Crohn's disease is an inflammatory bowel disease that involves all of the layers of the small and large intestines. The affected areas do not run contiguously. Instead, the inflammation skips: there is inflammation between areas of normal intestinal tissue. This disease affects other areas of the body in addition to the intestines.
Symptoms
Kenneth McQuaid, M.D., Professor of Clinical Medicine at the University of California, explains in "Current Medical Diagnosis & Treatment" that symptoms depend upon what areas of the intestines are affected. Symptoms may include abdominal pain, cramps, a low-grade fever, weight loss and diarrhea. The diarrhea will usually be a watery diarrhea. It will be bloody if there is inflammation in the rectum.
Fistulas
A fistula is an abnormal opening from one part of the body to another. It is seen in Crohn's disease because the inflammation caused by Crohn's penetrates all of the four layers of the intestines. There may be fistulas between parts of the intestines and between the intestines and the skin, bladder and vagina. Fistulas that go from one part of the intestines to another do not cause any additional symptoms beyond diarrhea and weight loss. According to Dr. McQuaid, fistulas from the intestines to the skin are found at the site of surgical scars, and the contents of the intestines can leak out of the skin along the scar. Fistulas that lead to the bladder will cause reoccurring infections. In the Nov. 15, 2001 issue of the "American Family Physician," Edward Feller, M.D. writes that fistulas to the vagina cause abscesses and inflammation.
Gallstones
Crohn's disease can cause gallstones if there is inflammation in the terminal ileum, the last section of the small intestine. The liver makes a substance called bile which serves to digest fats. Bile is composed of cholesterol, bilirubin, phospholipids, bile salts and water. But, if bile contains too much cholesterol, bilirubin or bile salts, it will harden and form gallstones. Normally, bile salts are absorbed in the terminal ileum, but if Crohn's has affected that area, the bile salts cannot be absorbed, which leads to gallstones.
Pyoderma Gangrenosum
According to Wingfield Rehmus, M.D., Clinical Assistant Professor at the University of British Columbia in "The Merck Manual for Healthcare Professionals," pyoderma gangrenosum is a skin disease found in association with several diseases, but it is especially common among people who are suffering from Crohn's and ulcerative colitis (another inflammatory bowel disease). At first there is a lesion, but the lesion spreads and soon develops into a large ulcer. The lesions can occur anywhere on the body but are usually found on the legs, buttocks, face and abdomen.
Toxic Megacolon
In very severe cases, Crohn's can cause the large intestines to become very dilated, or enlarged. Symptoms include abdominal pain, fever, rapid heartbeat and dehydration. There is also a great risk of the large intestines perforating, which can be fatal.
Erythema Nodosum
Erythema nodosum is a panniculitis, or inflammation of fat beneath the surface of the skin. Like pyoderma gangrenosum, this skin disease is seen in association with other diseases besides Crohn's disease. It causes very painful, red nodules, which are usually found on the front of both lower legs. In addition, there may also be fever and joint pain.
References
- American Family Physician: Gynecologic Aspects of Crohn's Disease
- "Current Medical Diagnosis & Treatment 2009"; Stephen McPhee, M.D., Maxine Papadakis, M.D.; 2009
- The Merck Manual for Healthcare Professionals: Pyoderma Gangrenosum
