What is the usual presentation of Crohn disease of the small intestine?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Crohn disease of the small intestine usually presents with evidence of malabsorption, including diarrhea, abdominal pain, weight loss, and anorexia. Initially, these symptoms may be quite subtle. Patients with gastroduodenal involvement more commonly have anorexia, nausea, and vomiting. [45] Those with perianal disease may have debilitating perirectal pain, malodorous discharge from the fistula, and disfiguring scars from active disease or previous surgery.

Patients may also present with complaints suggestive of intestinal obstruction. Initially, the obstruction is secondary to inflammatory edema and spasm of the bowel and manifests as postprandial bloating, cramping pains (lower right quadrant), and borborygmi. Once the bowel lumen becomes chronically narrowed from fibrosis, patients may complain of constipation and obstipation. These symptoms generally do not improve with anti-inflammatory agents. Complete obstruction may sometimes be caused by impaction of undigested foods.

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