Complications of Crohn’s Disease

Crohn’s disease, especially if the disease is left untreated or inappropriately treated, can result in physical complications. The complications that patients of Crohn's disease experience depend on the location and severity of the disease. Some complications can be serious, while others are manageable with the help of treatment plans prescribed by a gastroenterologist.

To avoid some of these complications, proper diagnosis that leads to prompt treatment and control of symptoms is necessary.

Serious complications

• Obstruction — The swelling and scarring associated with Crohn's disease can obstruct the intestine. When this occurs, a patient may experience painful cramps, or vomiting due to food that is not able to bypass the obstruction.

• Fistulas — Sometimes ulcers caused by Crohn's disease channel through the gut wall to adjacent organs, including the skin, bladder, vagina, intestine, and perianal areas.

• Abscesses — A fistula that tracks into the abdominal cavity may produce infection and form an abscess. Abscesses may also occur in the pelvic tissues or the perineum, if a fistula fails to drain. Abscesses can be difficult for gastroenterologists to diagnose; however, after they are located, they should be drained. This may require surgery. Patients are usually given a course of antibiotics to reduce the risk of further infection.

• Free Perforation — In rare cases, deep, penetrating ulcers tunnel through the layers of the gut into the abdominal cavity. Signs of free perforation include sudden, severe abdominal pain; shock; and excessive abdominal tenderness. The infection that results is called peritonitis, and requires emergency surgery in which the leak is sealed and the abdominal cavity is cleansed to stop infection.

• Hemorrhage — In other rare cases, a bleeding ulcer may burrow through the gut wall and shear an artery. This produces a life-threatening hemorrhage that may require blood transfusions and special measures to promote blood clotting. Sometimes emergency surgery is required.

Chronic complications

• Anemia — Anemia in Crohn's disease may be the result of chronic blood loss; bone marrow depression; or failure to absorb iron and folic acid, which are important in stimulating the production of red blood cells. Certain medications, such as sulfasalazine, may also exacerbate anemia. To combat most cases of anemia, gastroenterologists often prescribe supplements, and recommend a diet rich in iron.

• Malnutrition — Loss of protein, low energy levels, tissue breakdown due to steroid use, poor diet, and, in some cases, failure to absorb nutrients result in weight loss and nutritional deficiencies. Gastroenterologists often prescribe nutritional supplements to avoid the complications that result from deficiencies in vitamins A, D, E, and K.