Common Symptoms of Crohn’s

Crohn’s disease can cause a wide mix of symptoms, but some patterns are especially common. This article explains typical gut problems like diarrhea, abdominal pain, weight loss, and fatigue, along with warning signs of strictures and fistulas, which are more serious complications. Understanding these patterns can help families recognize when Crohn’s is active and when symptoms may signal a need for urgent care.

Key Takeaways

• The most common Crohn’s symptoms are diarrhea, crampy abdominal pain, weight loss, fatigue, and sometimes low‑grade fever.(mayoclinic.org)

• Symptoms often come in flares, with quieter periods called remission between them.(newsnetwork.mayoclinic.org)

• Strictures are narrow, stiff segments of bowel that can cause pain after eating, bloating, nausea, and symptoms of bowel blockage.(mayoclinic.org)

• Fistulas are abnormal tunnels between the intestine and nearby organs or skin, often causing drainage, abscesses, or infections.(mayoclinic.org)

• Severe or rapidly worsening pain, repeated vomiting, high fever, or an inability to pass stool or gas can signal an emergency and needs urgent medical care.(healthline.com)

How Crohn’s Symptoms Usually Show Up

Crohn’s is a chronic inflammatory condition that can affect any part of the digestive tract, from mouth to anus. Symptoms depend on where the inflammation sits and how deep or severe it is.(mayoclinic.org)

Many people first notice vague problems such as looser stools, mild cramping, or tiredness. Over time, these may build into clearer patterns of diarrhea, abdominal pain, and weight loss. Symptoms often wax and wane. Active periods are called flares, and quieter phases are called remission.(newsnetwork.mayoclinic.org)

Core Gut Symptoms

Diarrhea and urgency

Diarrhea is one of the hallmark symptoms of Crohn’s disease. Inflammation in the gut wall makes it harder to absorb fluid, so stool becomes loose or watery and more frequent.(mayoclinic.org)

Many people also have:

• A strong, sudden need to rush to the bathroom

• Nighttime stools during flares

• Occasional mucus or blood mixed with stool(aafp.org)

Diarrhea can range from a few loose stools a day to very frequent trips that disrupt school, work, and sleep.

Abdominal pain and cramping

Abdominal pain is another key symptom. It often feels crampy and may be worse:

• After meals

• In the lower right side of the abdomen, around the navel, or both

• During active flares or when a stricture is present(health.harvard.edu)

Pain can be mild and off‑and‑on, or severe and constant. Some people notice that pain starts 30 to 60 minutes after eating, which can be a clue that narrowed bowel segments are slowing food passage.(aafp.org)

Rectal bleeding and perianal symptoms

Crohn’s inflammation can cause small ulcers in the lining of the bowel. These may lead to:

• Bright red blood on the toilet paper or in the bowl

• Darker blood mixed with stool

• Pain with bowel movements(health.harvard.edu)

Some people also develop perianal disease. This can include skin tags, fissures (small tears), abscesses, or fistulas near the anus. These problems are covered in more detail in the Perianal Crohn’s article, but they often show up as pain, swelling, or drainage around the anus.(mcpress.mayoclinic.org)

Whole‑Body Symptoms

Weight loss and poor appetite

Ongoing gut inflammation can make eating uncomfortable and reduce appetite. Diarrhea and poor nutrient absorption also mean calories and vitamins are lost instead of absorbed.(mayoclinic.org)

Common patterns include:

• Unintentional weight loss over weeks or months

• Clothes fitting looser without trying

• Slower growth or delayed puberty in children and teens

Fatigue, fever, and feeling unwell

Fatigue is very common in Crohn’s disease. It can stem from poor sleep, active inflammation, pain, anemia, or vitamin deficiencies.(mcpress.mayoclinic.org)

Other general symptoms may include:

• Low‑grade fever during flares

• Weakness or low energy

• Night sweats during more active disease(mayoclinic.org)

Some people also develop joint pain, eye redness, or skin rashes, which are discussed further in the Extraintestinal Manifestations section of the knowledge base.(mcpress.mayoclinic.org)

Signs of Strictures (Bowel Narrowing)

A stricture is a segment of bowel that has become narrowed and stiff from long‑standing inflammation and scarring. Food and stool have a harder time passing through the area.(mayoclinic.org)

Typical symptoms of a partial obstruction from a stricture include:

• Crampy abdominal pain, often after meals

• Bloating or visible abdominal swelling

• Nausea or sometimes vomiting

• A feeling that food “sticks” or moves slowly

• Constipation or thinner, narrower stools than usual(healthline.com)

Stricture symptoms can come and go at first. Over time, a very tight stricture can cause a full blockage. Possible signs of a serious blockage include:

• Severe, constant pain

• Repeated vomiting

• A very swollen, tender abdomen

• Inability to pass gas or stool(merckmanuals.com)

These are emergency signs and need urgent evaluation, often in an emergency department.

Signs of Fistulas

A fistula is an abnormal tunnel that forms between the intestine and another part of the body. Crohn’s can cause fistulas between:

• Two loops of intestine

• Intestine and the bladder, vagina, or skin

• Intestine and the anus or perianal skin(mayoclinic.org)

Symptoms depend on where the fistula connects:

• Perianal fistulas

• Pain, swelling, or a lump near the anus

• Small openings in the skin that leak pus, mucus, or stool

• Repeated painful abscesses in the same area

• Fistulas to the skin (enterocutaneous)

• A tender spot on the belly that opens and drains fluid or stool

• Persistent, foul‑smelling drainage from a small hole in the skin

• Fistulas to the bladder or vagina

• Air, mucus, or stool in the urine

• Recurrent urinary infections

• Passage of gas or stool through the vagina(mayoclinic.org)

Fistulas can lead to infections and abscesses. High fever, chills, or rapidly worsening pain near a suspected fistula are warning signs and need urgent medical care.(mayoclinic.org)

When Symptoms Suggest Complications

Crohn’s symptoms cover a wide range, and not every bad day means a major complication. Some patterns, however, deserve fast attention. These include:

• Severe or constant abdominal pain, especially with vomiting or a very swollen belly

• Inability to pass gas or stool

• Heavy rectal bleeding

• High fever or chills with abdominal or perianal pain

• New openings or drainage near the anus or on the skin of the abdomen(aafp.org)

Tracking symptoms over time can help the care team see which patterns are usual for a given person and which might signal strictures, fistulas, or other complications that need more urgent evaluation.

FAQs

Can Crohn’s cause constipation instead of diarrhea?

Yes. Constipation or a change to thinner, narrower stools can occur, especially if a stricture is slowing stool movement. Some medicines and low‑fiber diets can also contribute to constipation in Crohn’s disease.(nm.org)

Are Crohn’s symptoms always severe?

No. Some people have mild symptoms for years, while others have more intense flares. Symptoms can also change over time as the pattern of inflammation or complications like strictures and fistulas develop.(newsnetwork.mayoclinic.org)

Do symptoms always match how much inflammation is present?

Not always. Some people feel relatively well even with active inflammation, while others have a lot of pain or fatigue from milder disease. This is why most care plans combine symptom tracking with tests such as stool calprotectin, blood markers, imaging, and scopes.(aafp.org)