Severe Crohn’s symptoms, such as long lasting diarrhea or bloody stools, severe or persistent pain, fever, and other symptoms, can be indicators that you may need emergency medical care.
Crohn’s disease is a chronic health issue that causes inflammation and irritation in the lining of the digestive tract.
If you have Crohn’s disease, you may go through periods of remission in which the disease is inactive with little or no symptoms. It’s also possible to experience flare-ups, in which symptoms are very active and sometimes severe.
Here’s how to know whether your Crohn’s flare-up or complication is severe enough to require a trip to a doctor or the emergency room.
Crohn’s disease flare-ups can be triggered by many factors, such as specific foods or stress, for different people. Over time, your triggers and the symptoms of your flares may change.
If you suddenly experience one or more of these symptoms, you may be having a Crohn’s flare-up:
- sudden diarrhea
- abdominal pain or cramps, most commonly in the right lower abdomen
- blood in stools
- fatigue
Other signs that your Crohn’s disease is active include:
- a fever
- generally feeling ill
- joint pain
- red, sore eyes
- patches of red and swollen skin — usually on the legs — that are painful
- mouth ulcers (canker sores)
Many people living with Crohn’s can navigate through routine flare-ups on their own or with previously prescribed medication.
If you’ve been living with Crohn’s for some time, you’ve no doubt learned how to manage your flares. But there are a few severe symptoms that may warrant a trip to a doctor or the ER:
- diarrhea that lasts for more than 7 days
- consistent blood in stools
- frequent stomach aches and cramps
- weight loss for no apparent reason
- rectal bleeding, drainage, or sores
- sores or lesions on skin that don’t seem heal
- fever that lasts more than 2 or 3 days
It’s typical for people living with Crohn’s disease to navigate complications arising from long-term inflammation and digestion issues. While many of these complications can be treated on their own, there are rare cases when they may create a medical emergency. A few complications of Crohn’s disease include:
Strictures
Strictures are scarring or narrowing of the bowel, resulting in a blockage in the intestine. Depending on the cause of the blockage, you may need medication or a procedure to resolve it.
Fistulas
Fistulas are small openings in the intestines that can cause the contents of your bowel to leak into other organs or the skin. This can cause sepsis, a life threatening systemic infection.
Abscesses
These pockets of pus are caused by infection and can form in the intestinal wall, causing it to bulge out. This may result from an untreated fistula.
Anal fissures
Fissures are tears in the lining of the anus.
Anemia
People with Crohn’s who experience bleeding often may develop anemia, a blood disorder that usually results from low iron levels.
Malabsorption of other nutrients
Malabsorption can occur due to constant digestion issues. The intestines may be unable to absorb all the nutrients the body needs from food.
Left untreated, these complications can worsen, and some may eventually require surgery.
In some cases, you may need to go to the emergency room for a severe Crohn’s flare or other complications.
If you have time before going to the ER, doctors typically recommend bringing a list of medications you take (or the medications themselves).
Some hospital systems may have access to electronic records of your medications. However, it can still be beneficial, especially if you are going to a hospital that is unaffiliated with where your treating physician practices.
People who go to the ER for a Crohn’s flare may stay in the hospital for
Recognizing new or worsening symptoms can help doctors intervene early and prevent severe complications.
If you notice your symptoms worsening, talk with a doctor. They may recommend changes in your medication that may help prevent a flare-up. Managing symptoms before they become an emergency may help you avoid the ER. But in some cases, this may not be possible.
If something feels very wrong, you should go to the hospital.
Taking medications for Crohn’s disease aims to reach and maintain remission by lessening the inflammation in your intestines.
Medications for Crohn’s include:
- steroids like prednisolone (Omnipred)
- immunosuppressants like methotrexate (Otrexup (PF), Xatmep, Trexall)
- biologics like adalimumab (Humira)
- anti-inflammatory medications like aminosalicylates, which are sometimes prescribed off label for Crohn’s disease
You may need to take some medications, such as immunosuppressants and biologics, for several months or years, even during periods of remission.
If you stop your medication suddenly, Crohn’s symptoms may flare up.
It’s also possible that your medication may become ineffective, allowing flares to become more constant. This could mean you need a higher dose or a different type of medication.
Lastly, medications can have their side effects. Many are manageable, but a few side effects of Crohn’s disease medications — like high blood pressure, pancreatitis, and toxic reactions — can be severe.
Talk with your doctor about your prescribed medication, and make sure you’re aware of all side effects before starting and have a plan for what to do if you experience severe forms.
Can you go to the hospital for Crohn’s disease?
People with Crohn’s disease may need to go to the hospital if they have a severe flare or complications or cannot manage it on their own.
Does Crohn’s disease require hospitalization?
Crohn’s disease may require hospitalization if you cannot manage the symptoms on your own. Some complications of Crohn’s disease can be severe or life threatening and may require hospitalization. In some cases, a person may need surgery to treat a complication.
When is Crohn’s considered severe?
Crohn’s disease can become severe or life threatening due to complications, such as strictures, fistulas, and abscesses. You may need emergency medical care for severe symptoms or a flare that cannot be managed with prescribed medication.
Many people manage Crohn’s disease with a doctor’s help.
If you’ve been living with Crohn’s disease for some time, you likely understand your symptoms well. However, if you find yourself suddenly facing a flare-up that feels too severe to manage on your own, a complication of Crohn’s disease that’s interfering with your daily life, or a medication side effect that seems unmanageable, you should go to the hospital.
This is especially true if you’re unable to reach your prescribing doctor promptly.