be used to control inflammation in Crohn’s disease include:

• 5-aminosalicylates (5-ASA medicines)
• corticosteroids
• medicines that suppress your immune system’s response to the inflammation caused by Crohn’s disease (known as immunomodulators)
• biologic medicines — that target specific cells or proteins in your body to reduce inflammation
• antibiotics

Nutrition

It’s recommended that most people with inflammatory bowel diseases follow the Australian Guide to Healthy Eating without any changes. Research is ongoing into whether special diets might worsen or improve symptoms of inflammatory bowel diseases.

Some people with inflammatory bowel diseases develop nutritional deficiencies. Ask your doctor or dietitian if you should take any dietary supplements, such as those to boost your levels of:

• iron
• vitamin D
• calcium

In some cases, switching from a normal diet to a completely liquid diet for a period of time (usually about 6 to 8 weeks) is helpful in relieving the inflammation caused by Crohn’s disease. This is known as exclusive enteral nutrition (EEN). Your doctor or dietitian can advise whether this is recommended for you. If you have EEN, your doctor or dietician would be responsible for prescribing the liquid nutrition and monitoring you closely for any complications.

To find an accredited practising dietitian who may be able to help manage your Crohn’s disease, visit the Dietitians Association of Australia.

Surgery

Surgery for Crohn's disease is sometimes needed to remove or widen sections of your bowel that are badly affected by the disease. The healthy ends of your bowel are usually reconnected to each other.

Sometimes, a stoma (an artificial opening in your tummy that diverts faeces (poo) into a bag outside your body) is needed. A stoma can be temporary or permanent. It's normal to feel uneasy about the idea of living with a stoma, but many people find it greatly improves their quality of life.

Living with Crohn’s disease

Seeing your GP or specialist for regular follow-up can reduce your symptoms and treat any flare-ups early. Your doctor can also help you manage medicine side effects and advise you if you experience other problems that affect your quality of life.

Here are some other things you can do to help stay healthy and reduce your chance of flare-ups:

• Quit smoking.
• Avoid excessive alcohol intake.
• Be vaccinated as recommended by your doctor, especially if you take medicines that affect lower your immune system.
• Exercise regularly to improve your general health, lift your mood and help relieve stress. Regular weight-bearing exercise can also help reduce your chance of developing osteoporosis.
• Maintain a balanced diet.

Living with a chronic condition can affect your quality of life and mental health. If you are struggling, seek help from your doctor or a mental health professional.

Learn more about living with a chronic condition.

Can Crohn’s disease be prevented?

While you can’t prevent Crohn’s disease, you can reduce your risk by quitting smoking. You can also help prevent flare-ups and complications by taking your medicines as prescribed and maintaining a healthy lifestyle.

What are the complications of Crohn’s disease?

There are many possible complications associated with Crohn’s disease. These can be related to your gut or other parts of your body.

Dietary deficiencies

It is possible to develop vitamin or mineral deficiencies or become malnourished. Your doctor or dietitian can advise you how to manage these.

Risk of osteoporosis

People with inflammatory bowel diseases often have many risk factors for developing osteoporosis, including:

• poor nutrition
• low BMI (Body mass index)
• chronic inflammation
• treatment with corticosteroids

To manage your risk, your doctor may recommend screening for osteoporosis with regular bone density scans.

Bowel obstruction

Crohn's disease can cause bowel obstruction. This is a medical emergency that needs to be treated in hospital.

Symptoms of bowel obstruction include increasing abdominal pain and cramping that comes and goes, as well as vomiting.

Other gut complications

Crohn's disease can cause complications anywhere in your gut. Complications around your anus can include:

• abscesses (boils)
• flaps of thickened skin
• anal fissures

Fistulas are another possible complication. Fistulas are tunnels, or ‘tracks’, that connect your bowel to:

• other parts of your gastrointestinal tract
• other organs
• your outer skin surface

Fistulas usually develop in areas of severe scarring and ulceration.

Inflammation in other parts of the body

Some people with Crohn’s can develop inflammation in other parts of the body, such as the:

• liver
• skin
• joints
• eyes

Resources and support

Speak with your doctor or gastroenterologist to learn more about your condition.

You can also visit Crohn's & Colitis Australia or call the IBD helpline on 1800 138 029.

The Gastroenterological Society of Australia (GESA) also has resources on Crohn’s disease.

For more information about living with a stoma, visit the Australian Council of Stoma Associations.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Other languages

Crohn’s & Colitis Australia has information about Crohn’s disease in a variety of community languages.