Clinical features

The main symptoms are abdominal pain, diarrhoea and weight loss. These tend to be episodic lasting a few days or weeks, and then resolve for a period of time.

Flare ups are often accompanied by:

• Fever
• poor appetite
• recurrent mouth ulcers
• weight loss
• malaise
• fatigue
• diarrhoea may be accompanied by rectal bleeding

The area around the anus may be affected by the development of:

• fleshy skin tags
• painful abscesses
• ulcers
• fissures
• fistulas.

In addition anaemia occurs as a result of blood loss and inflammation. There may be:

• associated back pain
• painful joints
• arthritis
• characteristic skin lesions (erythema nodosum, pyoderma gangrenosum)
• uveitis of the eye
• inflammation of the liver and the biliary tract may occur

There is much variation in the severity of the symptoms experienced by different individuals, and at different times, and the extent to which they develop complications or associated medical conditions. Severe episodes of abdominal pain and diarrhoea may require hospital admission to stabilise the condition and treat complications. Some people may need surgery, either as an emergency or electively, to the intestine to relieve blockage, repair fistulas or excise diseased portions of the gut.

Amended April 2008