Complications of Crohn's Disease

If you have Crohn’s disease, you may have symptoms and complications not related to your digestive tract.

Crohn’s disease can result in:

  • Arthritis
  • Eye inflammation
  • Skin disorders
  • Osteoporosis
  • Gallbladder or liver disease
  • Kidney disorders
  • Anemia

The cause of these complications isn’t known. You may be able to lower your risk by:

  • Staying on your Crohn’s medications
  • Exercising
  • Eating well
  • Not smoking
  • Seeing a doctor and an ophthalmologist (eye doctor) regularly

 

Arthritis

This is the most common complication of Crohn’s not related to the intestine. As many as 1 in 4 people with Crohn's get it.

Your doctor will work to put you on medications that will control the Crohn’s but also may need to prescribe medicine to ease your joint pain. Physical therapy and moist heat on your joints may also help.

Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to treat arthritis pain. But they may not be a good idea if you have Crohn’s. They could irritate the lining of your GI tract and cause your Crohn's symptoms to worsen.

Eye Complications

These can affect up to 10% of people with Crohn’s disease.

Uveitis is the most common eye issue for folks with Crohn's. It's a painful irritation of the uvea, the middle layer of your eye wall.

Symptoms of uveitis include:

  • Redness
  • Pain
  • Blurred vision
  • Sensitivity to light

Your eye doctor may also prescribe steroid eye drops to ease the inflammation. Untreated uveitis can lead to vision loss.

Another eye complication of Crohn's disease is episcleritis. This is an inflammation of the outer coating of the white of your eye. Your symptoms may get better on their own when your Crohn’s symptoms ease. Treatments include steroid and other medicated eye drops. 

Skin Disorders

About 5% of people with Crohn’s get one of the following:

Erythema nodosum: Tender reds bumps form on your shins, ankles, and sometimes your arms. This is more common in women than men and usually shows up during or just before a flare-up.

Pyoderma gangrenosum: These are small blisters that can join together to form deep ulcers, usually in the shins and ankles. Treatments for pyoderma gangrenosum include antibiotics and topical ointments. This affects about 1% of people with Crohn's.

Canker sores:  These small mouth sores usually grow between the gums and lower lip or along the tongue, typically during severe flare-ups.  A balanced diet, vitamin supplements, and prescription mouthwashes may help.

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Liver Disease

Some medications that treat Crohn’s disease may affect the liver. If you take azathioprine, 6-mercaptopurine, or methotrexate, you’ll need to get tests regularly to find out how well your liver is working.

Liver diseases include:

Primary sclerosing cholangitis (PSC): A severe inflammation and scarring of the bile ducts, which carry bile from your liver to the small intestine. These scars make the ducts hard and narrow, and gradually cause serious liver damage. Symptoms include:

  • Nausea
  • Itching
  • Jaundice
  • Weight loss

There is no effective medication for PSC, and in some cases a liver transplant is necessary.

Gallstones: Bile in your gallbladder hardens into “stones.” When the gallstones block the mouth of your gallbladder, you can have severe pain, especially after eating fatty foods. An ultrasound can confirm if you have gallstones. Your doctor may suggest medication or surgery.

Other Complications

Kidney stones are the most common kidney-related complication of Crohn’s disease. That can be because of dehydration or because fat isn’t absorbed properly. Symptoms include:

  • Sharp pain
  • Blood in the urine
  • Nausea
  • Vomiting

Drinking more fluids and watching your diet may help.

Some the complications from Crohn’s happen because the disease prevents you from absorbing enough nutrients. In children, this malnutrition can cause delayed growth or sexual development. As an adult, it can result in folate or vitamin B12 deficiency anemia, making you tired and without energy.

A shortage of nutrients may weaken your bones, and you may get osteoporosis. Steroids used to treat Crohn’s could also cause this.

Bleeding in your intestinal tract from Crohn’s can result in a different type of anemia called iron deficiency anemia. This can cause tiredness, shortness of breath, and a pale complexion.

WebMD Medical Reference Reviewed by Neha Pathak, MD on October 07, 2019

Sources

SOURCES:

Mayo Clinic: “Crohn’s disease.”

NHS Choices: “Crohn’s disease.”

Crohn’s and Colitis Foundation: “Extraintestinal IBD Complications,” “Arthritis,” “Skin Complications of IBD,” “Eye Complications of IBD,” “Liver Disease and IBD,” “Extraintestinal Complications: Kidney Disorders.”

UpToDate: "Natural history and management of nonalcoholic fatty liver disease in adultshistory and management of nonalcoholic fatty liver disease in adults," "Approach to the patient with incidental gallstonesApproach to the patient with incidental gallstones."

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