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Can Crohn’s Disease Lead to Appendicitis?

In rare cases, appendix acute inflammation can be brought on by Crohn's disease. In part because it is so uncommon, diagnosis can be challenging.

A chronic inflammatory bowel disease that affects the gastrointestinal (GI) tract is called Crohn's disease. The large or small intestines are frequently affected. Diarrhoea and stomach discomfort are possible symptoms.

The inflammation of the appendix, a little pouch connected to the big intestine, is known as appendicitis. It's regarded as a medical emergency that needs to be treated right once to avoid more catastrophic consequences. Severe stomach ache is the most typical symptom.

Inflammatory bowel disease is one potential cause of appendicitis. What you should know about the relationship between appendicitis and Crohn's disease is provided below.


Can Crohn’s disease cause appendicitis?

Crohn's disease can, however infrequently, result in acute appendix inflammation. Appendiceal Crohn's disease (ACD) is the term for this. According to studies, ACD only happens in 0.2% to 0.5% of instances with appendicitis.

A 2020 case study states that ACD is frequently accompanied by:
  • inflammation of the small intestine's ileum, or last segment
  • inflammation of the large intestine or colon
  • abdominal pain and diarrhea
Abdominal discomfort in the lower right region of the abdomen is most frequently caused by ACD. About 25% of individuals with ACD also report having chronic stomach pain and intestinal discomfort, which are further signs of Crohn's disease.

Particularly in elderly persons, it is unusual for Crohn's disease to damage the appendix alone without causing any previous signs of intestinal discomfort. Research indicates that younger individuals are more likely to experience ACD.

Diagnoses of ACD can be challenging, and it's common to mistake it for a separate case of acute appendicitis. This is due to several factors, including:
  • the rarity of ACD
  • both ACD and appendicitis unrelated to Crohn's disease cause lower right abdominal pain.
  • the appendix's unavailability for diagnostic examination
After the appendix is surgically removed (appendectomy) to treat appendicitis, ACD is typically detected. Following surgery, an examination of the excised appendix will assist the doctors in identifying the source of the inflammation. Crohn's disease may be indicated by a few symptoms, such as:
  • wall thickening
  • lymphoid aggregates, which are cell clumps found in some tissues
  • granulomas are tissue lumps that form as a result of persistent inflammation.
Granulomatous appendicitis is the name given to appendicitis involving granulomas. It's an uncommon illness that can result from non-infectious causes like Crohn's disease as well as infections like Mycobacterium tuberculosis.

According to a recent study, laboratory results such as increased platelet counts and low haemoglobin levels may aid in the early diagnosis of ACD, as well as recently discovered genetic abnormalities. Early detection of ACD may help reduce the possibility of problems after an appendectomy.


What can trigger appendicitis with Crohn’s disease?

An appendicitis's potential causes include:
  • growths or hardened stool that obstruct the appendix's opening
  • expanded tissue in the appendix wall brought on by GI tract infection
  • inflammatory bowel disease
The exact cause of appendicitis is frequently unknown.

Physicians are not entirely sure what triggers Crohn's disease. Certain elements, according to experts, could be involved. These include:
  • bacteria in the gastrointestinal tract that cause inflammation by triggering the immune system
  • genetics
  • high-fat diet
  • smoking
An appendectomy may raise your chance of getting Crohn's disease after the surgery, according to a 2023 systematic review. However, more study is required on this connection.


Is appendicitis common with Crohn’s disease?

It is rare to have acute appendicitis and Crohn's disease.

Only 0.5% of appendectomy specimens from a hospital spanning more than five years displayed signs of Crohn's disease, according to a 2014 analysis.

The prevalence of ACD has been estimated by other research to be between 0.2% and 0.5%.


What are the early warning signs and symptoms of appendicitis with Crohn’s?

Abdominal discomfort that is strong and persistent, especially in the lower right quadrant, is the most prevalent early warning indication of ACD. You might not feel pain like you have in the past.

Additional signs of ACD could be:
  • abdominal edoema and cramps
  • intestinal distress, such as constipation, diarrhoea, or difficulty passing gas
  • nausea or loss of appetite
  • weight loss
  • fatigue

When to contact a doctor

MEDICAL EMERGENCY
An appendix burst, an appendix abscess, or a major infection are examples of serious consequences that can occur from appendicitis and necessitate prompt medical attention. Make an immediate call to 911 or your local emergency services, or visit the emergency room, if you think you might be having appendicitis symptoms.

An expert in appendicitis treatment can help control symptoms and reduce the likelihood of complications.

Consult a physician if you're worried about symptoms associated with Crohn's disease but aren't sure if you have appendicitis. They can assess your symptoms and offer a diagnosis to assist you decide which course of action is best.


Takeaway

Although it's rare, acute appendicitis can result from Crohn's disease.

There are numerous possible causes of appendicitis, and frequently the cause is unknown. Because Crohn's disease-related appendicitis is so uncommon, diagnosis might be challenging.

Surgery to remove the appendix is the most typical therapy for appendicitis. This process can usually be used to treat ACD. To enhance results, researchers are still investigating the most effective ways to diagnose and treat ACD.

If you think you could have appendicitis, see a doctor or visit the emergency department.

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