The Dangers of Untreated Crohn’s Disease

When it comes to inflammatory bowel disease (IBD), ignorance is definitely not bliss. Letting Crohn’s disease go untreated can lead to more severe symptoms, as well as complications that can require irreversible treatment, such as surgical bowel resectioning.

That’s why it’s so important to get diagnosed with Crohn’s disease and start treatment as early as possible. A gastroenterologist can help you manage and treat the condition, thereby helping reduce — or delay — your risk of developing some of the more severe complications.

Severe Complications of Crohn’s

The beginning signs of Crohn’s inflammation include diarrhea, abdominal cramping, and rectal bleeding. Over the course of months or years, other, more serious symptoms can develop.

That’s because the inflammation caused by Crohn’s disease doesn’t occur in just one layer of the bowel. “It can spread throughout all the layers,” says Adam Cheifetz, MD, director of the center for inflammatory bowel disease at Beth Israel Deaconess Medical Center and a professor of medicine at Harvard Medical School in Boston.

This can lead to perianal fistulas — or tunnels that lead from the end of the bowel to the anus, a condition that affects around 26 percent of people with Crohn’s, according to the Crohn’s & Colitis Foundation — and strictures, which narrow the intestinal wall and may eventually lead to bowel obstructions.

Once Crohn’s has progressed to the stage at which fistulas or strictures form, patients often need surgery. Surgery is not a cure, though, says Dr. Cheifetz.

“Medicine may work to heal inflammation, but it doesn’t work on scar tissue,” says Rubin.

The longer the disease goes untreated, the more dangerous the symptoms become, heightening the risk of numerous complications, hospitalizations, disability, time off from work, surgery, and a decreased quality of life. “This is why an early diagnosis of Crohn’s disease is essential,” says Michele Rubin, an IBD advanced practice nurse at University of Chicago Medicine.

Additional Crohn’s Complications

Untreated Crohn’s may also increase the risk for colorectal cancer, especially a type that affects the colon, called Crohn’s colitis, say experts at the Foundation. The link between the two conditions isn’t as strong as it is for ulcerative colitis and colorectal cancer, but Cheifetz explains that inflammation in the colon that’s left untreated poses one of the biggest risks for colon cancer. “We know that patients with colonic inflammatory bowel disease are at a higher risk for colon cancer,” he says.

Malnutrition is another common complication of untreated Crohn’s. It may develop based on the “severity and location of bowel inflammation,” says Rubin. Symptoms may make it difficult to eat or for intestines to absorb nutrients. “Prolonged inflammation also leads to a loss of weight and muscle mass,” Rubin says. Nutrient deficiencies resulting from Crohn’s may require diet changes and the addition of supplements. If malnutrition becomes severe, some patients may require enteral (through a tube) or parenteral (intravenous) feeding.

Crohn’s & Colitis Foundation experts also say that people with Crohn’s may lose bone mass as a result of prolonged inflammation or a vitamin D deficiency.

Avoiding the Dangers of Untreated Crohn’s

If you have Crohn’s disease, it’s important to find a treatment that will lower your levels of untreated inflammation. If you have mild Crohn’s and have done fine over a number of years without the disease progressing, Cheifetz emphasizes that you still need to be monitored closely, so any changes in your condition can be addressed quickly.

He also says that it’s important to get treated and be monitored closely if you have moderate-to-severe Crohn’s, to make sure the medication is working and that the disease isn’t progressing. “Part of our goal is to treat the disease while it’s inflammatory, when Crohn’s will respond to the medication and we can prevent these progressive changes and complications,” Cheifetz says.

Although you may fear the potential risks of Crohn’s medications, Cheifetz encourages you to keep things in perspective. “It’s really important to be aware that the complications of untreated Crohn’s disease are much more common than the complications of these medications.”

He adds that while some risks are associated with certain medications, many of these drugs have also revolutionized the way Crohn’s disease is treated — and how well patients fare.