Common Complications Associated With Crohn's Disease

1. Intestinal Obstruction

One of the most common complications of Crohn's disease is intestinal obstruction. As the disease progresses, ulcers in the digestive tract repeatedly heal, leading to fibrous tissue buildup. This can cause the intestinal walls to thicken and the passageway to narrow, resulting in partial or complete blockage. Initially, doctors typically attempt conservative medical management, such as anti-inflammatory medications or dietary adjustments. However, if symptoms persist or the blockage worsens, surgical intervention may be necessary. In cases where the narrowed segment is short, balloon dilation during endoscopy may be an effective option.

2. Acute Bowel Perforation

Bowel perforation is a serious and potentially life-threatening complication. Deep ulcers can erode through the intestinal wall, causing a hole or perforation. This allows intestinal contents to leak into the abdominal cavity, leading to peritonitis — a severe infection. Emergency surgery is often required to repair the perforation and prevent further complications. Prompt diagnosis and treatment are crucial to avoid sepsis and other systemic infections.

3. Intra-Abdominal Abscesses

Another possible complication is the formation of abdominal abscesses, which are localized collections of pus caused by infection. These often develop around the inflamed areas of the intestine. Treatment typically involves draining the abscess using image-guided procedures, such as percutaneous drainage, along with a course of broad-spectrum antibiotics. In more severe cases, surgical removal or cleaning of the infected area may be necessary to fully resolve the infection.

4. Fistula Development

Fistulas are abnormal connections that form between different parts of the intestine, or between the intestine and other organs or the skin. Crohn's patients are particularly prone to developing fistulas, especially perianal fistulas. Managing these requires a multidisciplinary approach, often involving both gastroenterologists and colorectal surgeons. Treatment options may include medications to reduce inflammation, seton placement, or surgical repair depending on the complexity and location of the fistula.

5. Increased Risk of Colorectal Cancer

While rare, long-standing Crohn's disease, especially when it affects the colon, is associated with a slightly elevated risk of developing colorectal cancer. This risk increases the longer a person has had the disease and the more extensive the inflammation. Regular screening through colonoscopies is strongly recommended for early detection and prevention. Patients are advised to follow a surveillance schedule tailored to their individual risk profile by a healthcare provider.