The two most common complications that are associated with Crohn’s disease are:

• bowel obstruction – due to intensive inflammation, sections of the bowel can narrow and harden, leading to bowel contents becoming stuck in the bowel, and
• fistula – a fistula is an abnormal channel that develops between two sections of the digestive system.

These complications are discussed in more detail below.

Bowel obstruction

If your bowel becomes obstructed, you will either not be able to pass any stools at all, or you will only be able to pass watery stools because only liquid will be able to get past the point of obstruction. Other symptoms of bowel obstruction include abdominal pain and cramping, vomiting, bloating, and an uncomfortable feeling of fullness in your abdomen. A bowel obstruction requires immediate medical treatment. Left untreated, there is a risk that the bowel could rupture (split) which in turn can lead to internal bleeding and wide-spread infection.

If a bowel obstruction is suspected, it is likely that you will be admitted to hospital so that your health can be carefully monitored. In some cases, it may be possible to clear the bowel obstruction by switching you to a liquid-only diet and using medication to reduce inflammation. However, if this does not work, surgery will be required to unblock the bowel.

You may require a temporary colostomy while your bowel heals. A colostomy is an operation where a section of your colon is diverted, and attached to an opening in your abdominal wall. The opening is known as a stoma. A pouch is attached to the stoma to collect waste products, such as stools. Once your bowel has healed, the colon can be reattached and the stoma sealed.

If you experience repeated episodes of bowel obstruction, a permanent colostomy may be recommended.

Fistulas

If your digestive system becomes scarred as the result of excessive inflammation, ulcers (open sores) can develop. Over time, the ulcers can expand into tunnels, or passageways, that can run from one part of the digestive system to the other or, in some cases, to the bladder, anus, or skin. These passageways are known as fistulas.

Small fistulas usually cause no symptoms. Larger fistulas can become infected and cause symptoms such as a constant, throbbing pain, a high temperature (fever) of 38C (100F), or above, blood and/or pus in your faeces (stools), and generally feeling very unwell. If a fistula develops on the skin (usually on, or near, the anus) it may release a foul smelling discharge.

Surgery is usually required to treat a fistula. During surgery, the surgeon will cut open the fistula, while you are under general anaesthetic. They will scrape and flush out the contents of the fistula which will be laid open and flattened out.

Self-help for people with Crohn’s disease

Diet

While there is no evidence that diet causes, or plays a role in, Crohn’s disease, some people with the condition have found that certain foods seem to aggravate their symptoms. The types of food and drink that have been associated with a worsening of symptoms include milk, alcohol, dairy products, spicy foods, fatty foods, and high-fibre foods. However, there are no definitive dietary recommendations for Crohn’s disease because different people react differently to certain foods.

You may find it useful to keep a food diary in which you keep a note of the foods that you eat and record their effects on your symptoms. Eating six smaller meals a day, rather than three larger meals, may also help improve your symptoms.

Some researchers have suggested that an elimination diet may help control symptoms of Crohn’s disease. An elimination diet involves permanently removing entire food types from your diet, such as grains or sugars. However, an elimination diet is a controversial approach to treatment and it is not accepted by many experts who are working in the field of Crohn’s disease. Therefore, you should not attempt an elimination diet without first consulting your doctor.

You may also require vitamin and food supplements if you are unable, or unwilling, to eat certain foods. For example, as dairy products are an important source of calcium, you will require calcium supplements if you are no longer able to eat dairy products. Your doctor will be able to advise you about any supplements that may be appropriate for you.

Elemental diet

If you are experiencing particularly severe symptoms, and/or you are showing signs of malnutrition, your doctor may recommend an elemental diet.

An elemental diet means that you will switch to a liquid-only diet where all of your nutritional needs are met by drinking specially prepared liquid meals, which are a bit like the ‘slimming shakes’ that are used in some diet programmes. An elemental diet is a useful way of allowing your digestive system to rest while ensuring that you get all the nutrients that you require. In most cases, people only have to stay on an elemental diet on a short to medium term basis.

Related Articles:

1. Crohn’s dis­ease
2. Dia­gnos­ing Crohn’s dis­ease
3. Treat­ing Crohn’s dis­ease
4. Treat­ing Irrit­able bowel syn­drome (IBS)
5. Dia­gnos­ing and treat­ing Glu­ten Itol­er­ance — Celiac dis­ease
6. Inflam­ma­tion of the gall­blad­der — Acute cholecyst­itis
7. Appen­di­citis — the treat­ment, com­plic­a­tions and pre­ven­tion
8. Colostomy

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