Table of ContentsView AllTable of ContentsCommon SymptomsMild vs. Severe SymptomsWhat Is a Flare?PainSymptom in Females vs. MalesLong-Term ComplicationsWhen to Seek Urgent CareQuality of LifeNext in Crohn’s Disease GuideCrohn’s Disease: Causes and Risk Factors

Table of ContentsView All

View All

Table of Contents

Common Symptoms

Mild vs. Severe Symptoms

What Is a Flare?

Pain

Symptom in Females vs. Males

Long-Term Complications

When to Seek Urgent Care

Quality of Life

Next in Crohn’s Disease Guide

Crohn’s disease fluctuates between periods of very mild or no symptoms (remission) and periods when your symptoms return or worsen (a flare or flare-up).

Everyone experiences flares differently. Symptoms such as abdominal pain, fever, diarrhea, unexpected weight loss, fatigue, and frequent bowel movements may vary from person to person and may be intermittent.

Flares can be unpredictable, but if you maintain your treatment plan and a healthy lifestyle, you may be able to reduce their frequency.

A person at home feeling abdominal pain from Crohn’s disease

Crohn’s Common Symptoms

The symptoms of Crohn’s disease may differ from person to person based on several factors. These include the location and amount of inflammation in the digestive system and whether there are complications. However, the most common symptoms that occur in the digestive system include:

Related conditions and signs and symptoms that may appear outside the digestive system can include:

Crohn’s Disease MimicsThe symptoms of Crohn’s disease (and IBD in general) are similar to those of several other conditions. For that reason, it’s important to get a confirmed diagnosis. These other conditions can include:AppendicitisBehcet’s diseaseCeliac diseaseInfectionUlcerative colitis

Crohn’s Disease Mimics

The symptoms of Crohn’s disease (and IBD in general) are similar to those of several other conditions. For that reason, it’s important to get a confirmed diagnosis. These other conditions can include:AppendicitisBehcet’s diseaseCeliac diseaseInfectionUlcerative colitis

The symptoms of Crohn’s disease (and IBD in general) are similar to those of several other conditions. For that reason, it’s important to get a confirmed diagnosis. These other conditions can include:

Crohn’s Disease

Crohn’s disease includes categories of mild, moderate, or severe disease. How these different levels are decided can vary, but sometimes a clinical scale may be used.

The severity of the condition can help determine what treatments are needed. This is partly determined through the results of lab tests, colonoscopy or other endoscopy procedures, or imaging studies such as computed tomography (CT) scans, or magnetic resonance imaging (MRI).

Severity may also depend on complications, including those inside or outside the digestive system.

One research tool that might be used, such as in a clinical trial, is a Crohn’s disease activity index (CDAI), which can indicate the following using certain criteria:

A flare happens when your symptoms return or worsen. Most people with Crohn’s experience periods when symptoms are active. Knowing your baseline symptoms during remission may help you detect when your disease is becoming more active.

Some of the GI signs that indicate you are having a flare may include:

You may also experience symptoms outside the GI tract.

These may include:

Any of these symptoms, or a combination of several, may last from a few days to several months.

There is no specific test to diagnose a flare-up. It’s important to notify your healthcare provider if you have a flare in case you need a modified treatment plan, additional treatment, or testing,

Flare Triggers

You may have several triggers that result in a flare-up. Keep a journal to monitor and track your symptoms and a food diary to identify any food triggers. This may help to reduce the chance of a flare.

Some flare triggers can include:

Flares may also indicate your current treatment is no longer working. Your healthcare provider may perform tests to confirm this is the reason and adjust your medications.

In studies, 60% of people with IBD report abdominal pain.The pain may be related to a flare-up.

However, 30% to 50% of people with IBD may have pain even when inremission.It’s unclear why pain may not improve when the other signs and symptoms of Crohn’s disease improve.

Pain Locations

Abdominal pain tends to be more common with Crohn’s disease than in other forms of IBD (such as ulcerative colitis).The location of abdominal pain may vary based on where the inflammation is located.

The abdomen has four sections: the right upper, right lower, left upper, and left lower quadrant. Knowing where the pain is located is helpful in discussing it with your healthcare providers.

Here are some of the most common forms of Crohn’s disease and where the abdominal pain might be located:

Symptom Differences in Females vs. Males

People of any age, sex, or gender can develop Crohn’s disease. However, there may be differences in how the disease affects people assigned to males or females at birth.

Females

People whomenstruatemay have a flare-up before or during their period. This may be because of a change in hormone levels. Changes in the menstrual cycle are also common, with 60% of people reporting infrequent periods, no period at all, bleeding between periods, or heavy periods.

Penetrative intercourse may also be painful for some people who have vaginas. One study found that 17% of females with Crohn’s disease said that they had painful sex “sometimes,” “often,” or “every time.”

Crohn’s disease doesn’t appear to have a large effect on the symptoms or the age of onset for menopause (having a last period). However, this is not yet well understood.

Anemia(a low number of healthy red blood cells) is also more common in people with Crohn’s disease, especially for those who have a period.

Males

Sexual function in men is related to Crohn’s disease activity. Depression, which is more common in people with IBD, could be a factor in the development of erectile dysfunction, low libido (sexual desire), and decreased satisfaction.Erectile dysfunctionmay also be related to IBD, especially in the first two years after diagnosis.

People who have a prostate and have IBD may be more likely to developprostate cancer. However, it’s not known if this increased risk means that there is a need for more treatment or serious outcomes for prostate cancer.

Bone loss—osteopeniaandosteoporosis—is more common in men who have IBD than in the general population. One study done in Germany showed that 56% of males with IBD had bone loss. In females with IBD, 30% had bone loss.This shows the importance of screening men with IBD for bone loss.

Crohn’s disease may cause vitamin and mineral deficiencies. A lack of zinc, in particular, could lead toinfertilityin males.

Long-Term Complications of Unmanaged Crohn’s Symptoms

When Crohn’s disease goes untreated, the inflammation can cause various issues, both inside and outside the digestive system. These may include:

You may experience severe symptoms during a flare. Some of these may require immediate medical attention and may include:

Symptoms and Quality of Life

Crohn’s disease can diminish the quality of life. Symptoms can affect daily activities, social life, relationships, and mental well-being. Stress, anxiety, and depression can also affect quality of life.

It’s important to treat Crohn’s disease as best as possible to keep inflammation under control. That’s not necessarily an easy or quick thing to do. Sometimes, it means working with several different types of healthcare providers.

Summary

Crohn’s disease causes inflammation in the small and large intestines. Even with treatment, most people with Crohn’s disease will experience periods when symptoms are active. Understanding your baseline symptoms during remission may help you better detect when a flare-up may be starting.

Keeping track of your symptoms and triggers while maintaining a healthy lifestyle may help reduce the frequency of flare-ups. Crohn’s disease can diminish your quality of life, so starting treatment and controlling inflammation as early as possible is important. Work with your healthcare provider to establish the best treatment plan for you.

17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Feuerstein JD, Cheifetz AS.Crohn disease: epidemiology, diagnosis, and management.Mayo Clin Proc. 2017;92:1088-1103. doi:10.1016/j.mayocp.2017.04.010.Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Am J Gastroenterol. 2018;113(4):481-517. doi:10.1038/ajg.2018.27Crohn’s & Colitis UK.Flare Up.Crohn’s & Colitis.Crohn’s Symptoms and Flare-Ups.Bakshi N, Hart AL, Lee MC, Williams ACC, Lackner JM, Norton C, Croft P.Chronic pain in patients with inflammatory bowel disease. Pain. 2021;162(10):2466-2471. doi: 10.1097/j.pain.0000000000002304Veauthier B, Hornecker JR.Crohn’s disease: diagnosis and management.Am Fam Physician. 2018;98:661-669.Malinauskiene V, Zuzo A, Liakina V, Kazenaite E, Stundiene I.Menstrual cycle abnormalities in women with inflammatory bowel disease and effects of biological therapy on gynecological pathology.World J Clin Cases.2023;11:4989-4995. doi:10.12998/wjcc.v11.i21.4989.Nøhr EA, Nielsen J, Nørgård BM, Friedman S.Sexual health in women with inflammatory bowel disease in the Danish National Birth Cohort.J Crohns Colitis. 2020;14:1082-1089. doi:10.1093/ecco-jcc/jjaa038.Italian Group for the Study of Inflammatory Bowel Disease Working Group:, Armuzzi A, Bortoli A, et al.Female reproductive health and inflammatory bowel disease: A practice-based review.Dig Liver Dis.2022;54:19-29. doi:10.1016/j.dld.2021.05.020.Dranga M, Boiculese LV, Popa IV, et al.Anemia in Crohn’s disease - the unseen face of inflammatory bowel disease.Medicina (Kaunas). 2021;57:1046. doi:10.3390/medicina57101046.Park YE, Kim TO.Sexual dysfunction and fertility problems in men with inflammatory bowel disease.World J Mens Health. 2020;38:285-297. doi:10.5534/wjmh.190007.Shmidt E, Suárez-Fariñas M, Mallette M, et al.Erectile dysfunction is highly prevalent in men with newly diagnosed inflammatory bowel disease.Inflamm Bowel Dis. 2019;25:1408-1416. doi:10.1093/ibd/izy401.Burns JA, Weiner AB, Catalona WJ, et al.Inflammatory bowel disease and the risk of prostate cancer.Eur Urol. 2019;75:846-852. doi:10.1016/j.eururo.2018.11.039.Greuter T, Manser C, Pittet V, Vavricka SR, Biedermann L; on behalf of Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology.Gender differences in inflammatory bowel disease.Digestion. 2020;101 Suppl 1:98-104. doi:10.1159/000504701.Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Am J Gastroenterol. 2018;113(4):481-517. doi:10.1038/ajg.2018.27Crohn’s & Colitis UK.Flare-ups.Mitropoulou MA, Fradelos EC, Lee KY, et al.Quality of life in patients with inflammatory bowel disease: Importance of psychological symptoms.Cureus. 2022;14:e28502. doi:10.7759/cureus.28502

17 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Feuerstein JD, Cheifetz AS.Crohn disease: epidemiology, diagnosis, and management.Mayo Clin Proc. 2017;92:1088-1103. doi:10.1016/j.mayocp.2017.04.010.Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Am J Gastroenterol. 2018;113(4):481-517. doi:10.1038/ajg.2018.27Crohn’s & Colitis UK.Flare Up.Crohn’s & Colitis.Crohn’s Symptoms and Flare-Ups.Bakshi N, Hart AL, Lee MC, Williams ACC, Lackner JM, Norton C, Croft P.Chronic pain in patients with inflammatory bowel disease. Pain. 2021;162(10):2466-2471. doi: 10.1097/j.pain.0000000000002304Veauthier B, Hornecker JR.Crohn’s disease: diagnosis and management.Am Fam Physician. 2018;98:661-669.Malinauskiene V, Zuzo A, Liakina V, Kazenaite E, Stundiene I.Menstrual cycle abnormalities in women with inflammatory bowel disease and effects of biological therapy on gynecological pathology.World J Clin Cases.2023;11:4989-4995. doi:10.12998/wjcc.v11.i21.4989.Nøhr EA, Nielsen J, Nørgård BM, Friedman S.Sexual health in women with inflammatory bowel disease in the Danish National Birth Cohort.J Crohns Colitis. 2020;14:1082-1089. doi:10.1093/ecco-jcc/jjaa038.Italian Group for the Study of Inflammatory Bowel Disease Working Group:, Armuzzi A, Bortoli A, et al.Female reproductive health and inflammatory bowel disease: A practice-based review.Dig Liver Dis.2022;54:19-29. doi:10.1016/j.dld.2021.05.020.Dranga M, Boiculese LV, Popa IV, et al.Anemia in Crohn’s disease - the unseen face of inflammatory bowel disease.Medicina (Kaunas). 2021;57:1046. doi:10.3390/medicina57101046.Park YE, Kim TO.Sexual dysfunction and fertility problems in men with inflammatory bowel disease.World J Mens Health. 2020;38:285-297. doi:10.5534/wjmh.190007.Shmidt E, Suárez-Fariñas M, Mallette M, et al.Erectile dysfunction is highly prevalent in men with newly diagnosed inflammatory bowel disease.Inflamm Bowel Dis. 2019;25:1408-1416. doi:10.1093/ibd/izy401.Burns JA, Weiner AB, Catalona WJ, et al.Inflammatory bowel disease and the risk of prostate cancer.Eur Urol. 2019;75:846-852. doi:10.1016/j.eururo.2018.11.039.Greuter T, Manser C, Pittet V, Vavricka SR, Biedermann L; on behalf of Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology.Gender differences in inflammatory bowel disease.Digestion. 2020;101 Suppl 1:98-104. doi:10.1159/000504701.Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Am J Gastroenterol. 2018;113(4):481-517. doi:10.1038/ajg.2018.27Crohn’s & Colitis UK.Flare-ups.Mitropoulou MA, Fradelos EC, Lee KY, et al.Quality of life in patients with inflammatory bowel disease: Importance of psychological symptoms.Cureus. 2022;14:e28502. doi:10.7759/cureus.28502

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Feuerstein JD, Cheifetz AS.Crohn disease: epidemiology, diagnosis, and management.Mayo Clin Proc. 2017;92:1088-1103. doi:10.1016/j.mayocp.2017.04.010.Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Am J Gastroenterol. 2018;113(4):481-517. doi:10.1038/ajg.2018.27Crohn’s & Colitis UK.Flare Up.Crohn’s & Colitis.Crohn’s Symptoms and Flare-Ups.Bakshi N, Hart AL, Lee MC, Williams ACC, Lackner JM, Norton C, Croft P.Chronic pain in patients with inflammatory bowel disease. Pain. 2021;162(10):2466-2471. doi: 10.1097/j.pain.0000000000002304Veauthier B, Hornecker JR.Crohn’s disease: diagnosis and management.Am Fam Physician. 2018;98:661-669.Malinauskiene V, Zuzo A, Liakina V, Kazenaite E, Stundiene I.Menstrual cycle abnormalities in women with inflammatory bowel disease and effects of biological therapy on gynecological pathology.World J Clin Cases.2023;11:4989-4995. doi:10.12998/wjcc.v11.i21.4989.Nøhr EA, Nielsen J, Nørgård BM, Friedman S.Sexual health in women with inflammatory bowel disease in the Danish National Birth Cohort.J Crohns Colitis. 2020;14:1082-1089. doi:10.1093/ecco-jcc/jjaa038.Italian Group for the Study of Inflammatory Bowel Disease Working Group:, Armuzzi A, Bortoli A, et al.Female reproductive health and inflammatory bowel disease: A practice-based review.Dig Liver Dis.2022;54:19-29. doi:10.1016/j.dld.2021.05.020.Dranga M, Boiculese LV, Popa IV, et al.Anemia in Crohn’s disease - the unseen face of inflammatory bowel disease.Medicina (Kaunas). 2021;57:1046. doi:10.3390/medicina57101046.Park YE, Kim TO.Sexual dysfunction and fertility problems in men with inflammatory bowel disease.World J Mens Health. 2020;38:285-297. doi:10.5534/wjmh.190007.Shmidt E, Suárez-Fariñas M, Mallette M, et al.Erectile dysfunction is highly prevalent in men with newly diagnosed inflammatory bowel disease.Inflamm Bowel Dis. 2019;25:1408-1416. doi:10.1093/ibd/izy401.Burns JA, Weiner AB, Catalona WJ, et al.Inflammatory bowel disease and the risk of prostate cancer.Eur Urol. 2019;75:846-852. doi:10.1016/j.eururo.2018.11.039.Greuter T, Manser C, Pittet V, Vavricka SR, Biedermann L; on behalf of Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology.Gender differences in inflammatory bowel disease.Digestion. 2020;101 Suppl 1:98-104. doi:10.1159/000504701.Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Am J Gastroenterol. 2018;113(4):481-517. doi:10.1038/ajg.2018.27Crohn’s & Colitis UK.Flare-ups.Mitropoulou MA, Fradelos EC, Lee KY, et al.Quality of life in patients with inflammatory bowel disease: Importance of psychological symptoms.Cureus. 2022;14:e28502. doi:10.7759/cureus.28502

Feuerstein JD, Cheifetz AS.Crohn disease: epidemiology, diagnosis, and management.Mayo Clin Proc. 2017;92:1088-1103. doi:10.1016/j.mayocp.2017.04.010.

Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Am J Gastroenterol. 2018;113(4):481-517. doi:10.1038/ajg.2018.27

Crohn’s & Colitis UK.Flare Up.

Crohn’s & Colitis.Crohn’s Symptoms and Flare-Ups.

Bakshi N, Hart AL, Lee MC, Williams ACC, Lackner JM, Norton C, Croft P.Chronic pain in patients with inflammatory bowel disease. Pain. 2021;162(10):2466-2471. doi: 10.1097/j.pain.0000000000002304

Veauthier B, Hornecker JR.Crohn’s disease: diagnosis and management.Am Fam Physician. 2018;98:661-669.

Malinauskiene V, Zuzo A, Liakina V, Kazenaite E, Stundiene I.Menstrual cycle abnormalities in women with inflammatory bowel disease and effects of biological therapy on gynecological pathology.World J Clin Cases.2023;11:4989-4995. doi:10.12998/wjcc.v11.i21.4989.

Nøhr EA, Nielsen J, Nørgård BM, Friedman S.Sexual health in women with inflammatory bowel disease in the Danish National Birth Cohort.J Crohns Colitis. 2020;14:1082-1089. doi:10.1093/ecco-jcc/jjaa038.

Italian Group for the Study of Inflammatory Bowel Disease Working Group:, Armuzzi A, Bortoli A, et al.Female reproductive health and inflammatory bowel disease: A practice-based review.Dig Liver Dis.2022;54:19-29. doi:10.1016/j.dld.2021.05.020.

Dranga M, Boiculese LV, Popa IV, et al.Anemia in Crohn’s disease - the unseen face of inflammatory bowel disease.Medicina (Kaunas). 2021;57:1046. doi:10.3390/medicina57101046.

Park YE, Kim TO.Sexual dysfunction and fertility problems in men with inflammatory bowel disease.World J Mens Health. 2020;38:285-297. doi:10.5534/wjmh.190007.

Shmidt E, Suárez-Fariñas M, Mallette M, et al.Erectile dysfunction is highly prevalent in men with newly diagnosed inflammatory bowel disease.Inflamm Bowel Dis. 2019;25:1408-1416. doi:10.1093/ibd/izy401.

Burns JA, Weiner AB, Catalona WJ, et al.Inflammatory bowel disease and the risk of prostate cancer.Eur Urol. 2019;75:846-852. doi:10.1016/j.eururo.2018.11.039.

Greuter T, Manser C, Pittet V, Vavricka SR, Biedermann L; on behalf of Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology.Gender differences in inflammatory bowel disease.Digestion. 2020;101 Suppl 1:98-104. doi:10.1159/000504701.

Crohn’s & Colitis UK.Flare-ups.

Mitropoulou MA, Fradelos EC, Lee KY, et al.Quality of life in patients with inflammatory bowel disease: Importance of psychological symptoms.Cureus. 2022;14:e28502. doi:10.7759/cureus.28502

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