Crohn's disease and abdominal pain: what should you know?

Inflammation can cause cramping, tenderness and pain that comes with diarrhoea or urgency. Pain may be felt around the lower right abdomen, across the abdomen or in another area depending on which part of the digestive tract is affected. Gas, constipation, infection, gallbladder problems and other conditions can cause similar discomfort.

Pain that becomes constant, severe or focused in one area is more concerning than a familiar mild cramp. A blocked or narrowed bowel can cause swelling, vomiting and inability to pass stool or gas, and needs urgent assessment.

Note when pain starts, where it is, its character, what makes it better or worse, and whether it follows meals or bowel movements. Record diarrhoea, vomiting, fever, blood in the stool, urine changes and medicines. Arrange a GP consultation for recurrent, persistent or unexplained pain.

A clinician may examine your abdomen and arrange blood tests to look for inflammation, anaemia or dehydration. Continue prescribed Crohn's treatment unless told otherwise, and ask before taking anti-inflammatory painkillers because some can aggravate bowel symptoms.

Go to urgent care for severe or rapidly worsening pain, a hard or swollen abdomen, repeated vomiting, faintness, confusion, inability to pass stool or gas, heavy rectal bleeding, or high fever. Seek prompt advice when pain is new, wakes you repeatedly, or is accompanied by a marked change in your usual diarrhoea pattern.

Could this pain reflect active Crohn's disease, narrowing, infection or another problem? Do I need blood tests or imaging? Which pain medicines are suitable for me? What should I do during a flare? Which changes mean I should seek emergency care?