Complications of Crohn's
The complications that Crohn’s patients experience depend on the location and severity of the disease. Some complications can be life threatening, while others are manageable with the help of treatment plans prescribed by a gastroenterologist.
Serious complications
Crohn’s may cause serious complications, which can happen over the course of the illness:
- Obstruction: Obstructions can occur when the intestinal wall swells inward, reducing the capacity for fluids to flow through the intestine.
- A patient may experience painful cramps or vomiting due to food that is not able to bypass the obstruction.
- Patients who experience an obstructive episode are usually hospitalized and given intravenous fluids and salts to compensate for fluid losses.
- Fistula: Sometimes ulcers caused by Crohn's will channel through the gut wall to adjacent areas, including the skin, bladder, vagina, intestine, and perianal areas. These occurrences are known as fistulas and may require medical or surgical therapy.
- Abscess: An abscess is a localized collection of bacteria that eventually accumulates pus and places painful pressure on adjacent tissues.
- A fistula that tracks into the abdominal cavity may produce infection and form an abscess. Abscesses may also occur in the pelvic tissues or the perineum, if a fistula fails to drain.
- Abscesses can be difficult for gastroenterologists to diagnose; however, after they are located, they should be drained. This may require surgery.
- Patients are usually given a course of antibiotics to reduce the risk of further infection.
- Free perforation: A free perforation is the formation of a hole in the bowel wall that allows intestinal contents to enter the abdominal cavity.
- Signs of free perforation include sudden, severe abdominal pain, shock, and excessive abdominal tenderness.
- The infection that results is called peritonitis and requires emergency surgery in which the leak is sealed and the abdominal cavity is cleansed to stop infection.
- Hemorrhage: In rare cases, a bleeding ulcer may burrow through the gut wall and shear an artery. This produces a life-threatening hemorrhage that may require blood transfusions and special measures to promote blood clotting. Sometimes emergency surgery is required.
Chronic complications
People with Crohn’s may experience chronic or long-lasting complications that require ongoing management:
- Anemia: Anemia is a condition that results from lack of red blood cells.
- Anemia in Crohn's may be the result of chronic blood loss; bone marrow depression; or failure to absorb iron and folic acid, which are important in stimulating the production of red blood cells.
- Certain medications, such as sulfasalazine, may also exacerbate anemia. To combat most cases of anemia, gastroenterologists often prescribe supplements, and recommend a diet rich in iron.
- Malnutrition: Malnutrition occurs when the body does not receive enough nutrients to grow and develop properly.
- Loss of protein, tissue breakdown due to steroid use, poor diet and, in some cases, failure to absorb nutrients result in weight loss and nutritional deficiencies.
- Gastroenterologists often prescribe nutritional supplements to avoid the complications that result from deficiencies in vitamins A, D, E, and K.
Currently, there is no cure for Crohn’s. In the meantime, the goals of treating Crohn’s are to induce and maintain remission,
enable healing of the intestinal lining, and relieve the symptoms of fever, diarrhea, and abdominal pain.
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