Can you die from Crohn’s disease?
Crohn’s disease is not lethal. However, when it is not managed, it can lead to dangerous complications.
Generally, people affected by Crohn's disease have a higher risk of death than healthy ones [1].
Crohn’s disease is also associated with a higher risk of depression. Patients with depression are more prone to suicide and substance abuse. This further increases the risk of death in Crohn’s disease [2].
Untreated Crohn's disease is very dangerous. It can lead to serious complications. Among the most dangerous ones are colorectal cancer, ileus, and fistulas [3]. These complications, if not addressed in time, can lead to death.
What is Crohn's disease?
Crohn's disease is a chronic inflammatory bowel condition. The disease affects the gastrointestinal tract [4, 5].
The disease can affect any part of the gastrointestinal tract. It can occur in the anus as well as in the mouth. In Crohn’s disease, the inflammation is interrupted by healthy tissue. It gives a patchy or segmental pattern, where some strips are highly red and others are normal [6, 7].
Additionally, Crohn’s disease is characterized by periods of stronger and weaker symptoms. When not treated, it can be a dangerous disease. It can lead to intestine damage or disability [6].
The cause of Crohn’s disease is unknown. However, scientists suspect multiple factors contribute to the development of this disease. These factors are genetics, environmental factors, and immune response impairments [8, 7].
Also, Crohn’s disease is linked to an overreaction to some of the gut bacteria [8, 9].
What are the symptoms of Crohn's disease?
The symptoms of Crohn’s disease can vary in severity, depending on the period and advancement of the disease.
The most common symptoms of Crohn’s disease are:
Other presentations of Crohn’s disease include:
What makes Crohn's disease dangerous?
Overall, Crohn’s disease is not lethal. However, it can become dangerous when not treated.
Complications of Crohn’s disease can be potentially life-threatening and include:
- malnutrition [12],
- development of fistulas [3],
- intestine obstruction [13],
- colorectal cancer [3],
- psychological diseases like depression [2].
Malnutrition in Crohn’s disease is a consequence of the inflammation of the intestine wall. The inflamed or damaged intestine is not able to absorb nutrients and vitamins. With time, the lack of crucial vitamins or nutrients can become dangerous [13].
Fistulas in the gastrointestinal tract are openings of the tract inside the body. This leads to leakage of the content into the body’s cavity. Fistulas are very dangerous as they lead to intrabody inflammation and sepsis [3].
Approximately one-third of all Crohn’s patients will develop a fistula [3].
Intestinal obstruction can also be very dangerous. It is caused by the inflamed and thickened inward tissue of the intestine. This makes it impossible for the stool to pass by. It is an emergency and, in critical situations, requires surgery [13].
The risk of colorectal cancer in people with Crohn's disease is higher than in healthy ones [3]. The reason for that is the inflammation. It increases the chance of the beginning of a cancerous process by disrupting normal physiological conditions.
Lastly, patients with Crohn's disease can also suffer from psychological diseases. Crohn’s disease can contribute to the development of depression. The patients may experience suicidal thoughts or attempts [2].
Diagnosis of Crohn's disease
To diagnose Crohn’s disease, endoscopy, histology, and clinical evaluation can be used [14].
Often, gastroenterologists use colonoscopy as a first-line method for diagnosis. It allows them to directly look at the mucosa of the gastrointestinal (GI) tract. If there is any suspicion, a biopsy will be taken.
The part of the tissue extracted from the colon or other GI organ will be further examined in a lab. A pathologist will evaluate the sample under a microscope and confirm or negate the suspected Crohn’s disease [15].
Sometimes the doctors can also use CT. It allows for the evaluation of any perforations and other symptoms [15].
Additionally, blood samples may be taken. Evaluation of the blood sample allows the doctors to see any micronutrients, red blood cell count, and inflammatory markers like calprotectin [16, 14].
Treatment of Crohn's disease
The aim of treatment for Crohn’s disease is control of the disease and prevention or treatment of complications [17].
Medications used in the treatment of Crohn’s disease include:
- anti-inflammatory medication, for instance, olsalazine,
- corticosteroids, like prednisone,
- antibiotics, for example, ciprofloxacin,
- immunomodulators, like 6-mercaptopurine or azathioprine [18].
Scientists also work on biological treatments for Crohn’s disease [15].
When the pharmacological treatment fails, surgery may be considered [19].