Crohn's Disease

Crohn’s disease is a long-term inflammatory bowel disease, usually shortened to IBD. It causes inflammation, and sometimes ulcers, in the digestive system.

It can affect any part of the digestive system, from the mouth to the bottom, although it commonly affects the end of the small bowel or the large bowel.

Crohn’s is an immune-mediated condition: the immune system does not work as it should and attacks healthy tissue in the digestive system.

It is not infectious and cannot be passed between people.

Crohn’s is different from irritable bowel syndrome, known as IBS. IBS does not cause the inflammation and damage seen in Crohn’s.

Symptoms and severity differ greatly between individuals. Two people with the same diagnosis can have very different experiences.

• Recurring diarrhoea.
• Tummy pain or cramps.
• Blood or mucus in poo.
• An urgent need to use the toilet.
• Extreme tiredness or fatigue.
• Unintended weight loss.
• Reduced appetite.
• Feeling generally unwell.
• Fever during active inflammation.
• Mouth ulcers.
• Pain, swelling or discharge around the bottom.
• Delayed growth or puberty in children.

Some people also experience problems outside the digestive system, including painful joints, eye inflammation or skin problems.

These symptoms can have several causes and do not automatically mean someone has Crohn’s disease. A proper assessment is what tells the difference.

A flare-up is a period when symptoms become active or worsen. Remission is a period when symptoms are reduced or under control.

The length and severity of flare-ups vary from person to person, and from one flare-up to the next. Some people have long stretches of remission.

Follow the plan agreed with your IBD team. Contact the IBD team, your GP or NHS 111 if symptoms become worse or your normal treatment plan is not helping.

Arrange a GP appointment if you have:

• Diarrhoea lasting more than seven days.
• Repeated tummy pain.
• Blood or mucus in your poo.
• Unexplained weight loss.
• Persistent tiredness alongside bowel symptoms.
• Symptoms that keep returning.

The GP may arrange blood tests and stool tests, and refer you to a gastroenterology specialist. Our GP Services page explains how appointments and referrals usually work.

There is no single simple test. Diagnosis is built up from several pieces of information.

Assessment may include:

• Medical history and examination.
• Blood tests.
• Stool tests, including tests for inflammation and infection.
• Colonoscopy or another form of endoscopy.
• Biopsies — small tissue samples taken during endoscopy.
• MRI, CT or ultrasound scans.
• Tests examining the small bowel.

Diagnosis sometimes takes time, because infections, coeliac disease, IBS and other bowel conditions can cause similar symptoms.

There is currently no cure, but treatment can control inflammation, reduce symptoms and help maintain remission. Many people live full lives with the right treatment.

• Steroids for short-term control of some flare-ups.
• Immunosuppressant medicines.
• Biological and other targeted medicines.
• Nutritional treatment in selected cases.
• Medicines for particular symptoms when recommended.
• Surgery when medicines are ineffective or complications develop.
• Regular reviews with an IBD or gastroenterology team.
• Support from IBD nurses, dietitians, pharmacists and other specialists.

This page does not give doses or recommend a particular medicine. Those decisions belong with the IBD team or prescribing clinician.

Surgery can remove damaged areas of bowel and treat complications, but it does not guarantee that Crohn’s will never return elsewhere in the digestive system.

Complications are not inevitable, and monitoring and treatment can reduce the risks. It is still worth knowing what to look out for:

• Stricture — narrowing of the bowel.
• Bowel blockage.
• Fistulas — abnormal tunnels between the bowel and another part of the body.
• Abscesses — collections of infected fluid.
• Malnutrition and vitamin or mineral deficiencies.
• Anaemia.
• Perforation — a hole in the bowel.
• Increased bowel-cancer risk for some people with long-standing inflammation of the colon, which is why regular monitoring is offered.

Our Cancer page explains NHS screening and monitoring in more detail.

• Keep an individual flare-up or care plan agreed with your IBD team.
• Know how to contact the IBD team, including out-of-hours arrangements.
• Keep an up-to-date list of your medicines.
• Plan access to toilets when away from home.
• Carry essential supplies discreetly if that helps your confidence.
• Drink enough fluid during diarrhoea to avoid dehydration.
• Ask for workplace or education adjustments — you are entitled to request them.
• Seek help with fatigue, pain, continence or mental health rather than putting up with it.
• Do not smoke — smoking can make Crohn’s disease worse.
• Discuss pregnancy planning with the IBD team in advance where possible.
• Keep vaccinations and health reviews up to date when using immune-suppressing treatments.

Urgency, pain, tiredness and unpredictable flare-ups can affect confidence, work, relationships and mental health. Many people find the uncertainty harder than the symptoms themselves.

If you experience anxiety, low mood, isolation or difficulty coping, speak to your GP, IBD nurse or specialist team. Our Mental Health page explains what help exists and how to reach it.

• NHS — Crohn’s disease
• NHS — Inflammatory bowel disease
• NICE guideline NG129 — Crohn’s disease: management
• Crohn’s & Colitis UK — Crohn’s disease
• Crohn’s & Colitis UK
• NHS — Find a GP
• NHS 111

Important notice: Sixpence Support UK provides general information only. This page is not a diagnosis, medical advice, or a substitute for assessment and treatment by a qualified healthcare professional. Always speak to a GP, pharmacist or another qualified health provider about your own symptoms, medicines and circumstances. In an emergency, call 999.