Crohn's disease natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

If left untreated, patients with Crohn’s disease can progress into colorectal cancer depending upon the region involved. The common complication of Crohn’s disease include obstructions, abscesses, free perforation, and hemorrhage. With treatment, most people achieve a healthy life, and the mortality rate for the disease is low.

If left untreated, patients with Crohn’s disease can progress into colorectal cancer depending upon the region involved. For example, individuals with Crohn’s disease involving the small bowel are at higher risk for small intestinal cancer. Similarly, people with Crohn’s colitis have a relative risk of 5.6 for developing colon cancer.^[1] Screening for colon cancer with colonoscopy is recommended for anyone who has had Crohn’s colitis for eight years, or more.^[2][3][4]

Common complications of Crohn’s disease include:^[5]

• Abscess – Abscesses are walled off collections of infection, which can occur in the abdomen or in the perianal area in Crohn’s disease sufferers.
• Bowel obstructions – Obstruction typically occurs from strictures or adhesions which narrow the lumen, blocking the passage of the intestinal contents.
• Complications of corticosteroid therapy
• Erythema nodosum
• Fistulae can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin.
• Impaired growth and sexual development in children
• Inflammation of the joints
• Lesions in the eye
• Nutritional deficiencies (particularly vitamin B12 deficiency)
• Pyoderma gangrenosum
• Development of cancer
• Malnutrition^[6]

• Crohn’s disease is a chronic condition for which there is currently no cure. It is characterized by periods of improvement followed by episodes when symptoms flare up.
• With treatment, most people achieve a healthy life, and the mortality rate for the disease is low.
• Crohn’s disease is associated with an increased risk of small bowel and colorectal carcinoma.^[7]
• Many patients will have temporary stoma formations together with possible associated complications.^[8]

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