Life is hectic.
We’ve got places to be, things to do, people to see – and sometimes it’s so overwhelming and crazy, that the one thing we neglect most is ourselves!
For people living with the inflammatory bowel disease, Crohn’s, it’s even worse. Black patients in particular face unique challenges that demand attention, especially given that any part of the digestive tract can be affected.
In fact, many Black individuals with Crohn’s often show more aggressive patterns, including higher rates of penetrating disease, such as abscesses, greater hospitalization, and more complications overall.
Bottom line: ignoring ongoing symptoms isn’t just uncomfortable — it can lead to irreversible damage. Sadly, the racial disparities in Crohn’s symptoms and Crohn’s outcomes continue to show up in studies.
It’s important to move beyond simply coping with symptoms and to pursue appropriate treatment options. Even if symptoms aren’t extremely painful, persistent symptoms can signal uncontrolled inflammation. Uncontrolled inflammation can increase the risks of strictures, fistulas, abscesses, and bowel damage.
Fortunately, with all this bad news, there’s some good news. Thanks to early, proactive disease management, many Black patients with Crohn’s are able to reduce symptoms and complications. Early intervention may also positively impact long-term health outcomes.
Looking to improve your quality of life? Here are some important signs to watch for and steps you can take.
Sure, the occasional discomfort or loose stools might seem manageable, but in Crohn’s, they often mean active inflammation. According to the Centers for Disease Control and Prevention (CDC), Crohn’s disease is a type of inflammatory bowel disease that can affect any part of the digestive tract, potentially leading to complications like scarring, blockages, and malnutrition.
Don’t dismiss symptoms as just stress or diet. You should be getting objective testing, not subjective assessments. In other words, options like a fecal calprotectin test, advanced imaging, or a colonoscopy.
After all, uncontrolled disease progresses faster than many realize.
If you are experiencing multiple flare-ups each year or require emergency room care, your current treatment may not be effective. According to research from the Crohn’s & Colitis Foundation, Black patients with Crohn’s disease tend to have worse clinical outcomes compared to Caucasian American patients. One analysis even found that Black patients were hospitalized at nearly twice the rate of other races.
With frequent flares, the bowel takes damage over time, and this can raise the risk of infection, not to mention a higher potential need for surgery.
These are some of the most concerning and uncomfortable symptoms of Crohn’s, and ones that should definitely not be ignored. Whether it’s pain, swelling, drainage, or abscesses around the anus, all of these hit harder in Black patients. Perianal Crohn’s disease is a complication involving inflammation around the anus, which can cause pain, swelling, bleeding, ulcers, and sometimes fecal incontinence. Ignoring symptoms such as drainage or pain may allow the infection to worsen. This is why it’s best to visit a specialist as soon as possible. Prompt attention, paired with imaging and medical-surgical approaches, is essential for optimal care.
RELATED: Thinking About a Biologic for Crohn’s? Questions Many Black Patients Are Asking
Crohn’s affects what you can eat and manage in terms of diet. And unfortunately, when you’re unable to eat or constantly restrict what you consume, this can lead to downstream effects on your overall health. With impaired nutrient absorption come issues like fatigue, anemia, bone loss, and even muscle wasting.
Are you losing weight without trying, or do you feel constantly drained despite eating? If so, this signals poor disease control.
In cases like this, getting bloodwork is key. Bloodwork can show if you have low albumin, iron, or vitamin D. Because long-term malnutrition raises infection risk and slows healing, it’s always important to discuss your diet with your team.
If need be, you can always be referred to a nutrition specialist for people with irritable bowel disease.
Are you missing more work? Avoiding social events? Struggling with intimacy or battling constant anxiety or depression?
People don’t realize that Crohn’s is more than a gut issue. If left uncontrolled, it can disrupt all aspects of life, turning normal activities into exhausting, arduous efforts. Many people with Crohn’s experience higher depression rates and reduced productivity.
So, don’t just try to ‘tough it out.’ If your Crohn’s is extending well beyond just managing symptoms and affecting the way you feel mentally – if it’s crushing your motivation and mood – therapy is a sound option. It’s not a sign of weakness; it’s a sign of strength.
You’re recognizing your issues, and you’re doing something about them. And that, more than many things, takes real, respectable courage.
As previously noted, Black patients with Crohn’s are more likely to have penetrating (B3) disease behavior, higher surgery rates (up to 71 percent in some cohorts vs. 56 percent in white patients), and more postoperative complications like infections.
Many Black patients also receive advanced therapies like biologics less frequently, relying more on steroids, which carry long-term risks. The reason for these patterns? Many are attributable to delays in specialist care. Then you have systemic biases in the system, as well as broader socioeconomic hurdles that make it harder to access timely, high-quality care.
Know what better care looks like!
See an IBD-experienced gastroenterologist and ask about advanced therapies early. Some terms to jot down include medications such as anti-TNFs. IL-23 inhibitors, JAK inhibitors, and others.
If you’ve had recent lab work, be sure to bring it to your appointment as well.
Questions to ask include:
Seek second opinions if your provider dismisses concerns, and whatever you do, don’t accept “manageable” pain or bathroom urgency as normal.
Better health and vitality are possible, but first, you have to come armed with a little knowledge, and it’s actually quite empowering as you learn more and seize back your health.
With some consistency and self-advocacy, life with Crohn’s can improve and become more manageable.
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