Why do I have severe abdominal pain, anal tags and diarrhea?

Question

Hello doctor,

I am dealing with debilitating symptoms that are affecting every aspect of my life. I have severe abdominal pain that comes in waves, especially after eating, and I have been having diarrhea mixed with blood and mucus for months. I have lost 25 pounds and feel weak and malnourished. I have developed painful sores in my mouth and what look like skin tags around my anal area. Sometimes I run low-grade fevers and feel like I have the flu.

Eating has become a nightmare because I never know what will trigger excruciating pain. I am scared about malnutrition and the long-term damage it is doing to my intestines.

What exactly is Crohn’s disease, and why is it affecting my entire digestive tract?
Will I need multiple surgeries, and what are the chances this will lead to complications like blockages or cancer?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The symptoms you are describing are not only painful and distressing but also deeply disruptive to your daily life. The severe abdominal pain after eating, chronic diarrhea with blood and mucus, significant weight loss, fatigue, mouth sores, and anal lesions are all hallmark signs of Crohn’s disease, a type of inflammatory bowel disease (IBD).

Your body is clearly in a state of chronic inflammation, and it is completely understandable that you feel scared, exhausted, and unsure of what the future holds. Crohn’s disease is an autoimmune condition where the immune system mistakenly attacks the lining of the digestive tract. What makes Crohn’s unique compared to ulcerative colitis is that it can affect any part of the gastrointestinal (GI) tract, from the mouth to the anus, often in patchy segments.

This explains the mouth ulcers, anal skin tags or fissures, and the diffuse intestinal symptoms you’re experiencing. The inflammation in Crohn’s disease extends deep into the bowel wall, which is why it can cause pain, bleeding, diarrhea, malabsorption, and weight loss, as you have described.

Because this inflammation can be persistent and aggressive, complications like strictures (narrowing of the intestines), fistulas (abnormal connections between organs), abscesses, and bowel obstructions can occur if the disease is not well controlled. In some cases, this leads to surgery, especially when the bowel becomes severely damaged or blocked.

However, surgery is not a cure. It helps manage complications but does not prevent the disease from recurring, which is why ongoing medical therapy remains essential even after surgical interventions. It is also true that people with long-standing, uncontrolled Crohn’s disease affecting the colon may have a slightly increased risk of developing colon cancer. But this risk can be significantly reduced with regular monitoring and effective treatment.

The good news is that treatment options for Crohn’s disease have advanced significantly. There are powerful medications available that can induce and maintain remission, reduce inflammation, and prevent complications. These include:

Aminosalicylates (for mild disease).
Corticosteroids (for short-term use during flares).
Immunomodulators like Azathioprine or Methotrexate.
Biologic therapies such as Infliximab, Adalimumab, or Ustekinumab target specific pathways in the immune system.
Newer small-molecule drugs that block inflammation more precisely.

You absolutely do not have to live in this state of pain and fear. With the right care team, you can find a treatment plan that works, protect your intestines, restore nutrition, and start feeling stronger again.

Nutritional support (sometimes through supplements or enteral nutrition), stress management, and, in some cases, surgery all play a role depending on the severity of the disease. You are not alone in this, and you have every reason to be hopeful.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.