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Crohn’s Disease

A lifelong type of inflammatory bowel disease (IBD) that can inflame any part of the digestive tract. There is no cure yet, but modern treatment aims for long-term remission and a healed bowel lining.

Get emergency care (call 911 or go to an emergency room) if you have:

Contact your care team promptly if you:

If you have thoughts of harming yourself, call the 988 Lifeline at 988, call 911 or go to the nearest emergency room (Crohn’s & Colitis Foundation).

What is Crohn’s disease?

Crohn’s disease is a long-term disease in which abnormal reactions of the immune system cause inflammation in the digestive tract. It most often affects the small intestine and the beginning of the large intestine, but it can affect any part from the mouth to the anus. Times when symptoms are active are called flares; most people have periods of remission in between that can last weeks or years (NIDDK).

  • Ulcerative colitis, the other main type of IBD, affects only the innermost lining of the colon and rectum. Crohn’s can affect the whole thickness of the bowel wall and can “skip,” leaving normal areas between patches of disease (Crohn’s & Colitis Foundation). MBHA’s colitis guide is coming soon.
  • Irritable bowel syndrome (IBS) can cause pain, bloating, diarrhea or constipation, but no inflammation or permanent damage. Anemia, bleeding, weight loss and fever point to IBD, not IBS (Crohn’s & Colitis Foundation). See our Bowel Problems guide for other causes of bowel symptoms.

Who gets it, and why?

CDC figures put the number of Americans with IBD at 2.4 to 2.8 million based on insurance-claims data, or up to 3.1 million adults based on national survey data, and the number is rising (CDC). About 1 million people in the United States are estimated to have Crohn’s disease. It can start at any age, but it is more likely in people who are 20 to 29, have a parent or sibling with IBD, are of Jewish descent, or smoke (NIDDK). About 1 in 4 people with IBD are diagnosed before age 20 (Crohn’s & Colitis Foundation).

Doctors aren’t sure what causes it. Experts think the immune system may attack bacteria that normally live in the gut, with genes, environment and the gut microbiome all playing a part; research has shown smoking may double the chance of developing it (NIDDK). Diet and stress may aggravate Crohn’s, but they don’t cause it (Crohn’s & Colitis Foundation).

Symptoms, in the gut and beyond

The most common symptoms are diarrhea, cramping belly pain and weight loss; others include tiredness, fever, nausea and loss of appetite (NIDDK). Diarrhea may be bloody (MedlinePlus). Children may show delayed growth or puberty and poor weight gain (Crohn’s & Colitis Foundation).

Between 25% and 40% of people with IBD have problems outside the intestines (Crohn’s & Colitis Foundation):

Complications

Up to half of people develop an intestinal complication within 20 years of diagnosis (ACG guideline, 2025): strictures, a narrowing of the intestine from long-term inflammation (Crohn’s & Colitis Foundation) that can block it; fistulas, abnormal tunnels between organs or to the skin, which may become infected; and abscesses, painful pockets of pus. Crohn’s can also cause anal tears, anemia, malnutrition and slowed growth in children (NIDDK).

Diagnosis and colon cancer checks

Doctors use blood tests for anemia and inflammation, stool tests to look for inflammation and rule out infection, imaging such as CT or MRI, and endoscopy — usually colonoscopy with biopsies, the most accurate test (NIDDK). A stool test called fecal calprotectin helps tell inflammation from non-inflammatory problems (ACG guideline, 2025).

Crohn’s in the large intestine raises the risk of colorectal cancer, more so the longer you’ve had it or if you also have PSC (NIDDK). Guidelines strongly recommend regular surveillance colonoscopy for Crohn’s of the colon (ACG guideline, 2025), most often starting 8 to 10 years after diagnosis and repeated every 1 to 5 years; people with PSC may need it yearly from diagnosis (NIDDK).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Medicines chosen by severity — short courses of steroids, immunomodulators, biologics and a JAK inhibitor — plus nutrition therapy (especially for children), surgery for complications, vaccines, and regular colonoscopy checks. IBD care often costs $9,000–$12,000 a person a year, and much more on biologics. Biosimilars may cost less; Medicare Part D caps out-of-pocket drug costs at $2,100 in 2026; maker and charity programs can help. No cure yet, but treatment aims to bring on and keep remission and heal the bowel lining. Many people still need surgery at some point; it treats complications but doesn’t cure the disease.
Chiropractic Being researched — coming soon.
Acupuncture Acupuncture, often combined with moxibustion (heat applied near acupuncture points), used alongside standard medical treatment. About $90–$185 a follow-up visit and $125–$230 for a first private visit; community clinics about $50–$90. Medicare doesn’t cover it for Crohn’s disease. Small trials suggest it may ease symptoms and disease-activity scores in mild to moderate disease, but the evidence is low quality. It is not a replacement for medicines that control inflammation.
Herbal medicine No herb or supplement is proven to treat Crohn’s disease. The useful roles are correcting proven deficiencies with your doctor and avoiding products that interact with your medicines. Cost estimate being researched. Curcumin’s promise is mainly in ulcerative colitis; it didn’t prevent Crohn’s returning after surgery in a trial. Probiotics aren’t recommended for Crohn’s outside research, and cannabis’s effects are uncertain.
Massage therapy Gentle massage for relaxation as one part of managing stress — not a treatment for the disease. About $60–$120 for 45–60 minutes with a private therapist, or $50–$90 at clinics, gyms and spas. We found no research on massage for Crohn’s disease itself. Some people may find it relaxing; avoid pressure on a tender belly, a fistula or a stoma.
MBHA Wellness Coach Quitting smoking, a food and symptom diary to share with an IBD-focused dietitian, fluids during flares, pacing fatigue, stress and mood, school and work accommodations, support groups, and planning around restrooms. Cost estimate being researched. Practical habits that support your medical care — quitting smoking in particular is linked to fewer flares — alongside, never instead of, your gastroenterologist.

Approach 1 of 6

Conventional medicine (AMA)

Medicines don’t cure Crohn’s disease, but they can bring on and maintain remission; the goals are to lower inflammation, prevent flares and keep you in remission (NIDDK). Healing of the bowel lining seen on endoscopy (mucosal healing) is also a goal, and is linked to fewer surgeries and hospital stays (ACG guideline, 2025).

1. Medicines

U.S. guidelines suggest that people with moderate to severe disease can start an advanced therapy (a biologic or JAK inhibitor) early, rather than having to fail older treatments first (ACG guideline, 2025, AGA guideline, 2025).

For pain: acetaminophen is preferred for mild pain; avoid NSAIDs such as ibuprofen, naproxen and aspirin, which can make symptoms worse (NIDDK).

2. Infection precautions and vaccines

More than 70% of people with IBD will take immune-modifying medicines at some point, raising the risk of infections that vaccines can prevent (ACG preventive care guideline, 2025). Vaccines such as hepatitis B, pneumococcal, shingles, HPV and flu should ideally be brought up to date before a biologic is started, and live vaccines (such as MMR, chickenpox, yellow fever and the nasal flu vaccine) avoided while on immunomodulators or biologics (ACG guideline, 2025). Tell your doctor right away about a fever or other signs of infection (Crohn’s & Colitis Foundation).

3. Nutrition therapy

4. Surgery

Even with medicines, 30% to 55% of people with Crohn’s need surgery within 10 years of diagnosis. Surgery doesn’t cure it, but it can treat fistulas, abscesses, blockages from scarring, serious bleeding, cancer or precancer, and disease medicines don’t control (NIDDK). The ACG stresses that surgery is not a failure of medication (ACG guideline, 2025).

What it costs

Find a medical doctor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is sometimes used alongside standard treatment for Crohn’s disease. The Crohn’s & Colitis Foundation lists it among mind-body therapies that may help reduce stress and improve well-being (Crohn’s & Colitis Foundation). The 2025 ACG treatment guideline doesn’t include it.

What the research says

  • In a German trial of 51 people with mild to moderately active Crohn’s, traditional acupuncture lowered disease-activity scores more than needling at non-acupuncture points. Both groups improved — the authors noted a marked placebo effect (Joos et al., 2004).
  • Two Chinese trials (92 and 66 people) combined acupuncture with moxibustion and compared it with a sham version; disease-activity scores and remission rates improved more in the real-treatment groups (Bao et al., 2014, Bao et al., 2022).
  • A 2023 review of 12 trials found benefits for acupuncture with moxibustion in mild to moderate Crohn’s, but rated most of the evidence low or very low certainty. Its trials were small and all from China, and the effect of acupuncture alone was inconclusive; the authors say it may be an add-on but there isn’t enough evidence to make it a main treatment (Bae et al., 2023).

In short: acupuncture may help some people feel better, but the evidence is weak. Keep taking the medicines that control inflammation.

Safety

Relatively few complications have been reported; problems have come from non-sterile needles and poor technique. In the U.S., needles must be sterile and single-use, and most states license acupuncturists (NCCIH). In the 2023 review, side effects were minor, such as small bruises, and no serious ones were reported (Bae et al., 2023). As a precaution, MBHA suggests telling your acupuncturist if you take an immune-suppressing medicine, and avoiding needles or heat near an active fistula or a stoma.

What it costs

Published examples run about $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer). Medicare covers acupuncture only for chronic low back pain (Medicare.gov).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Don’t stop or replace your prescribed medicine with a supplement, and talk with your provider before starting one (Crohn’s & Colitis Foundation, NIDDK). Supplements can be sold without FDA approval, so claims about them are largely unproven (Crohn’s & Colitis Foundation). We don’t list doses here.

Turmeric (curcumin)

Probiotics

The American Gastroenterological Association recommends probiotics for Crohn’s disease only in the context of a clinical trial (AGA guideline, 2020), and its panel chair advised people taking them for Crohn’s to consider stopping (AGA). A review of 14 studies found no evidence they help Crohn’s, and risks are greater for people with weakened immune systems (NCCIH). Fecal microbiota transplants aren’t FDA-permitted as an IBD treatment at this time (Crohn’s & Colitis Foundation).

Cannabis

A Cochrane review found only 3 small trials (93 people) in active Crohn’s, and the effects of cannabis and cannabis oil were uncertain (Kafil et al., Cochrane, 2018). It may ease pain, nausea and poor appetite, but there is no evidence it reduces inflammation, and side effects include severe vomiting, memory problems and anxiety, with extra risks for teens and in pregnancy (Crohn’s & Colitis Foundation). CBD has been linked to liver injury and drug interactions (NCCIH).

Interactions with immune-suppressing medicines

Vitamins and minerals do have a role when tests show you’re low; your doctor may recommend them (NIDDK).

Approach 5 of 6

Massage therapy

We found no research on massage therapy for Crohn’s disease itself, and it does not treat the inflammation. Relaxation techniques are among the stress-management strategies the Crohn’s & Colitis Foundation suggests (Crohn’s & Colitis Foundation), and some people may find a gentle massage helps them relax.

Safety

The risk of harm from massage appears to be low, but rare serious problems have been reported, sometimes with vigorous or deep-tissue massage (NCCIH). MBHA suggests:

  • No pressure on a tender or swollen belly, or near a fistula, a stoma or a healing surgical wound.
  • Tell the therapist if you have joint pain, bone thinning or skin sores.
  • Never use massage to put off care for severe belly pain or the warning signs at the top of this page.

What it costs

About $60–$120 for 45–60 minutes with a private therapist, or $50–$90 at clinics, gyms and spas (CostHelper).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you turn your gastroenterologist’s and dietitian’s advice into daily habits — alongside, never instead of, your medical care.

Quitting smoking

This is one of the most important steps. Smoking makes Crohn’s more active and speeds its return after surgery (ACG guideline, 2025); people with Crohn’s who smoke need more surgery and more medicine (Crohn’s & Colitis Foundation). In a French study of smokers with Crohn’s who were counseled to quit, those who stayed smoke-free for more than a year had flares no more often than people who had never smoked, and needed steroids and immune-suppressing medicines less than people who kept smoking (Cosnes et al., 2001). Free, confidential coaching is available at 1-800-QUIT-NOW, and counseling plus medicine together gives the best chance of quitting (CDC).

A food diary and an IBD-focused dietitian

  • No single diet works for everyone: researchers haven’t found that specific foods cause or worsen Crohn’s, and your doctor may suggest a food diary to spot foods that seem to make symptoms worse (NIDDK). In a randomized trial, the specific carbohydrate diet did no better than a Mediterranean diet (ACG guideline, 2025).
  • Skip strict diets from the internet unless your care team supports them; they can cause nutrient shortfalls, weight loss and disordered eating. People with strictures may need to adjust foods such as popcorn, raw nuts and steak (Crohn’s & Colitis Foundation).
  • An IBD-focused registered dietitian can check for malnutrition and help you add foods back (Crohn’s & Colitis Foundation); a coach can help you keep the diary and bring it to visits.

Fluids

Drink enough to keep your urine light yellow (Crohn’s & Colitis Foundation). During a flare you lose fluids and electrolytes faster: sip steadily through the day, use an oral rehydration solution or broth, and limit caffeine and alcohol (Crohn’s & Colitis Foundation).

Fatigue, stress and mood

Pace tasks across the day, rest before you’re exhausted, and ask your doctor to check for anemia, a common, treatable cause of fatigue (Crohn’s & Colitis Foundation). In a review of 77 studies, about a third of people with IBD had anxiety symptoms and a quarter had depression symptoms, more so during active disease and somewhat more with Crohn’s than ulcerative colitis (Barberio et al., 2021); guidelines recommend checking for both (ACG guideline, 2025). Relaxation and breathing exercises, yoga or tai chi, light exercise, support groups and cognitive behavioral therapy can help (Crohn’s & Colitis Foundation).

School, work and getting out

Support groups

Social support helps with the stress of illness (MedlinePlus). The Crohn’s & Colitis Foundation runs support groups for adults, young adults, parents, kids and teens, and older adults (Crohn’s & Colitis Foundation); its group finder can be searched by chapter, including Northern California (Crohn’s & Colitis Foundation). Its IBD Help Center is at 1-888-MY-GUT-PAIN (Crohn’s & Colitis Foundation).

Still being researched: Chiropractic. We add each approach once its costs and results are sourced. Are you a practitioner with experience treating Crohn’s Disease? Tell us.

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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