Is Crohn’s Disease Fatal? Understanding Complications and Life Expectancy

Crohn’s disease can be serious, but it is not considered fatal. However, there is the potential for severe or even life-threatening complications when not managed effectively. Crohn’s disease is a form of inflammatory bowel disease (IBD) which currently has no cure.

Life expectancy depends on age at diagnosis, symptom severity, and treatment. A recent study has shown that people with IBD are no more likely to die than people without IBD, but the disease has known risks. Managing symptoms, living a healthy lifestyle, and getting regular check-ups may help reduce the risk of complications.

Can You Die From Crohn’s Disease?

Crohn’s disease isn’t usually thought of as being a fatal disease. It’s considered to be a chronic condition—one that lasts a long time and needs regular management.

However, Crohn’s disease can be quite serious in some people. It can cause complications that might be life-threatening. People with Crohn’s disease may need to have treatments like surgery, which carry their own risk. Whether or not Crohn’s plays a small or a large role in a person’s death can be difficult to determine.

The thought of having a disease that could be fatal can be upsetting and could lead to difficult emotions. People with chronic conditions like Crohn’s may want to take care to address their mental and physical health.

Currently, the best way to avoid potential complications is to see a healthcare provider regularly and to treat the inflammation caused by Crohn’s disease as well as possible.

Factors That Affect Crohn’s Disease Life Expectancy

A 2022 study from Sweden found that, over 10 years, people with Crohn’s had the same mortality as the general population. However, some things affected mortality.

The study found:

• Survival was lower for people diagnosed before 1985.
• Older females had a greater mortality (especially when diagnosed before 1985).
• Having a colon disease and complications like stricture (narrowing of the colon) may also play a role, but the connection was not strong.

Life-Threatening Complications of Crohn’s

Some conditions associated with Crohn’s disease increase the risk of a life-threatening complication. People concerned about these related conditions should discuss their risk with a healthcare provider because it is not the same for everyone with Crohn’s disease.

Colorectal Cancer

People with Crohn's disease affecting the colon are at an increased risk for colorectal cancer. It is a major cause of mortality in people with IBD. One study showed that it may be responsible for the deaths of 10% to 15% of people with IBD.

Everyone's risk of colorectal cancer is going to be different. The risk increases the longer a person has had Crohn's disease and if there is inflammation in the colon.

Intestinal Obstruction

An obstruction happens when the bowel is blocked and stool can’t move through it. Obstructions are more common in people with IBD than in the general population. This can be due to inflammation, which causes the bowel tissue to swell. It can also happen when scar tissue forms from the inflammation, causing ulcers and then healing.

Obstructions may be treated with surgery, usually a resection to remove the narrowed part of the bowel. There is not enough data about how often surgery for an obstruction can lead to a poor outcome. One study showed that 7% of people who had surgery for obstruction had a severe complication.

Older studies show that the mortality rate can be higher with an emergency surgery, as opposed to a scheduled one. However, there were no deaths in a study examining operations on 61 people from 2013 to 2017.

Fistulas

One of the complications that can lead to lowered quality of life and the need for more treatments is a fistula. A fistula is an abnormal channel that is created between two organs or an organ and the skin. About 12% of people with Crohn’s live with a fistula.

Unfortunately, having a fistula may be associated with other conditions that have a higher risk of mortality. It’s rare, but one study showed that unmanaged Crohn’s disease was thought to be the biggest factor leading to a risk of death.

A 2022 study of people in the United States who were hospitalized to treat a fistula showed a decrease in deaths between 2009 and 2019. This was true even though there was an increase in people being admitted to the hospital during that time.

Perforated Colon

Perforations are a risk for every form of IBD. However, they are rare, occurring in 1% to 3% of people with Crohn’s disease. However, they are an emergency, and they can be life-threatening.

It's thought that chronic inflammation weakens the intestinal wall and allows bacteria into the abdomen. This is called peritonitis (inflammation of the abdominal lining, or peritoneum) which can lead to potentially life-threatening conditions like shock or sepsis. However, there is no good data on how often complications from perforation lead to poor outcomes, including death.

Toxic Megacolon

Toxic megacolon is a rare complication of IBD in the large intestine where the colon expands rapidly, and rupture is a risk. This is potentially life-threatening. Studies report different rates, but it is generally thought to occur more frequently in ulcerative colitis than in Crohn’s disease.

Toxic megacolon is usually treated with surgery. Mortality after toxic megacolon was high decades ago but is now thought to be between 0% and 2%.

Adverse Effects of Medication

Some medications that are used to treat Crohn’s disease may also carry a risk of serious side effects. Steroids, which are commonly used for treating flare-ups, can put people at risk for infections.

Anti-tumor necrosis factor (TNF) medications, such as Humira (adalimumab) may be used for long-term maintenance but may increase the risk of infection, especially tuberculosis. Asacol (mesalamine) and anti-TNF drugs may also contribute to a worsening of heart failure.

Thiopurines such as Azasan (azathioprine) are immunosuppressive medications and can increase the risk of viral infections (including cytomegalovirus), nonmelanoma skin cancers, and lymphoma.

The risks of medications will be different for each person. There are a variety of treatments for IBD, so if one drug carries too much risk, there are other options. Crohn's disease must be treated because the inflammation it causes could lead to serious complications.

When to See a Healthcare Provider for Complications

People with Crohn’s disease need regular management of their condition. This means seeing a healthcare provider (commonly a gastroenterologist) on a regular basis for treatment and to prevent potential complications.

It’s important to consult with your healthcare provider about any new symptoms or if existing symptoms worsen.

These are some symptoms that are a reason to see a healthcare provider:

• Blood in the stool
• Discharge in the anal area
• Incontinence 
• Leaking stool
• Lumps or bumps around the anus
• Mucus in the stool
• Severe or worsening abdominal pain
• Severe or worsening diarrhea
• Vomiting that won’t stop
• Fever and/or chills

However, people with IBD should reach out to a healthcare provider whenever they have a concern. It’s better to find out symptoms are not serious rather than waiting until they become an emergency.

Summary

Crohn’s disease is a chronic inflammatory condition that can affect many parts of the body, but it's not considered fatal. People with any form of IBD may have a slightly shorter average lifespan than those without it. However, life expectancy depends on age at diagnosis, symptom severity, and treatment.

Life-threatening complications from Crohn’s disease are not common. Maintaining your treatment plan, regular check-ups, a healthy lifestyle, and avoiding triggers, may help manage your condition and prevent complications. It's important to consult with your healthcare provider regarding any new or worsening symptoms.