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.

In Crohn’s, inflammation in the gastrointestinal 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 GI tract.

The natural course of IBD can vary, with some having a disease that progresses and some having symptoms that come and go, and everything in between. Keeping inflammation under control is the most important strategy to avoid complications.

While Crohn’s itself is not fatal, it can lead to serious, potentially fatal 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.

Could having this disease shorten your life? Perhaps.

A 2009 meta-analysis of nine population-based studies explained that there seems to be a “slightly but significantly increased mortality among patients — especially women” with Crohn’s disease. The increase seems to be mostly the result of gastrointestinal diseases and diseases with a possible link to smoking, such as respiratory and genitourinary diseases. More research is needed to see if newer treatments may be helpful in reducing that risk.

Some research indicates that taking certain kinds of medication for Crohn’s disease for a long time may also affect a person’s lifespan.

People who taken immunosuppressive drugs known as thiopurines, such as azathioprine, may be more vulnerable to opportunistic infections and lymphoma, according to several studies. Opportunistic infections are those that occur more frequently and more severely in people with compromised immune systems. People who take azathioprine have about a five times higher risk of developing lymphoma than people who don’t take this medication. However, some people prefer to take that risk if the medicine allows them to stay in remission longer.

Factors like gender, age, and disease severity can influence how withdrawing a person from thiopurine treatment will likely affect their lifespan. People with extensive symptoms may actually see a likely increase in their lifespan by continuing to take thiopurines, and may also have a decreased risk of developing colorectal cancer.

Left untreated, Crohn’s disease may raise your chances of experiencing serious complications.

Colorectal cancer

People with Crohn’s disease have a higher risk of developing colorectal cancer. They’re also at increased risk for dying from colorectal cancer than people without Crohn’s disease who are diagnosed with colorectal cancer, according to a large 2020 cohort study. The risk increases the longer you live with the disease, according to the Crohn’s and Colitis Foundation of America.

Intestinal obstruction

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, which makes it less likely to be responsive to medication alone. That’s why it’s important for inflammation to be under control before a scar forms.

You might feel abdominal cramping, or experience bloating or vomiting.

Medication can often decrease inflammation, but if the stricture is so severe that medication doesn’t work, you may need surgery. If not addressed, that obstruction can cut off the blood supply to part of your intestines, and the tissue can die. Tissue death can also lead to perforations or even life-threatening infections.

Fistulae

About 30 percent of people with Crohn’s disease develop fistulae, which 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.

Perforated colon

A perforation, or hole, in the intestinal wall is a serious complication because the bowel’s contents can spill through the hole and into the abdomen. The bacteria could potentially lead to peritonitis, a serious infection of the lining of the tissue inside your abdomen.

Spontaneous perforation is rare, affecting only 1 to 2 percent of people with Crohn’s disease in Western nations, but it requires emergency surgery to correct.

Toxic megacolon

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.

It’s a rare complication of Crohn’s disease, and more likely to occur in people who have ulcerative colitis.

Many people go into remission for prolonged periods of time. But if your Crohn’s disease has led to a serious complication, your life may indeed be at risk.

For example, an infection or sepsis can be fatal if not caught early or treated effectively.

Not everyone develops those complications, however, so it’s not a foregone conclusion that you will develop any of them. But that knowledge may be an impetus to seek treatment and to remain consistent with it.

Crohn’s disease is dangerous in that it can lead to potentially life-threatening complications. But it can also cause complications that, while not potentially fatal, can have a significant impact on your quality of life. You might develop:

Crohn’s disease doesn’t seem to differentiate between men and women, but it does develop most commonly when a person is between the ages of 15 and 35. There may also be genetic factors and environmental factors at work.

If you experience flare-ups, which can happen at any time throughout the course of your life, let your doctor know. They may want to know if you’ve changed anything about your management approach, such as consistently taking prescribed medications.

Research suggests that people who don’t stick with their medication regimens are more likely to experience flare-ups than people with good medication adherence.

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 like:

  • bloody bowel movements
  • unexplained weight loss
  • fever
  • diarrhea that can’t be controlled with over-the-counter medications

Doctors may choose from a list of possible diagnostic tests when they suspect someone may have 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 X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI).
  • colonoscopy, a procedure that uses a long, thin, and flexible endoscope with a tiny camera on the end inserted into your anus so the doctor can view your entire colon.
  • sigmoidoscopy, a procedure that uses an endoscope to view just the end of your colon.
  • upper endoscopy, which is a top-down view of your small intestine, using an endoscope threaded through your mouth and down your esophagus.
  • capsule endoscopy, a minimally invasive procedure which entails swallowing a capsule containing a camera that will provide a view into the small intestine.

During an endoscopic procedure, your doctor may collect tissue samples for testing, a process known as a biopsy.

There’s not a single recommended treatment regimen for Crohn’s disease. The goal is always to decrease inflammation and reduce your symptoms.

Your doctor may recommend certain medications and dietary changes to start. If your symptoms get worse, you may need to consider surgery.

Medication

Your symptoms will dictate what medications your doctor will recommend. People with mild symptoms may find success with a category of drugs known as aminosalicylates, which are anti-inflammatory drugs. Corticosteroids are also anti-inflammatories that are sometimes prescribed for temporary use in severe symptoms. Other medications used to treat Crohn’s disease include:

  • immunomodulators
  • antibiotics
  • biologic therapies

Dietary changes

Dietary changes may 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.

Bowel rest

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.

Surgery

When medication can no longer effectively control symptoms, you may need surgery to preserve part of your gastrointestinal tract. According to the Crohn’s and Colitis Foundation, between two-thirds and three-quarters of people with Crohn’s disease will need surgery at some point in their lives. People with Crohn’s disease may need to undergo one or more of these procedures, depending on the severity of their disease and symptoms.

  • strictureplasty to shorten or widen the intestine to get rid of scarring
  • ostomy to bring an end of the intestine up to the abdominal wall, so waste can be removed (typically in an ostomy bag)
  • colectomy to remove diseased sections of the bowel
  • proctocolectomy to remove the rectum and colon

Natural remedies

While the U.S. 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:

  • fish oil
  • prebiotics
  • probiotics
  • supplements
  • aloe vera
  • acupuncture

Before you try any of these therapies, speak with your doctor.

Crohn’s disease is a serious disease, and while it can’t be cured, it can be managed and treated. As with many other chronic diseases, you may have flare-ups and periods of remission. If you’re experiencing new symptoms or the worsening of symptoms, tell your doctor. It’s always better to address potential complications early on, before they can progress.