Crohn’s disease is a type of inflammatory bowel disease (IBD) that most commonly develops in the small intestines and the colon. It affects more than 780,000 people in the United States.
While Crohn’s itself is not fatal, it can lead to serious, potentially fatal complications.
When you live with Crohn’s, inflammation in the gastrointestinal (GI) tract can lead to a number of symptoms like severe diarrhea, abdominal pain, and cramping. Some people also lose weight and experience malnutrition because they can’t absorb enough nutrients from their food, due to the damage to their gastrointestinal (GI) tract.
The natural course of inflammatory bowel diseases can vary. Some people experience a disease that progresses, while others experience symptoms that come and go — and everything in between. Managing inflammation is the most important strategy to avoid dangerous complications.
On its own, Crohn’s disease is not fatal. However, it can lead to life threatening complications, depending on the extent and location of the disease. Those complications could potentially lead to death if not addressed or treated promptly.
Life expectancy for people living with Crohn’s depends on a variety of factors, including disease severity, age at diagnosis, and treatment. Many people with Crohn’s live healthy lives with extended periods of remission, and new treatments are emerging. Here’s what the research says.
A 2009 meta-analysis found a slightly increased mortality among patients with Crohn’s disease, particularly women. The increase may be the result of gastrointestinal diseases and diseases with a possible link to smoking, such as respiratory diseases and those that affect the urinary and genital tracts. More research is needed to see if newer treatments may be helpful in reducing that risk.
According to the study, females with IBD may live from 6.6 to 8.1 years less than females without IBD. Males with IBD may live from 5.0 to 6.1 years less than males without the condition. The researchers suggested one reason for reduced lifespan could be the effect of pain on daily functioning.
Opportunistic infections are those that occur more frequently and severely in people with compromised immune systems. People who take azathioprine have about a five times higher risk of developing lymphoma than people who do not take the medication. However, some people choose to take azathioprine if it allows them to stay in remission longer.
For people receiving thiopurine treatment, certain factors can influence how withdrawing from the medication may affect their lifespan. These factors include gender, age, and disease severity.
Many people with Crohn’s go into remission for prolonged periods of time and live happy, healthy lives, despite the occasional flare. But certain risk factors may affect life expectancy. These factors can include:
- your gender
- what kind of medications you take to treat Crohn’s
- whether you smoke
- your age at diagnosis
- the severity of the disease
- whether prolonged inflammation has damaged other organs
Not everyone develops serious complications from Crohn’s. Seeking treatment early and making any changes your doctor recommends can help to manage Crohn’s effectively and prevent any complications.
If Crohn’s disease is left untreated, this may raise the chance of serious complications.
People living with Crohn’s disease have a higher risk of developing colorectal cancer. The risk increases the longer a person lives with the disease, according to the Crohn’s and Colitis Foundation of America.
An intestinal obstruction is the most common complication for people with Crohn’s disease.
Swelling from inflammation or scar tissue that forms along the bowel wall can make the passage narrower. This is called a stricture.
When a stricture is only due to inflammation, it is more likely to be reversible with medications.
Inflammation can also cause a scar to form. This makes it less likely to be responsive to medication alone. That’s why it’s important to properly manage and reduce inflammation before a scar forms.
Medication can often decrease inflammation. However, if the stricture is severe and medication isn’t effective, surgery may be needed. If not addressed, the stricture can cut off the blood supply to part of the intestines, causing the tissue to die. Tissue death can also lead to perforations or life threatening infections.
About 30 percent of people with Crohn’s disease develop fistulas. These are tracts or tunnels that form from ulcers or sores in the intestinal tract. They may develop in or between the intestines, but they may also tunnel out into the bladder or other tissues.
Fistulas can get infected and cause abscesses. Medication, surgery, or both may be necessary, especially for numerous or large fistulas.
A perforation, or hole, in the intestinal wall is a serious complication. The bowel’s contents may spill through the hole and into the abdomen. Bacteria could potentially lead to peritonitis, a serious infection of the lining of the tissue inside your abdomen.
Spontaneous perforation is rare and requires emergency surgery to correct.
Many experts consider toxic megacolon to be the most serious of the possible Crohn’s disease complications. The colon is unable to contract, so the abdomen becomes alarmingly distended. If left untreated, it can lead to sepsis, and possibly perforations in the colon.
Toxic megacolon is a rare complication of Crohn’s disease and more likely to occur in people who have ulcerative colitis.
Crohn’s disease is not life threatening with proper medical treatment and lifestyle changes. The only time it may lead to potentially life threatening complications is if it’s left untreated.
However, Crohn’s can cause complications that can impact your quality of life. Severe cases may cause:
Crohn’s disease seems to affect both men and women equally, and it develops most commonly when a person is between the ages of 15 and 35. There may also be genetic and environmental factors.
Doctors may choose from a list of possible diagnostic tests to diagnose Crohn’s disease.
Typically, they start with blood tests and stool tests. In addition, they may do one of the following procedures:
- imaging tests, such as an X-ray, CT scan, or MRI scan
- upper endoscopy
- capsule endoscopy
During an endoscopic procedure, your doctor may collect tissue samples for testing, a process known as a biopsy.
There’s no single recommended treatment regimen for Crohn’s disease. The goal is always to decrease inflammation and reduce your symptoms, so whatever works for you is the right treatment.
Your doctor may recommend certain medications and dietary changes to start. If your symptoms get worse, you may need to consider surgery.
Your symptoms will determine which medications your doctor recommends.
People with mild symptoms may have success with a category of drugs known as aminosalicylates. These are anti-inflammatory drugs. Corticosteroids are also anti-inflammatories sometimes prescribed for temporary use in severe symptoms.
Other medications used to treat Crohn’s disease include:
- biologic therapies
Dietary changes may also help improve symptoms. These include:
- hydrating properly
- avoiding high fiber foods
- limiting fat and dairy
- eating smaller meals
Your doctor may also suggest specific changes like boosting your calorie intake and taking vitamins or supplements if you’re not absorbing enough nutrients.
People experiencing severe flare-ups may need to take a break from eating solid food for a few days or even a few weeks. You may need to drink high calorie drinks or receive intravenous nutrition while on bowel rest.
When medication can no longer effectively control symptoms, you may need surgery to preserve part of your gastrointestinal tract.
Depending on the severity of the disease and symptoms, people with Crohn’s disease may need to undergo one or more of these procedures:
While the Food and Drug Administration (FDA) hasn’t approved complementary and alternative medicine (CAM) therapies for the treatment of Crohn’s disease, some people have found them helpful. These include:
Before you try any of these therapies, speak with your doctor.
If you experience a flare-up, contact your doctor right away. They may want to know if you’ve changed anything about your management approach, such as consistently taking prescribed medications.
Also, if you start developing new or severe symptoms, let your doctor know right away. Sudden abdominal pain could be a sign of a bowel obstruction.
Call your doctor if you experience other symptoms such as:
- bloody bowel movements
- unexplained weight loss
- diarrhea that can’t be controlled with over-the-counter medications
Crohn’s disease is a serious disease. While there is currently no cure, treatments can effectively manage the disease. As with many other chronic diseases, you may have flare-ups and periods of remission.
If you’re experiencing new symptoms or worsening of symptoms, speak with your doctor. It’s always best to address potential complications early, before they can progress.
Your doctor can help you create an effective treatment plan to manage Crohn’s and reduce its impact on your life.