Symptoms of Crohn’s Disease
The most common symptoms of Crohn’s disease are cramping pain in the belly (abdomen) and ongoing diarrhea. This happens because inflammation makes the intestine empty itself often. The symptoms range from mild to severe. They can vary over time. It’s normal for people with Crohn’s disease to have periods without any symptoms (remission), sometimes for months or years, and then to get symptoms again (recurrence).
Crohn’s disease can lead to other health problems, which cause symptoms and complications of their own. The main complications doctors watch for include:
- Dehydration, or loss of fluids, due to diarrhea
- Ulcers, or sores, in the colon, where waste collects before passing out through the anus. When ulcers go all the way through the intestinal wall, it is called perforation.
- Anemia, or low level of red blood cells, due to bleeding from ulcers. Anemia can cause extreme tiredness (fatigue).
- An abnormal channel (fistula) that develops when a sore extends into another segment of intestine or into the bladder, vagina or skin. A fistula may get infected.
- Tears, or fissures, in the rectum or anus, which may bleed
- Pockets of pus, or abscesses, from infection
- Short-term constipation or complete blocked intestine due to swelling and scarring in the intestine
- Weight loss and, in children, slowed growth or delayed puberty due to trouble getting enough nutrients. Children with Crohn’s disease may have little appetite and eat less, and their intestines may not absorb nutrients well.
- Toxic megacolon, in which the major part of the large intestine (colon) gets severely inflamed. The colon wall then weakens and balloons out. This can rupture, or perforate, the colon.
Some people with Crohn’s disease develop health problems that affect other parts of their bodies. These problems include:
- Arthritis
- Skin problems
- Eye and mouth inflammation
- Kidney stones
- Gallstones
- Liver problems.
Crohn’s Disease Diagnosis
The common symptoms and some complications of Crohn’s disease are similar to those of other forms of IBD, like ulcerative colitis. Because it is often hard to tell whether a child has Crohn’s disease, ulcerative colitis, or some other intestinal problem, it can take time for doctors to make a diagnosis.
First, the doctor will ask for a detailed history of your child’s illness. Then the doctor will examine your child. Next, the doctor may ask your child to have some tests.
Several tests can help doctors diagnose Crohn’s disease. They include:
- Blood tests to check for anemia, which is a sign of bleeding, and to look for a high level of white blood cells, which is a sign of inflammation
- Tests on a stool (feces) sample to look for blood or signs of infection
- X-rays, including sets of X-rays called an upper GI (PDF 48KB) (gastrointestinal) series and a lower GI (PDF 44KB) series (barium enema). Before having either of these X-rays, your child will drink a liquid or have a liquid put in their colon (enema) that helps the intestine show up on X-ray film.
- CT scan, which is a way to see inside the belly.
- Sigmoidoscopy (pronounced sig-moid-OSS-cope-ee) and colonoscopy (pronounced coal-un-OSS-cope-ee) let doctors look inside your child's intestine using a thin tube with a camera called an endoscope. The endoscope lets doctors see pictures on a TV monitor. Colonoscopy looks at the whole colon, while sigmoioscopy looks only at the lower colon.
Looking Inside
One of the best ways to tell what’s happening in your child’s intestine is for the doctor to look at it. Doctors do this by inserting a thin, flexible, lighted tube (endoscope) through your child’s anus. The tube has a camera that’s connected to a computer and a TV monitor. Using this camera, the doctor can look for inflammation, ulcers, and bleeding, and can even take a tiny sample, or biopsy, of the intestine for testing. When doctors look at only the lower colon, this procedure is called sigmoidoscopy (pronounced sig-moid-OSS-cope-ee). When they look at the whole colon, it’s called colonoscopy (pronounced coal-un-OSS-cope-ee). Sometimes the doctors will also do this procedure to look at the stomach and the first part of the small intestine, called the duodenum.