The two major inflammatory bowel diseases, ulcerative colitis and Crohn's disease, share certain characteristics:
- Symptoms usually appear in young adults.
- Symptoms can develop gradually or have a sudden onset.
- Both are chronic. In either disease, symptoms may flare up (relapse) after symptom-free periods (remission) or symptoms may be continuous without treatment.
- Symptoms can be mild or very severe and disabling.
The specific symptoms of Crohn’s disease vary depending on where the disease is located in the intestinal tract (ileum, colon, stomach, duodenum, or jejunum). Common symptoms of Crohn’s disease include:
- Abdominal pain, usually in lower right side
- Weight loss
- Rectal bleeding
- Nausea and vomiting
- Skin lesions
- Joint pain
Eyes. Inflammation in the eyes is sometimes an early sign of Crohn's disease. Retinal disease, including detachment, can occur but is rare. People with accompanying arthritic complications may be at higher risk for eye problems.
Joints. Inflammation causes arthritis and stiffness in the joints. The back is commonly affected. Patients with Crohn's disease are also at risk for clubbing (abnormal thickening and widening at the ends of fingers and toes).
Mouth Sores. Canker sores are common, and when they occur they persist. Mouth yeast infections are also common in people with Crohn's disease.
Skin Disorders. Patients with Crohn's disease may develop red knot-like swellings. Such swellings or other skin lesions, such as ulcers, may spread to sites far removed from the colon, (including the arms and legs). People with Crohn's disease have an increased risk for psoriasis.
Difference between Symptoms of Mild and Severe Crohn’s Disease
Mild Crohn's Disease. The fewer the number of bowel movements, the milder the disease. In mild disease, abdominal pain is absent or minimal. The patient has a sense of well-being that is normal or close to normal. There are few, if any, complications outside the intestinal tract. The doctor does not detect any mass when pressing the abdomen. The red blood cell count is normal or close to normal, and the patient is not underweight. There are no fistulas, abscesses, or other chronic changes.
Severe Crohn's Disease. In severe Crohn's disease, the patient has bowel movements frequent enough to need potent anti-diarrhea medication. Abdominal pain is severe and usually located in the lower right quadrant of the abdomen. (The location of the pain might not indicate the site of the actual problem, a phenomenon known as referred pain.) The red blood cell count is low. The patient has a poor sense of well-being and experiences complications that may include weight loss, joint pain, inflammation in the eyes, reddened or ulcerated skin, fistulas, abscesses, and fever. The surgical and medical treatments of Crohn's disease, as with ulcerative colitis, have complications of their own that can be severe.
Review Date: 09/28/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.