by Nicole Evans M.D.

Created on: December 22, 2009   Last Updated: July 31, 2010

Crohn’s disease is an inflammatory bowel disease characterized by intestinal ulcers that penetrate beyond the inner intestinal mucosal layer.  Unfortunately, in some individuals Crohn’s disease can spread beyond the intestines.

Crohn’s ulcers can occur in the esophagus as well as inside the mouth.  Crohn’s disease ulcers on the oral mucosa are often mistaken for canker sores or herpes simplex ulcers. 

Adults and children with Crohn’s disease can also have fistulas develop that connect their intestines with other organs or the surface of the skin.  In addition, there are some Crohn’s disease symptoms that occur entirely outside of the gastrointestinal tract. 

Symptoms of Crohn disease that originate in areas other than the gastrointestinal tract are called extraintestinal Crohn’s disease symptoms.  The affected extraintestinal areas can include the skin, the genitals, the eyes, and the joints.

Joint symptoms of Crohn’s disease:

The arthritis of inflammatory bowel disease (IBD) is a form known as a seronegative spondyloarthropathy.  IBD arthritis may flare up during flares of intestinal symptoms or may flare up independently of any intestinal symptoms.  This arthritis may affect the large or small joints causing joint pain, redness and swelling. 

Eye symptoms of Crohn’s disease:

Crohn’s disease can affect the eyes, causing uveitis (inflammation of the inner part of the eye) and episcleritis (inflammation of the whites of the eye).  Both conditions are painful and may cause vision loss if left untreated.

Genital symptoms of Crohn’s disease:

Crohn’s disease can cause painful ulcerations on the genital mucosa.  The glans of the penis or labia may develop ulcerations that are often mistaken for a sexually transmitted disease such as herpes simplex virus, chancroid or syphilis. 

Skin symptoms of Crohn’s disease:

There are a variety of skin complications caused by Crohn’s disease.  Skin symptoms include:

-Erythema nodosum: Painful, red, firm nodules that usually occur on the shins but can occur elsewhere.

-Pyoderma gangrenosum: Tissue, often on the legs, ulcerates and becomes necrotic (dying and sloughing off).

-Metastatic Crohn’s disease:  Sufferers of metastatic Crohn’s disease may have granulomatous Crohn’s ulcers appear in almost any area of the body.  Cases of metastatic Crohn’s disease ulcerations have been reported around the genital area, on the head and neck, on the thigh and on the forearm.  Fortunately, this form of Crohn’s is uncommon.

Crohn’s disease is thought to be an autoimmune disease.  It can be quite difficult to achieve remission and maintain remission.  Unfortunately, Crohn’s disease can manifest outside of the intestinal tract, in addition to the more widely seen systemic and gastrointestinal effects of this disease. 

Learn more about this author, Nicole Evans M.D..
Click here to send this author comments or questions.