Granulomas are white blood cell clusters sometimes found in people with Crohn’s disease. They can make a Crohn’s diagnosis more definitive. Treatments don’t necessarily change based on granulomas being present.

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Crohn’s disease is a type of inflammatory bowel disease (IBD) that affects the digestive tract.

Although millions of peopleTrusted Source in the United States live with IBD – which also includes ulcerative colitis – the symptoms don’t always make it easy to diagnose the particular condition.

That said, one of the ways to more confidently confirm a Crohn’s disease diagnosis is by identifying granulomas, or nodules of white blood cells and other tissues.

Keep reading to learn more about the connection between granulomas and Crohn’s disease and what their presence can mean in diagnosing the condition.

A granuloma is a cluster of cells and other tissues that clump togetherTrusted Source in response to inflammation. They could develop beneath the skin or deep inside the body, such as in the lungs and intestines.

If you have Crohn’s disease, granulomas will develop in the gastrointestinal (GI) tract. Some research suggests they more commonly affect the lower GI tract, but they can also affect the upper GI tract.

Granulomas are typically noncancerous and part of the body’s responseTrusted Source to inflammation, infection, or foreign objects. They may be caused by diseases, irritating substances, and autoimmune conditions.

They try to protect the body in two ways:

  1. keeping an infection in one place and preventing it from spreading
  2. isolating an irritant or foreign object to prevent it from doing more damage

Granulomas in Crohn’s disease are usually detected during surgery or as part of an endoscopy-related biopsy.

Granulomas are a key characteristic to help differentiate Crohn’s disease from other IBDs, such as ulcerative colitis.

However, researchers aren’t exactly sure why granulomas form in some individuals with Crohn’s disease.

For instance, the authors of a 2022 study concluded that while specific bacteria and organisms have been identified in the development of granulomas for other conditions, there haven’t been consistent findings for Crohn’s disease.

That said, one theory is that granulomas are the body’s way of managing the source of inflammation in Crohn’s.

Although the exact causeTrusted Source of Crohn’s disease is unknown, several environmental, psychological, and immunological factors may contribute to inflammation. The body may be forming granulomas around the source of inflammation.

The prevalence of granulomas in Crohn’s disease ranges widely.

A 2018 study in 1,466 participants with Crohn’s disease found that just under 13% had granulomas.

Similarly, 17% of participants in the 2022 study mentioned above had granulomas, although the authors noted that older studies found a prevalence of 20% to 50%.

Lastly, a 2018 review suggests that up to 33% of people with Crohn’s disease have granulomas.

More research is needed to better understand the prevalence of granulomas in Crohn’s disease.

Some studiesTrusted Source have shown that granulomas may indicate a more severe disease course with a greater degree of flare-ups, unpleasant symptoms, and need for hospitalizations.

Granulomas, in particular, are associated with a higher prevalence of fistulas and abscesses.

According to Crohn’s and Colitis UK, fistulas are holes that develop in the intestinal wall and connect organs to other body parts. If left untreated, a fistula can lead to an abscess, which is an infection that may be life threatening.

People with granulomas may require more aggressive management of their Crohn’s disease.

More research is needed to understand the significance of granulomas in Crohn’s disease and how they may affect symptoms.

Crohn’s disease symptoms

In general, these are the symptoms you may experience with Crohn’s disease with or without granulomas present:

There is currently no known cure for Crohn’s disease.

However, treatments are available to help reduce inflammation, relieve symptoms, and improve quality of life.

Anti-inflammatory medications and, in some cases, surgery may be used to help manage inflammation. Some researchTrusted Source suggests that granuloma formation may decrease when anti-TNF therapy is used for Crohn’s treatment.

That said, more research is needed to understand how Crohn’s disease treatment could help reduce granulomas.

In addition to medication and surgery, doctors may suggest dietary adjustments, since some foods can trigger inflammation in the GI tract for those with Crohn’s disease.

The United Kingdom’s National Health Service (NHS) recommends speaking with a healthcare professional if you experience any of the following symptoms:

  • bloody stools
  • diarrhea that lasts longer than 1 week
  • abdominal pain or cramps
  • unexplained weight loss

A doctor could examine your symptoms to provide a proper diagnosis and develop the best treatment plan for you.

Granulomas are small clusters of cells that develop in response to inflammation in your body. Finding intestinal granulomas can be one way to more definitely confirm a diagnosis of Crohn’s disease.

Keep in mind that it’s still possible to have Crohn’s disease without granulomas, and they aren’t limited to Crohn’s disease only.

More research is needed to better understand the link between granulomas and Crohn’s disease. Hopefully, this can offer more guidance into disease management.