Common Symptoms of Crohn’s

Crohn’s disease causes inflammation anywhere from mouth to anus, so symptoms vary. The most common day‑to‑day issues are diarrhea, belly pain or cramps, weight loss, and fatigue. Some people also have fevers, mouth sores, and blood in the stool. Over time, deeper inflammation can create narrowings (strictures) or tunnels (fistulas) that have their own warning signs and may need urgent care. (mayoclinic.org)

Key takeaways

• Diarrhea, abdominal pain, weight loss, and fatigue are the most typical symptoms. (mayoclinic.org)

• Symptoms differ by location of disease in the gut and can come and go. (mayoclinic.org)

• Fatigue often reflects active inflammation or anemia, even during “quiet” periods. (crohnscolitisfoundation.org)

• Strictures cause crampy pain after meals, bloating, nausea, and sometimes vomiting or constipation. (crohnscolitisfoundation.org)

• Fistulas can cause anal pain or drainage, or unusual symptoms like air or stool in urine or the vagina. (mayoclinic.org)

• Seek urgent care for severe pain with vomiting, inability to pass gas or stool, high fever, or heavy bleeding. (mayoclinic.org)

Why symptoms vary in Crohn’s

Crohn’s can affect any part of the digestive tract and often inflames the full bowel wall. That pattern explains why some symptoms are mild while others signal complications. Transmural inflammation can heal with scar tissue, leading to strictures (narrowing), or can burrow to form fistulas (abnormal tunnels). Symptoms also reflect where disease is located, such as small intestine, colon, or around the anus. (pubmed.ncbi.nlm.nih.gov)

Typical day‑to‑day symptoms

• Diarrhea, often multiple loose stools a day.

• Abdominal pain and cramping, sometimes worse after meals.

• Fatigue and low energy.

• Reduced appetite and weight loss.

• Fever, mouth sores, and blood in the stool in some people.
  Children and teens may show poor growth or delayed puberty, sometimes before obvious bowel symptoms appear. (mayoclinic.org)

What symptoms can reveal about location

• Small intestine involvement: crampy pain near the belly button or right lower abdomen, diarrhea without much blood, nutrient shortfalls like vitamin B12 or iron that worsen fatigue. (niddk.nih.gov)

• Colon involvement: more frequent urgency and bleeding with stools. (mayoclinic.org)

• Perianal area: pain, swelling, drainage, skin tags, fissures, or abscesses. These are common in Crohn’s and may be the first sign. (crohnscolitisfoundation.org)

Fatigue, anemia, and nutrient loss

Feeling wiped out is common in Crohn’s. Active inflammation, iron deficiency, low vitamin B12 or folate, poor sleep, and certain medicines can all contribute. About half of people in remission and most with active disease report fatigue. Anemia often adds to tiredness and shortness of breath, so checking blood counts and iron is important. (crohnscolitisfoundation.org)

Signs of strictures (narrowing)

A stricture is a narrowed segment of bowel from swelling and scar tissue. Symptoms include:
- Crampy or colicky abdominal pain, often after eating
- Bloating or belly distention
- Nausea or vomiting
- Constipation or difficulty passing gas

These symptoms can come and go, but a complete blockage causes severe pain with vomiting and an inability to pass gas or stool, which is an emergency. (crohnscolitisfoundation.org)

Signs of fistulas and perianal disease

A fistula is a tunnel from the intestine to nearby skin or organs.

• Perianal fistulas: pain, swelling, drainage of pus or stool near the anus, or recurrent “boils.” Skin tags and fissures are common. Fever and severe, throbbing pain suggest an abscess that needs prompt treatment. (crohnscolitisfoundation.org)

• Enterovesical fistula (to the bladder): recurrent urinary infections, air bubbles in urine (pneumaturia), or stool in urine (fecaluria). (ccjm.org)

• Enterovaginal fistula: passage of gas or stool through the vagina. (mayoclinic.org)

Quick guide: strictures vs fistulas

Sources for features and red flags: Crohn’s Colitis Foundation, Mayo Clinic, and Cleveland Clinic Journal of Medicine. (crohnscolitisfoundation.org)

When symptoms mean urgent care

Contact the care team or seek urgent help for:
- Severe or worsening belly pain, especially with vomiting
- Inability to pass gas or stool, or a very swollen abdomen
- High fever, or fever 100.4°F or higher that lasts more than a day
- Heavy or ongoing rectal bleeding
- Painful perianal swelling with fever or chills
- Signs of dehydration, like dizziness, very dark urine, or confusion

These can signal obstruction, abscess, or significant blood loss. (pennmedicine.org)

FAQs

Can Crohn’s cause constipation instead of diarrhea

Yes. Constipation can happen with strictures or with disease in the rectum or anus. New or persistent constipation with cramps or vomiting needs evaluation. (crohnscolitisfoundation.org)

Is fatigue a sign of a flare

Often yes, but fatigue can also persist in remission. Checking for anemia, nutrient deficits, poor sleep, and mood symptoms helps find other treatable causes. (crohnscolitisfoundation.org)

Do children show different symptoms

Children may have belly pain, diarrhea, and bleeding, but slowed growth or delayed puberty are key clues and should prompt evaluation. (gi.org)

Are mouth sores part of Crohn’s

They can be. Mouth ulcers may appear during active inflammation and usually improve as gut inflammation is controlled. (mayoclinic.org)