Complications of Crohn's Disease

The most common complication of Crohn's disease is obstruction or blockage of the intestine due to swelling and the formation of scar tissue. The result is thickening of the bowel wall and a significantly narrowed intestinal passage. Symptoms of intestinal obstruction include crampy pain around the mid-abdomen, frequently associated with vomiting. The abdomen may also become bloated and distended. Medications may relieve the obstruction by reducing the local area of inflammation, but surgery may be required if the obstruction is severe and does not respond to medical treatment. Surgery may also be indicated if the blockage recurs frequently.

Another complication is sores or ulcers within the intestinal tract. Sometimes these deep ulcers turn into tracts -- called fistulas -- that connect different parts of the intestine. But fistulas may also tunnel into surrounding tissues such as the bladder, vagina, or skin. These abnormal passages, which affect about 30 percent of people with Crohn's disease, often become infected. If the fistula is small, medical treatment may be sufficient to heal it. Large or multiple fistulas, on the other hand, may signal the need for surgery, particularly if they are accompanied by fairly persistent symptoms, such as fever or abdominal pain. Occasionally a fistula forms an abscess, or collection of pus, near the intestine. This is a pocket of infection that requires drainage either through a catheter inserted by a radiologist or a special drain that is surgically inserted. The areas around the anus and rectum are often involved. In addition to fistulas, cracks or fissures may also develop in the lining of the mucus membrane of the anus.

Another type of complication commonly encountered in people with Crohn's disease is related to malnutrition or the presence of nutritional deficiencies. These are deficiencies of proteins, calories, and vitamins. They generally do not develop unless the disease is extensive and of long duration, conditions that may contribute to inadequate dietary intake and poor absorption of nutrients. Medical treatment is usually effective in the replacement of nutrients. For example, a deficiency in vitamin B-12 can be corrected by an injection of this vitamin. Similarly, an iron deficiency can be reversed by taking this mineral in liquid or tablet form. Nutritional supplements, containing both vitamins and minerals, are available in concentrated form.