Crohn's Disease

Understanding and managing Crohn's disease

What is Crohn's disease?

Crohn's disease is one of the two main forms of inflammatory bowel disease (IBD). It causes chronic inflammation that can affect any part of the digestive tract from mouth to anus — most commonly the end of the small intestine (ileum) and the colon. The inflammation extends through the full thickness of the bowel wall, which is why Crohn's can cause complications such as narrowings (strictures), abscesses and fistulas (abnormal tunnels between the bowel and other structures). It typically follows a pattern of flares and remission, and while there is no cure yet, modern treatment controls the disease very effectively in most people.

Common symptoms

• Abdominal pain (often right lower abdomen), diarrhoea — sometimes with blood

• Fatigue, weight loss, reduced appetite, fevers

• Mouth ulcers, and problems around the anus (pain, abscesses, fistulas)

• Symptoms outside the gut: joint pain, eye inflammation, skin rashes

Diagnosis and monitoring

Diagnosis usually involves blood tests, faecal calprotectin (a stool marker of bowel inflammation), colonoscopy with biopsies, and imaging of the small bowel (MRI or CT enterography, or intestinal ultrasound). These same tools are used over time to confirm your treatment is truly healing the bowel — not just improving symptoms — because deep healing prevents long-term complications.

Treatment

• Corticosteroids (e.g. prednisolone, budesonide) settle flares quickly but are not safe long-term maintenance therapy

• Immunomodulators (azathioprine, methotrexate) help maintain remission in some people

• Biologic and targeted therapies (e.g. anti-TNF agents such as infliximab and adalimumab, ustekinumab, risankizumab, vedolizumab, and newer oral agents) are highly effective and have transformed Crohn's care; most are available on the PBS

• Exclusive enteral nutrition (a complete liquid diet) is an effective flare treatment, particularly in younger patients

• Surgery helps when strictures, fistulas or resistant disease develop — it is a valuable tool, not a failure, and is often combined with medication to prevent recurrence

Stopping smoking is the single most important lifestyle step in Crohn's disease — smoking clearly worsens its course and reduces treatment effectiveness.

Living well with Crohn's

• Take maintenance medication consistently, even when well — stopping treatment is the most common cause of flares

• Stay up to date with vaccinations and skin checks, especially on immune-suppressing therapy

• Maintain good nutrition; a dietitian is invaluable, and iron, B12 and vitamin D commonly need monitoring

• Pregnancy is very achievable with Crohn's — the key is planning conception during remission; most IBD medicines are safe to continue, so talk to us early

• Crohn's & Colitis Australia (crohnsandcolitis.org.au) offers excellent support and resources

⚠ Contact us promptly if you have A flare not settling within a few days, or severe abdominal painPersistent vomiting or inability to keep fluids down (possible obstruction)Fevers, or a new painful swelling near the anus (possible abscess)Significant rectal bleedingSymptoms of dehydration, or before stopping any IBD medication

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This information is general and not a substitute for personalised medical advice. Please discuss any questions with your gastroenterologist or GP. If you develop severe symptoms, call 000 or go to your nearest emergency department.