As mentioned, silent Crohn’s is typically discovered incidentally, through tests done for other reasons. That’s why ongoing monitoring is vital for those at higher risk, such as people with a family history of IBD. About 20 percent of people with IBD have another family member with Crohn’s or ulcerative colitis, and they often share a similar pattern of disease.
But other, less common Crohn’s symptoms may crop up, and they may be subtle. “Inherently, [silent Crohn’s] is difficult to detect when individuals do not have classic symptoms … like abdominal pain and diarrhea. I think paying attention to your body is helpful,” says the gastroenterologist Brigid Boland, MD, an assistant professor of medicine at the University of California in San Diego and a spokesperson for the American Gastroenterological Association.
She points to some of the less-common potential signs of Crohn’s, which can include:
- Mild fatigue tied to anemia (low iron levels)
- Changes in bowel movements, like a shift toward looser stools
- Unexplained weight loss
- Slow or stunted growth in children and teens
- Rashes or psoriasis
Because these symptoms overlap with many other conditions, people may chalk them up to other possible factors, like stress, diet, or aging.
“Not everyone shows up with the typical pain and diarrhea. Some may first have unexplained anemia, inflamed joints, or unusual skin rashes — and only later do we confirm it’s Crohn’s,” Moss says.
In rare cases, silent Crohn’s is first noticed in the emergency room, Moss says. “Occasionally, we see patients whose first manifestation of Crohn’s is a blockage or a fistula, despite having no symptoms beforehand. Thankfully, that’s very uncommon.”
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