Crohn's disease is generally more difficult to diagnose than the other major inflammatory bowel disease (IBD) ulcerative colitis. This is because, unlike the ulcerative colitis, Crohn's isn't confined to any one area of the gastrointestinal (GI) tract. Ulcerative colitis is located in the colon, while Crohn's may appear anywhere from the mouth to the anus. Because of this, there are several different types of Crohn's disease, each with its own set of symptoms. If you know which symptoms to watch out for, you can better help your doctor make a proper diagnosis.
General Symptoms of Crohn's Disease
A few symptoms are common among all types of Crohn's disease. These symptoms include abdominal pain with cramps, diarrhea, weight loss, and a lack of energy. Pain usually begins within an hour of eating and is most often centered around the navel, the lower right abdomen, or both. Activities such as jogging will often make the pain worse. Another symptom that differentiate Crohn's from ulcerative colitis is an area of swelling—found in about 25 percent of Crohn's patients—that’s usually located in the lower right part of the abdomen. The swelling is typically about the size and firmness of a small grapefruit. The tenderness of the swelling, which is easily felt, ranges from mild to extreme. Mild tenderness points to an inflamed intestine and enlarged lymph glands. Extreme tenderness may be due to an abscess, in which case the skin may appear red and/or stretched. Moderate tenderness could signal a combination of the above causes.
Another symptom of Crohn's disease that affects 25 percent of patients is perianal disease. It’s usually is in the form of a fistula (an abnormal connection between two organs that aren't usually joined) which may also include one or more abscesses. Some patients have swollen skin tags around the anus as well.
Symptoms of Crohn's Disease of the Colon
Symptoms of Crohn's disease of the colon, also known as Crohn's colitis, manifest differently depending on where the disease is located in the colon.
If the disease is on the right side of the colon, a patient will generally have cramps and diarrhea. If it’s located on the left side or involves most of the colon, a person may experience blood in the stool in addition to the other symptoms.
If the disease is located on the rectum, symptoms will be similar to ulcerative colitis and include bloody diarrhea or false urges,the feeling of having a bowel movement in which little or nothing comes out.
Symptoms of Crohn's Disease of the Small Intestine
Between 70 and 80 percent of patients with Crohn's disease of the small intestine (small bowel Crohn's) will experience cramps, diarrhea, and weight loss.
Occasionally, a person with small bowel Crohn's will have constipation rather than diarrhea. Pain is so extreme with this type of Crohn's that some people will avoid eating, which accounts for most of the weight loss.
Symptoms of Crohn's Disease of the Ileum and Colon
Someone with both Crohn's of the ileum (a portion of the small intestine) and Crohn's colitis may experience symptoms associated with either of the diseases above, or both. This is because Crohn's of the ileum may flare up when the colonic disease is in remission, or vice versa.
Symptoms of Crohn's Disease of the Stomach or Duodenum
Many people who have Crohn's of the stomach or duodenum will experience no symptoms at all. Over 90 percent of those who have symptoms, however, will have pain in the upper abdomen either during or immediately following a meal. A smaller percentage will experience nausea, vomiting, or both.
Around half of the people who have symptoms of Crohn's of the stomach or duodenum will experience weight loss due to food avoidance. In some cases, because of scarring, this type of Crohn's will cause a narrowing of the outlet of the stomach into the duodenum. If this happens, patients will usually experience a decrease in appetite, a prolonged bloated feeling located in the upper abdomen, and nausea.
Symptoms of Crohn's Diseases of the Appendix, Esophagus, and Mouth
These types of Crohn's are extremely rare; therefore, it’s not possible to identify their "typical" symptoms. Crohn's disease of the appendix may mimic appendicitis and can be present without any other unique symptoms. Crohn's of the esophagus may cause pain behind the breastbone while swallowing.
If the esophagus has become narrower due to scarring, a person may have trouble swallowing or food may become stuck on the way down. If you have these symptoms, contact your doctor immediately.