Gastrointestinal diseases are the most common conditions today. From a simple stomach ache to acute gastroenteritis, through hemorrhoids and rectum conditions. Together, all diseases related to the digestive system are part of the daily life of a doctor’s office. However, as important as the doctor’s job is the patient’s responsibility to be informed and describe their symptoms in detail to facilitate diagnosis. This time around, we will examine the symptoms of one not very common disease and usually confused with other conditions of its kind: Crohn’s disease.
This illness is a chronic condition with alternates periods of flare-ups. This means that symptoms show up for a while and then the disease remains inactive (remission). These symptoms can range from mild to severe, and they occur gradually or suddenly. On the other hand, its symptoms can be divided in a general way or according to the distinct areas.
The most important symptoms are as follows:
1. Abdominal and colicky pain
They both describe a sensation of discomfort in the area between the chest and the groin. It occurs when the muscles of the digestive organs contract spasmodically. We can talk about colicky pain when abdominal pain increases in intensity, there is a climax in the sensation of pain, then gradually decreases, and they occur again after a while. Patients describe these abdominal pains “as if the wall of the abdomen was about to explode.” Even so, both its intensity and location vary depending on the area affected by the disease. If there is involvement of the ileum, the pain is in the right abdominal area at the appendix. In gastric involvement, pain is in the epigastric region or the pit of the stomach. Sometimes, the symptom of abdominal pain can be similar to an ulcer or acute gastritis pain. If the pain appears in the lower abdomen, it is most likely that there is involvement of the colon.
2. Diarrhea
It is one of the most common symptoms in patients with Crohn’s disease. They are usually progressive and manifest during the day or night, accompanied by anal pain, incontinence, and a feeling of incomplete deposition (tenesmus). The presence of scarce diarrhea may be indicative of an affectation of Crohn’s disease in the colon, since the cells that cover it become inflamed and are unable to absorb all the fluid, so the feces remain loose and watery or even wholly liquid. However, if diarrhea is abundant, it may indicate that the condition is located in the small intestine, and it is probably a secretory type of diarrhea caused by malabsorption of nutrients that may also lead to poor nutrition and weight loss.
3. Constipation
It is a decrease in frequency in bowel movements. We say that a person is constipated when defecating less than three times a week, making an excessive effort to eliminate hardened stool. More recent definitions about constipation contemplate a change in the composition of stools and it is not necessarily focused on stool frequency. Although not familiar, with Crohn’s disease episodes of diarrhea and constipation alternate. Its duration depends on each person.
4. Anorectal abscesses
It is the accumulation of pus in an infected cavity near the anus or rectum. According to its location, there are 4 types: 1) Supralevator abscess (it is the most common in cases of Crohn’s disease, it is located above the anus elevator). 2) Ischiorectal abscess (it is more profound and extends through the sphincter to the ischiorectal space, below the elevator of the anus). 3) Intersphincteric abscess and 4) perianal abscess (they are superficial, very close to the skin). Superficial abscesses are usually the most painful, while the deepest ones are sometimes painless; they only generate fever or malaise.
5. Anal fistula
It is a small tunnel that originates from an opening inside the anal canal and ends in an outer opening near the anus. Up to 50% of people with an abscess develop a fistula. However, a fistula can also occur without an abscess. Fistulas are consequences of the blockage of the exit of an anal gland, so an abscess is formed and breaks the skin of the perianal area.
It establishes an anomalous connection with the internal surface of the anal canal and through which It can be left to produce stool. They do not cause pain, except in cases where the abscess that originates it is recurrent, but irritation or itching due to the pus they exude.
6. Rectal bleeding
It is not a common symptom of this condition. Even so, sometimes those affected can present blood after defecation when cleaned with toilet paper or directly in the stool, which may have red, black or tarry-looking feces. Its color indicates the height of bleeding within the digestive system.
Stools with intense red color is a consequence of anal pathologies, such as hemorrhoids or a fistula, while a darker color in the stool indicates the presence of bleeding ulcers in the walls of the colon or small intestine.
7. Fever
It is a temporary increase in a person’s body temperature. It arises as a response to the human body to defend against bacteria and viruses. During severe outbreaks or periods of disease activity, patients may develop a fever as a result of intestinal inflammation.
However, fever can also be attributed to the existence of some other associated infectious process, such as the presence of abscesses. The fever is characterized by being prolonged, with an average temperature of 102.2 ºF.
8. Swelling
It is the sensation of enlargement of the abdominal region, especially the area that includes the stomach and large and small intestines. Although it could give that impression, the swelling is not caused by excessive gas accumulation. Instead, it is a consequence of the inflammation of some section of the digestive tract that causes this disease.
9. Loss of appetite
It is a drastic reduction in the desire to eat. It is the result of a combination of symptoms that directly affect the bowel movements of the person. Colicky pain, diarrhea, and swelling can make eating more than a daily task for the affected person; It becomes a whole odyssey. However, it is recommended to maintain a balanced diet to avoid malnutrition.
10. Anemia
It is the decrease or loss of the level of hemoglobin in red blood cells. This iron-rich protein is responsible for supplying oxygen to different parts of the body. Therefore, in patients with anemia, the amount of oxygen that goes to the brain is reduced, which in turn generates other complications such as fatigue, lack of energy, weakness, shortness of breath, dizziness, palpitations, and paleness. This symptom may be indicative of internal bleeding, so attention should be paid to other signs, such as blood in bowel movements to see a doctor as soon as possible.
11. Weight loss
Alterations in the intestinal wall caused by the disease can cause a failure in the ability of the intestines to absorb nutrients, which in turn causes weight loss. Besides, when an inflammatory process takes place, the energy demand increases. The energy comes from the degradation of nutrients present in the foods that are usually consumed. Therefore, intestinal inflammation leads to the consumption of a large amount of energy or nutrients, which translates into a more accelerated metabolic process and weight loss.
12. Varying symptoms according to the affected area
There are also varying symptoms according to the area of the gastrointestinal tube that is being affected by Crohn’s disease. Usually, the most commonly affected area is the ileum and the beginning of the large intestine. Even so, it can affect any section of the digestive system, from the valve to the end of the rectum (anus). For that reason, symptoms may vary from one patient to another, depending on the part of the affected digestive tract. They are:
Ileitis
When the disease affects the ileum, it causes pain in the lower right abdominal area. It is more painful after eating or evacuating (mainly if it occurs in the form of diarrhea). It can derive in fistulas and stenosis.
Colitis
When the large intestine is affected. It can affect one or more parts of it. It can cause weight loss, fever and joint inflammation
Ileus-colitis
When Crohn’s disease affects the ileum and the nearest large intestine areas. It is the most frequent location of the illness. It usually causes abdominal pain, diarrhea, fever, intestinal obstruction, and fistulas.
Without a doubt, diseases of gastrointestinal origin are conditions that should not be taken lightly. Many of them resemble each other so that a dull stomach ache could be confused with Crohn’s disease in its early stages. Therefore, in addition to knowing the symptoms it produces, we must urgently go to our doctor if we notice any of them. That way, any disease can be identified in its initial stages, which will make it easier to cure. Consequently, we will enjoy a healthy body and a better quality of life.