What Are the Complications of Crohn's Disease?
The most common complication is blockage of the intestine. Blockage occurs
because the disease tends to thicken the intestinal wall with swelling and scar
tissue, narrowing the passage. Crohn's disease may also cause sores, or ulcers,
that tunnel through the affected area into surrounding tissues such as the
bladder, vagina, or skin. The areas around the anus and rectum are often
involved. The tunnels, called fistulas, are a common complication and often
become infected. Sometimes fistulas can be treated with medicine, but in some
cases they may require surgery.
Nutritional complications are common in Crohn's disease. Deficiencies of
proteins, calories, and vitamins are well documented in Crohn's disease. These
deficiencies may be caused by inadequate dietary intake, intestinal loss of
protein, or poor absorption (malabsorption).
Other complications associated with Crohn's disease include arthritis, skin
problems, inflammation in the eyes or mouth, kidney stones, gallstones, or
other diseases of the liver and biliary system. Some of these problems resolve
during treatment for disease in the digestive system, but some must be treated
What Is the Treatment for Crohn's Disease?
Treatment for Crohn's disease depends on the location and severity of
disease, complications, and response to previous treatment. The goals of
treatment are to control inflammation, correct nutritional deficiencies, and
relieve symptoms like abdominal pain, diarrhea, and rectal bleeding. Treatment
may include drugs, nutrition supplements, surgery, or a combination of these
options. At this time, treatment can help control the disease, but there is no
Some people have long periods of remission, sometimes years, when they are
free of symptoms. However, the disease usually recurs at various times over a
person's lifetime. This changing pattern of the disease means one cannot always
tell when a treatment has helped. Predicting when a remission may occur or when
symptoms will return is not possible.
Someone with Crohn's disease may need medical care for a long time, with
regular doctor visits to monitor the condition.
Most people are first treated with drugs containing mesalamine, a substance
that helps control inflammation. Sulfasalazine is the most commonly used of
these drugs. Patients who do not benefit from it or who cannot tolerate it may
be put on other mesalamine-containing drugs, generally known as 5-ASA agents,
such as Asacol, Dipentum, or Pentasa. Possible side effects of mesalamine
preparations include nausea, vomiting, heartburn, diarrhea, and headache.
Some patients take corticosteroids to control inflammation. These drugs are
the most effective for active Crohn's disease, but they can cause serious side
effects, including greater susceptibility to infection.
Drugs that suppress the immune system are also used to treat Crohn's
disease. Most commonly prescribed are 6-mercaptopurine and a related drug,
azathioprine. Immunosuppressive agents work by blocking the immune reaction
that contributes to inflammation. These drugs may cause side effects like
nausea, vomiting, and diarrhea and may lower a person's resistance to
infection. When patients are treated with a combination of corticosteroids and
immunosuppressive drugs, the dose of corticosteroids can eventually be lowered.
Some studies suggest that immunosuppressive drugs may enhance the effectiveness