Complications of Crohn’s and Colitis
Treatment for Crohn’s disease and ulcerative colitis has advanced greatly over the past two decades. Today, there are more effective medications available than ever before, helping many patients control their symptoms and prevent complications. In the past, when fewer options existed, serious complications from advanced disease were much more common. Below are some examples of treatments now used in IBD
1. Strictures
In Crohn’s disease, long-lasting or deep inflammation can cause scar tissue to form in the digestive tract. Over time, this scar tissue may create a narrowing, called a stricture. Strictures can slow or block the passage of food, sometimes leading to bowel obstruction, which may require surgery. Strictures are a complication of Crohn’s disease but are not typically seen in ulcerative colitis.
2. Fistulas
In Crohn’s disease, inflammation can extend deep into the wall of the digestive tract. This can sometimes lead to the formation of abnormal tunnels, called fistulas, which connect the bowel to other parts of the digestive system, the bladder, or even the skin. Fistulas can become infected and cause severe pain, often requiring urgent medical care. They are considered a hallmark complication of Crohn’s disease and are not typically seen in ulcerative colitis.
3. Nutritional deficiency
The terminal ileum is the last part of the small intestine and plays an important role in absorbing vitamin B12 and bile acids. In Crohn’s disease, this area is often affected, which can reduce the absorption of these nutrients. As a result, patients may develop nutritional deficiencies that can cause anemia (low blood counts) or osteoporosis (weak bones). While nutritional deficiencies are more common in Crohn’s disease, they can also occur in ulcerative colitis, especially if the disease is severe or long-standing.
4. Colon cancer
Long-standing inflammation in the bowel increases the risk of developing cancer. Because inflammation is the hallmark of IBD, people with Crohn’s disease or ulcerative colitis involving the colon have a higher risk of colon cancer if the disease is not well controlled. The risk is most significant in patients with continuous colonic inflammation lasting more than 8 years, as this can lead to precancerous changes and eventually colon cancer. In contrast, people with short-segment ulcerative colitis or Crohn’s disease limited to the small bowel do not appear to have a significantly increased risk of colon cancer. For this reason, patients with long-standing colonic IBD are advised to undergo regular surveillance colonoscopy to detect precancerous changes early and reduce the risk of colon cancer.
Gastroenterologists treat Crohn’s disease and ulcerative colitis aggressively to reduce the chances of complications occurring, which could be very debilitating. Fortunately, treatments are widely available in Canada.
Please visit the American College of Gastroenterology website for more information and updates regarding Inflammatory Bowel Disease. Inflammatory Bowel Disease (IBD) | ACG