Crohn’s disease can cause symptoms that go beyond digestive problems, including skin conditions, osteoporosis, and even arthritis.
Gas, bloating, diarrhea, nausea: You’re probably all-too familiar with these common Crohn’s disease symptoms, especially if they strike on a regular basis. Yet because Crohn’s disease is a systemic or whole-body condition, its symptoms could extend beyond your digestive system.
“Crohn’s disease is a body-wide disease that is caused by excessive inflammation,” says Nirmal Kaur, MD, director of the inflammatory bowel disease center at Henry Ford Health System in Detroit. “Some people with Crohn’s disease only have inflammation in the bowel, but about 30 percent to 40 percent of people have what are called extra-intestinal manifestations, or Crohn’s disease symptoms outside of their gastrointestinal tract.”
In most cases, the treatments for non-digestive symptoms of Crohn’s are the same as the treatment for bowel-related symptoms: primarily medication. These medications may include aminosalicylates (for mild cases), immunosuppressive agents, biologic therapies, and corticosteroids. For most people, they work well for all Crohn’s symptoms. “Most people notice that when their digestive Crohn’s disease symptoms are treated, their non-digestive symptoms get better as well,” Dr. Kaur says.
Understanding Non-Digestive Symptoms of Crohn’s Disease
Here are eight symptoms of Crohn’s disease that show up outside of the digestive tract, why they occur, and how they can best be managed.
Increased arthritis risk. Because of the inflammation associated with the disease, up to 25 percent of people with Crohn’s also develop arthritis, according to the Crohn’s & Colitis Foundation of America. “This arthritis risk is highest in the larger joints, such as the knees, elbows, and wrists, which is called peripheral arthritis,” Kaur says. “But arthritis can show up anywhere in people with Crohn’s disease.” Usually if the Crohn’s is treated, the arthritis improves as well.
Increased osteoporosis risk. “People with Crohn’s disease are at higher risk for osteoporosisthan the general population is,” says Mariam Fayek, MD, attending physician in the Center for Women’s Gastrointestinal Health at Women & Infants Hospital of Rhode Island in Providence. “The chronic inflammation of Crohn’s disease leads to increased bone loss, and people with Crohn’s are also more likely to be vitamin-D deficient, both which contribute to osteoporosis risk.”
This vitamin D deficiency occurs partly because the portion of the bowel that absorbs vitamin D is diseased. Another contributor to an increased osteoporosis risk is steroid use, specifically the drug prednisone, which thins the bones. “Prior to the 1990s, there weren’t many therapies for Crohn’s disease outside of prednisone, so many people with Crohn’s disease who are older in age received a lot of this drug and now have osteoporosis,” Kaur says. Prednisone is still used as a temporary therapy for moderate to severe Crohn’s when other treatments don’t work, increasing osteoporosis risk in some younger people with the condition as well.
To reduce the risk for osteoporosis:
- Avoid prolonged use of prednisone
- Perform regular weight-bearing exercises
- Avoid smoking
- Minimize alcohol and caffeine
- Eat a healthy, balanced diet
“You should also get your vitamin D levels checked and have regular bone density tests,” Dr. Fayek says.