Crohn’s disease is not usually life-threatening, but it can cause severe or even fatal complications.
Crohn’s is a long-term inflammatory bowel disease (IBD). It most commonly affects the ileum, which is the end section of the small intestine, and the first section of the large intestine, or colon.
However, Crohn’s can affect any part of the gastrointestinal tract, from the mouth to the anus.
Depending on the location and extent of the disease, a person with Crohn’s may develop serious complications.
In this article, we identify some life-threatening complications of Crohn’s disease and describe associated symptoms.
According to the Crohn’s & Colitis Foundation, a person with Crohn’s is unlikely to die from the disease.
Crohn’s can, however, cause life-threatening complications, such as severe infections and colorectal cancer.
Being aware of these complications’ symptoms is essential so a person can talk to a doctor as soon as possible.
Prompt treatment can increase the likelihood of a good recovery. A person can also take preventative measures to reduce their risk of these complications.
Below are some severe complications of Crohn’s disease:
People with IBD have an increased risk of developing dysplasia. This occurs when abnormal cells form in the lining of the colon or rectum. Over time, these cells can become cancerous.
When Crohn’s disease affects the colon, a person may have an increased risk of colorectal cancer, compared to the general population.
This risk is higher for people who have had Crohn’s for 8–10 years or more.
To help a doctor detect dysplasia early and possibly prevent colorectal cancer:
- have a routine colonoscopy every 1–2 years
- see a gastroenterologist every year
- notify a doctor of any new symptoms or concerns
- manage inflammation with prescription medication
- tell the doctor if a family member develops colorectal cancer
- exercise regularly and eat a healthful diet
Despite the increased risk, the vast majority of people with Crohn’s disease never develop colorectal cancer.
Nonetheless, people should be familiar with the symptoms of this type of cancer and report any to a doctor. The disease is highly treatable in the early stages.
Symptoms of colorectal cancer include:
- diarrhea or constipation lasting more than a few days
- a constant feeling of needing to make a bowel movement
- bleeding from the rectum
- stools that are dark or contain fresh blood
- abdominal pain or cramping
- weakness and fatigue
- unintended weight loss
Inflammation from Crohn’s disease can spread through the intestinal wall, creating an abscess.
As the abscess grows, it forms a small hole in the wall, and this hole can develop into a fistula. A fistula is an abnormal passageway that connects one organ to another.
Around 1 in 4 people with Crohn’s develop fistulas. In most cases, fistulas originate in the bowel. They may connect to other parts of the bowel or other internal organs.
Sometimes, a fistula forms a tunnel from the intestine to the outer surface of the skin. The medical term for this is an enterocutaneous fistula (ECF).
Most people with ECFs experience at least one complication, such as malnutrition or sepsis. Sepsis is a whole-body inflammatory response to infection. Without treatment, malnutrition and sepsis can result in death.
Fistulas usually contain intestinal bacteria and other infectious material, so doctors will use antibiotics to treat them.
Large, numerous, or persistent fistulas usually require surgery.
The symptoms of a fistula differ, depending on the location. However, some common symptoms include:
- frequent urinary tract infections
- nausea and vomiting
- abdominal pain
- vaginal symptoms, such as leaking urine from the vagina, or leaking gas or feces into the vagina
Fistulas that do not respond to medications increase the risk of sepsis and may require emergency surgery.
Sepsis constitutes a medical emergency, and it can be fatal.
Symptoms of sepsis include:
- signs of infection, including fever, fatigue, and pain
- tiredness and fatigue
- severe pain or discomfort
An intestinal obstruction is the most common complication of Crohn’s disease.
An obstruction usually results when a buildup of scar tissue narrows a section of the colon, making it difficult for the stool to pass. Doctors call these narrowed passages “strictures.”
The medical community generally does not consider strictures to be life-threatening. However, the narrowing of the passage can lead to a tear, or perforation, in the colon.
A perforated colon can be life-threatening, so strictures and other forms of intestinal obstruction usually require immediate surgery.
Symptoms of an intestinal stricture include:
- severe abdominal pain and cramping
- nausea and vomiting
- a bloated and distended abdomen
- loud noises emanating from the gut
Chronic inflammation, abscesses, fistulas, and strictures can weaken points in the intestinal wall.
Over time, the wall can tear, or perforate, allowing bacteria and other infectious substances to leak from the intestine into the abdomen. The medical term for this is peritonitis.
Peritonitis can cause more severe complications, such as blood poisoning and sepsis.
A perforated colon is a medical emergency. A person needs surgery to repair the hole in the intestine.
Symptoms of a perforated colon include:
- severe abdominal pain
Toxic megacolon is a rare but life-threatening complication of IBD. Although it is more common among people with ulcerative colitis, it can also occur in people with Crohn’s disease.
Toxic megacolon occurs when inflammation causes the colon to expand to such an extent that it cannot contract. The result is a buildup of gas.
The buildup can cause the colon to burst, leaking harmful bacteria and toxins into the bloodstream.
This can lead to a range of life-threatening complications, including:
- internal bleeding
Recognizing indications of toxic megacolon and receiving prompt treatment can reduce the risk of life-threatening complications.
Symptoms of toxic megacolon include:
- swelling and pain in the abdomen
- frequent or bloody diarrhea
- a rapid heart rate