Stages of Crohn's Disease
Key takeaways
Crohn's disease symptoms can be mild, moderate, or severe. It's a progressive disease, but its stages are hard to determine because each person's condition progresses differently.
The earlier you treat and manage Crohn's, the more likely you are to reduce your chance of developing more severe symptoms.
There's no cure for Crohn's disease, but medications and lifestyle changes can help manage the condition. This is why it's crucial to identify the disease when symptoms are still mild.
Crohn's disease is a type of inflammatory bowel disease (IBD). It's considered a chronic condition, which means that you'll have it for your entire life. The exact cause of Crohn's is unknown. It most often develops in your late teens or 20s.
Crohn's disease is marked by inflammation of the gastrointestinal (GI) tract. The inflammation can appear anywhere in the GI tract, from the mouth to the anus.
What are the stages of Crohn's disease?
Crohn's is a progressive disease that starts with mild symptoms and gradually gets worse. With mild to moderate Crohn's, you may experience diarrhea or abdominal pain, but you won't experience other symptoms or complications.
You're able to move, eat, and drink as normal, and the disease has a minimal impact on your quality of life. In some cases, you won't even require treatment.
If you have moderate to severe Crohn's disease, you may experience diarrhea or abdominal pain, as well as additional symptoms and complications, such as fever or anemia. If your Crohn's is severe, you might be in constant pain and discomfort, and you may need to use the bathroom frequently.
That said, it's difficult to classify Crohn's disease into stages because people tend to experience ups and downs in symptoms. What progression looks like can be different for each person, and treatment can affect your outlook.
How quickly does Crohn's disease progress?
Over time, Crohn's can cause damage to the intestines and lead to potential complications such as strictures, fistulas, and abscesses.
Stricture means that a portion of the intestine becomes narrower due to scar tissue on its wall.
While there's no time frame for how long it would take for such complications to develop, there are risk factors that may speed up progression. These include:
being under 30 years old
having a history of smoking
having ulcers found in a colonoscopy
having the long bowel segments affected by the disease
having anal inflammation
having symptoms that go beyond the intestinal system, such as in the eyes, skin, liver, or joints
having a history of bowel resections
At diagnosis, 10% of people already have strictures, and an additional 15% to 20% will develop them within the next 10 to 20 years.
Five types of Crohn's disease
Progression may also depend on the type of Crohn's disease you have. These are:
ileocolitis
ileitis
gastroduodenal Crohn's disease
diffuse jejunoileitis
Crohn's colitis
Crohn's disease progression patterns
The patterns by which Crohn's might progress are:
Chronic relapsing: With this progression type, you typically experience at least 12 months of remission before experiencing a flare. Common symptoms of a Crohn's disease flare-up may include diarrhea, abdominal pain, weight loss, blood in stool, and fatigue.
Remission: Remission means that your symptoms improve or disappear completely. Various studies show most people will relapse within 8 years of diagnosis, with a 43% to 45% remission rate after 10 years. But if you stay in remission for a year, there's an 80% chance remission will continue for the next year.
Improved and stable: This is when your condition has progressed to having no symptoms and has remained this way, though signs of the disease might still show up on tests.
Chronic refractory: This means you continue to show symptoms without any breaks or remission. About 10% to 15% of people with Crohn's experience a chronic refractory disease course.
That said, even different people living with the same Crohn's pattern might progress differently. Genetics, type of treatment, and surgery are also factors that may affect which disease course you follow.
The earlier you treat and manage Crohn's, the more likely you are to reduce your chance of developing more severe symptoms.
What is the life expectancy of someone with Crohn's disease?
There's no cure for Crohn's disease, though many people can live fulfilling lives with long periods of remission.
That said, although there's been an increase in life expectancy for people living with inflammatory bowel diseases (IBDs), the life expectancy of Crohn's is still lower compared to those without IBDs for both males and females.
When Crohn's causes complications, it can, in rare cases, lead to death. Common causes of death include cancer, heart disease, and infection.
What are the early symptoms of Crohn's disease?
In Crohn's disease, healthy cells in the GI tract attack themselves, causing inflammation. As a result, you'll likely experience a range of symptoms.
Early signs of Crohn's disease include:
frequent cramps
ongoing abdominal pain
frequent diarrhea
bloody stools
unintentional weight loss
As the disease progresses, you may start feeling fatigued and even develop anemia. You may also experience nausea from constant irritation of the GI tract.
In addition, you may start experiencing symptoms outside of the GI tract. These symptoms include:
eye pain
fever
joint inflammation and pain
red skin rashes and bumps
mouth sores
Early diagnosis is important to help prevent damage to the intestines.
If you experience these symptoms and have a family history of Crohn's, you should ask your doctor for testing.
How is Crohn's disease treated and managed?
Medications can treat inflammation and stop your body from attacking its own cells.
As your symptoms progress, your gastroenterologist may also recommend occasional bowel rest. However, not all doctors agree with this measure.
A bowel rest involves a strict diet of only liquids for a few days. The purpose is to let the GI tract heal from inflammation and essentially take a break. To prevent malnutrition, you may need an IV.
Talk with your doctor before switching to a liquid diet. Following this, your doctor may follow a special Crohn's diet and take supplements.
You also may need to take pain medication. Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), as these can make Crohn's worse. Instead, ask your doctor if you can safely take acetaminophen (Tylenol).
You may need surgery if your symptoms become life threatening. Around 67% to 75% of all people with Crohn's will eventually need surgery, according to the Crohn's & Colitis Foundation.
Surgery can't cure the disease, but it may help repair severely damaged tissues and remove blockages.
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