What is Crohn's disease? Doctors explain symptoms, causes and care

Often mistaken for acidity or stress, Crohn's disease is a chronic autoimmune condition that can damage the gut if ignored; doctors explain symptoms, causes and long-term management

Crohn’s disease is often misunderstood as a “stomach problem” or dismissed as stress-related indigestion. In reality, it is a chronic, lifelong inflammatory condition that can quietly damage the digestive system and affect multiple organs if left untreated. Doctors say delayed diagnosis is common in India, largely because early symptoms are vague and awareness remains low.

 

Understanding how Crohn’s disease works and recognising the warning signs early can make a crucial difference to long-term health and quality of life.

 

What is Crohn’s disease?

 

Crohn’s disease is a type of inflammatory bowel disease (IBD) in which the body’s immune system mistakenly attacks healthy tissue in the digestive tract, leading to chronic inflammation.

 

 

“Crohn’s disease is an autoimmune disorder; the immune system misrecognises healthy cells and tissues as harmful and targets them, resulting in intestinal inflammation,” explains Dr Amit G Yelsangikar, gastroenterologist at Apollo Spectra Hospital, Bangalore.

 

While Crohn’s disease and ulcerative colitis are both forms of IBD, they differ in where and how inflammation occurs. Crohn’s disease can affect any part of the digestive tract, from the mouth to the anus, and often involves deeper layers of the bowel wall. Ulcerative colitis, by contrast, is limited to the colon and rectum.

 

“Although both conditions are chronic and relapsing, they have different inflammatory pathways, tissue penetration and complications,” adds Dr Aditya Shah, general surgeon and gastroenterologist at Apollo Spectra Hospital, Chennai.

 

What early symptoms do people often ignore?

 

One of the biggest challenges with Crohn’s disease is that its early symptoms are easy to dismiss. Common gut-related signs include

 

• Abdominal pain
• Diarrhoea
• Constipation
• Rectal bleeding
• Poor appetite
• Night sweats
• Persistent fatigue

 

Beyond the gut, Crohn’s can show up in unexpected ways. Skin rashes, joint pain or arthritis, mouth ulcers, eye inflammation, kidney stones, bone loss and skin tags may all be linked to underlying intestinal inflammation.

 

“If symptoms persist for more than two to four weeks, they should be treated as red flags and investigated further,” Dr Shah warns.

 

Why is Crohn’s often diagnosed late in India?

 

There is no single test that can confirm Crohn’s disease. Diagnosis is based on a combination of symptoms, blood and stool tests, endoscopy, imaging scans and biopsy findings.

 

According to Dr Yelsangikar, lack of awareness plays a major role in delayed diagnosis. “Many patients mistake symptoms for acidity, gastric trouble or indigestion and delay a proper evaluation,” he says. As symptoms are non-specific, patients may be treated for other conditions for years, increasing the risk of complications and surgery.

 

Dr Shah adds that overlap with other diseases, especially intestinal tuberculosis, limited access to specialised diagnostics and social stigma around bowel symptoms further contribute to late detection.

 

What causes Crohn’s disease?

 

There is no single cause of Crohn’s disease. Experts believe it develops due to a complex interaction between genetics, immune dysfunction, gut microbes and environmental factors.

 

People with a family history of Crohn’s are at higher risk. An abnormal immune response causes persistent inflammation, while changes in the gut microbiome may worsen immune activity. Smoking and diets high in ultra-processed foods are known risk factors, though diet alone does not cause the disease.

 

How is Crohn’s disease managed long term?

 

There is currently no permanent cure for Crohn’s disease, but effective treatment can control symptoms, reduce flare-ups and help patients live full, active lives.

 

“The main aim of treatment is to reduce inflammation and pain so that patients can carry on with daily activities and avoid surgery,” Dr Yelsangikar explains.

 

Medications may include anti-inflammatory drugs, steroids for short-term use, immunosuppressants and biologic therapies. Once remission is achieved, ongoing treatment is essential to prevent relapses.

 

Diet and lifestyle changes play a supporting role. Patients are advised to stay well hydrated, eat smaller and more frequent meals, limit fatty and dairy foods, and avoid high-fibre items during flare-ups. In severe phases, temporary liquid diets may be recommended. Regular exercise, adequate sleep and quitting smoking are also important.

 

“With timely diagnosis, adherence to treatment, awareness of flare signs and mental health support, patients with Crohn’s can live a near-normal life,” says Dr Shah.

 

Myths that delay treatment and fuel stigma

 

Despite growing awareness, misconceptions around Crohn’s disease remain widespread. Many people believe it affects only the colon, is caused by stress, or can be cured with surgery. Others confuse it with irritable bowel syndrome or assume that symptoms disappearing means treatment is no longer needed.

 

“These myths are dangerous,” doctors warn. Crohn’s is not contagious, cannot be cured with surgery alone, and requires long-term medical and lifestyle management, even during symptom-free periods.

 

Early recognition, expert care and informed support can dramatically change outcomes for people living with Crohn’s disease.     

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This report is for informational purposes only and is not a substitute for professional medical advice.