Stages of Crohn's Disease
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Stages of Crohn’s Disease

Stages of Crohn’s Disease

Crohn’s disease is marked by inflammation of the gastrointestinal (GI) tract. The inflammation can appear anywhere in the GI tract from the mouth to the anus. People with the disease often experience ups and downs in symptoms. They may even experience periods of remission. However, Crohn’s is a progressive disease that starts with mild symptoms and gradually gets worse. The stages of Crohn’s range from mild to moderate to severe. The earlier you treat and manage Crohn’s, the more likely you’ll reduce your risk for developing severe symptoms.

Risk Factors for Crohn’s Disease

Crohn’s is a type of inflammatory bowel disease. It’s considered a chronic condition, which means that you’ll have it for your entire life. The exact cause of Crohn’s is unknown. It most often develops in your 20s.

You have an increased risk for developing Crohn’s if you:

  • have a family member with Crohn’s
  • have a family history of autoimmune diseases, even those outside of Crohn’s
  • smoke
  • are obese
  • eat a high-fat diet
  • live in urban or industrialized areas

Early Signs of Crohn’s Disease

In Crohn’s disease, healthy cells in the GI tract attack themselves, causing inflammation. As a result, you will likely experience a range of symptoms. Early signs of Crohn’s disease include:

  • frequent cramps
  • ongoing abdominal pain
  • frequent diarrhea
  • bloody stools
  • unintentional weight loss

Early diagnosis is important to help prevent damage to the intestines. If you experience these symptoms and have a family history of Crohn’s, you should ask your doctor for testing. Aside from a physical exam, your doctor may also order lab tests, an endoscopy of the intestines, and a CT scan of the GI tract.

Medications can treat inflammation and stop your body from attacking its own cells. Treatment options come in the form of:

  • aminosalicylates that prevent inflammation
  • biologic therapies that reduce the risk of inflammation
  • corticosteroids that reduce immune system activity
  • immunomodulators that prevent inflammation

Disease Progression and Management

As the disease progresses, you may start feeling fatigued, and even develop anemia. You may also experience nausea from constant irritation of the GI tract.

In addition, you may start experiencing symptoms outside of the GI tract. These symptoms include:

  • eye pain
  • fever
  • joint inflammation and pain
  • red skin rashes and bumps
  • mouth sores

At this point, you might need additional medication to treat these symptoms. You should avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, as these can make Crohn’s worse. Instead, ask your doctor if you can safely take acetaminophen (Tylenol).

Your gastroenterologist may also recommend occasional bowel rest. However, not all doctors agree with this measure. A bowel rest involves a strict diet of only liquids for a few days. The purpose is to let the GI tract heal from inflammation and essentially take a break. To prevent malnutrition, you may need an IV. Talk to your doctor before switching to a liquid diet.

Severe Crohn’s and Treatment Options

The severe stage of Crohn’s is marked by symptoms that disrupt your daily life. You might be in constant pain and discomfort, and you may need to use the bathroom frequently. At this stage, inflammation occurs often and your body tissues are at risk of permanent damage.

Despite consistent treatment, you may need surgery if your symptoms become life-threatening. An estimated 20 percent of all people with Crohn’s end up having surgery. Surgery can’t cure the disease, but it may help repair severely damaged tissues and remove blockages.

Although any stage of Crohn’s disease can impact your nutritional intake, your risk of malnutrition is even more severe in the later stages. At this point, your doctor may recommend supplements. Potential supplements include:

  • calcium
  • iron, especially if you are susceptible to anemia
  • multivitamins
  • vitamin B-12
  • vitamin D
  • Protein

A low-fiber diet may be recommended to prevent intestinal blockage. It may also help reduce the occurrence of frequent diarrhea.

Colon Cancer and Other Complications

Severe stages of Crohn’s disease can put you at risk for colon cancer. The constant inflammation and related tissue damage may also lead to other complications, such as:

  • anal fissures
  • bowel obstruction
  • fistulas
  • malnutrition
  • osteoporosis
  • ulcers
  • liver inflammation and disease
  • gallbladder disease
  • frequent infections from taking immune-suppressing medications

Outlook

There’s no cure for Crohn’s disease, but medications and lifestyle changes can help. This is why it’s crucial to identify the disease in its earlier stages. Untreated Crohn’s can lead to further complications of the GI tract, some of which may become permanent. 

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Achieving Remission with Crohn's: Q&A with a GI
Understanding Crohn's: The Remission and Relapse Cycle
How to Know If Your Crohn’s Is Advancing
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