Name
The disease was named after gastroenterologist Burrill Bernard Crohn, who in 1932, together with two colleagues at Mount Sinai Hospital in New York, described a series of patients with inflammation of the terminal ileum of the small intestine, the area most commonly affected by the illness. Signs and symptoms
Gastrointestinal
Many people with Crohns disease have symptoms for years before the diagnosis. The usual onset is in the teens and twenties, but can occur at any age. Because of the patchy nature of the gastrointestinal disease and the depth of tissue involvement, initial symptoms can be more subtle than those of ulcerative colitis. People with Crohns disease experience chronic recurring periods of flare-ups and remission. The symptoms experienced can change over time as inflammation increases and spreads. Symptoms can also be different depending on which organs are involved. It is generally thought that the presentation of Crohns disease is different for each patient due to the high variability of symptoms, organ involvement, and initial presentation. Perianal
Perianal discomfort may also be prominent in Crohns disease. Itchiness or pain around the anus may be suggestive of inflammation of the anus, or perianal complications such as anal fissures, fistulae, or abscesses around the anal area. Perianal skin tags are also common in Crohns disease, and may appear with or without the presence of colorectal polyps. Fecal incontinence may accompany perianal Crohns disease. Intestines
The intestines, especially the colon and terminal ileum, are the most commonly affected areas of the body.
Abdominal pain is a common initial symptom of Crohns disease, especially in the lower right abdomen. Flatulence, bloating, and abdominal distension are additional symptoms and may also add to the intestinal discomfort. Pain is often accompanied by diarrhea, which may or may not be bloody. Inflammation in different areas of the intestinal tract can affect the quality of the feces. Ileitis typically results in large-volume, watery feces, while colitis may result in a smaller volume of feces of higher frequency. Fecal consistency may range from solid to watery. In severe cases, an individual may have more than 20 bowel movements per day, and may need to awaken at night to defecate. Visible bleeding in the feces is less common in Crohns disease than in ulcerative colitis, but is not unusual. Bloody bowel movements are usually intermittent, and may be bright red, dark maroon, or even black in color. The color of bloody stool depends on the location of the bleed. In severe Crohns colitis, bleeding may be copious. Stomach and Esophagus
The stomach is rarely the sole or predominant site of CD. To date there are only a few documented case reports of adults with isolated gastric CD and no reports in the pediatric population. Isolated stomach involvement is very unusual presentation accounting for less than 0.07% of all gastrointestinal CD. Rarely, the esophagus and stomach may be involved in Crohns disease. These can cause symptoms including difficulty swallowing (dysphagia), upper abdominal pain, and vomiting. Oropharynx (Mouth)
The mouth may be affected by recurrent sores (aphthous ulcers).