What Is ‘Silent Crohn’s Disease’ and How Do You Know if You Have It?
Digestive HealthCrohn's Disease

What Is ‘Silent Crohn’s Disease’ and How Do You Know if You Have It?

What Is ‘Silent Crohn’s Disease’ and How Do You Know if You Have It?
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Published on November 11, 2025
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Crohn’s disease is a chronic inflammatory bowel disease (IBD) that can affect any part of the digestive system. While it’s often tied to symptoms like diarrhea, abdominal pain, and weight loss, some people with the condition may experience a harder-to-detect version of the disease called “silent Crohn’s disease.”

As in symptomatic Crohn’s disease, inflammation is occurring in the digestive tract, but symptoms may be subtle or even absent, leaving people with the condition unaware that anything is wrong.

 It can come to light incidentally, when evidence of inflammation is found during a routine screening colonoscopy, or another test performed for unrelated reasons.

In some cases, silent Crohn’s can cause a delay in diagnosis and treatment, potentially leading to complications and irreversible tissue damage.

 Understanding what silent Crohn’s disease is, how to detect it, and when to seek help from a gastroenterologist is key to protecting your long-term health.

What Is ‘Silent Crohn’s Disease’?

Crohn’s disease is an incurable relapsing-remitting condition. That means people who have it experience periods of flares and periods of remission when they have no symptoms. Repeated cycles of inflammation during flares can lead to complications that may require surgery, such as strictures (narrowing in the intestine), fistulas (tunnels from the intestines to the skin), and abscesses (infected, pus-filled, inflamed tissue).

The term "silent Crohn’s" refers to a phase in which there’s inflammation ongoing in the digestive tract but it isn’t triggering the hallmark symptoms often linked with Crohn’s, according to Alan Moss, MD, the chief scientific officer at the Crohn’s & Colitis Foundation and a professor of gastroenterology at Boston University.

Some experts view this as a “prodromal” stage — an early period where the disease process has begun, but the person isn’t fully aware of it yet. And it usually comes to light in one of two ways, Dr. Moss says:

  • Via a screening colonoscopy in people 45 and older, which uncovers inflammation or damage in the digestive tract
  • Through other tests, such as blood or stool tests or MRI scans, in which inflammatory markers in samples or visual evidence of inflammation are discovered

“[During a colonoscopy], we can see at the end of the colon an inflamed [small] intestine, which is typical for Crohn’s disease — but only a very small portion of those people will go on to develop what we call typical Crohn’s disease,” he says. In this scenario, monitoring with regular colonoscopies is recommended, to see if inflammation or damage has worsened.

In this early stage, the inflammation may quietly progress if not detected, sometimes for months or years, before typical Crohn’s symptoms emerge — if they do. “We don’t fully understand yet why people have features of Crohn’s disease in their intestine but have no symptoms,” Moss says.

This makes silent Crohn’s disease tricky. Without obvious digestive distress, people with the condition may not realize they need to seek care.

How Do You Know if You Have ‘Silent Crohn’s Disease’?

As mentioned, silent Crohn’s is typically discovered incidentally, through tests done for other reasons. That’s why ongoing monitoring is vital for those at higher risk, such as people with a family history of IBD. About 20 percent of people with IBD have another family member with Crohn’s or ulcerative colitis, and they often share a similar pattern of disease.

But other, less common Crohn’s symptoms may crop up, and they may be subtle. “Inherently, [silent Crohn’s] is difficult to detect when individuals do not have classic symptoms … like abdominal pain and diarrhea. I think paying attention to your body is helpful,” says the gastroenterologist Brigid Boland, MD, an assistant professor of medicine at the University of California in San Diego and a spokesperson for the American Gastroenterological Association.

She points to some of the less-common potential signs of Crohn’s, which can include:

  • Mild fatigue tied to anemia (low iron levels)
  • Changes in bowel movements, like a shift toward looser stools
  • Unexplained weight loss
  • Slow or stunted growth in children and teens
  • Rashes or psoriasis
Several forms of inflammatory arthritis commonly occur alongside Crohn’s as well. These include spondyloarthritis, which affects the spine; enteropathic arthritis, which affects the joints, spine, and digestive system; and rheumatoid arthritis, which affects the joints.

Because these symptoms overlap with many other conditions, people may chalk them up to other possible factors, like stress, diet, or aging.

“Not everyone shows up with the typical pain and diarrhea. Some may first have unexplained anemia, inflamed joints, or unusual skin rashes — and only later do we confirm it’s Crohn’s,” Moss says.

In rare cases, silent Crohn’s is first noticed in the emergency room, Moss says. “Occasionally, we see patients whose first manifestation of Crohn’s is a blockage or a fistula, despite having no symptoms beforehand. Thankfully, that’s very uncommon.”

When to See a Doctor

Even if your symptoms seem minor, it’s important not to ignore ongoing digestive problems or other unexplained health issues. You should see a doctor if you experience typical or atypical symptoms of Crohn’s disease, including:

Your doctor can run blood work, do imaging tests, or perform visual inspections such as a colonoscopy to check for signs of inflammation or intestinal damage, Moss says. Early diagnosis allows for earlier treatment, which can help prevent complications down the road.

“We would always rather diagnose people before they develop serious complications — and we know that the best success with the newer therapies is in the first two years after disease onset,” he says.

In general, if Crohn’s goes untreated for too long, newer biologic medications may be less effective. Preventing the disease from worsening is usually easier than trying to heal damage to the digestive tract, which is often irreversible.

But research hasn’t confirmed whether people with silent Crohn’s are at high risk of similar potential consequences if they wait to begin maintenance treatment.

In fact, the American College of Gastroenterology’s clinical treatment guidelines advise that opting out of maintenance treatment is a possibility for some people with silent Crohn’s. Routine monitoring for disease progression is recommended, however, for those who decide not to go on maintenance therapies.

The Takeaway

  • Silent Crohn’s disease involves intestinal inflammation without typical gastrointestinal (GI) symptoms; it’s often discovered during a routine colonoscopy or blood, stool, or imaging tests meant to investigate a different health concern.
  • Subtle or non-GI-related symptoms such as fatigue, anemia, joint pain, or rashes can sometimes precede classic Crohn’s symptoms.
  • Early detection and monitoring are key for preventing complications and protecting your long-term health.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. What Is Crohn's Disease? Crohn’s & Colitis Foundation.
  2. Silent Inflammatory Bowel Disease. University of Pittsburgh Medical Center. January 24, 2022.
  3. Coates MD et al. Silent Inflammatory Bowel Disease. Crohn’s & Colitis 360. July 2021.
  4. Grinman A et al. Incidentally Diagnosed Asymptomatic Crohn’s Disease: A Retrospective Cohort Study of Long-Term Clinical Outcomes. Crohn’s & Colitis 360. July 2022.
  5. Cantoro L et al. The Earlier You Find, the Better You Treat: Red Flags for Early Diagnosis of Inflammatory Bowel Disease. Diagnostics. October 12, 2023.
  6. Cockburn E et al. Crohn’s Disease: An Update. Clinical Medicine. November 2023.
  7. What Are Crohn's & Colitis? Crohn’s & Colitis Foundation.
  8. Liebowitz J. Gut Feeling: A Comprehensive Look at the Pathogenesis, Management & Treatment of Inflammatory Bowel Disease. The Rheumatologist. May 24, 2021.
  9. Enteropathic Arthritis. Cleveland Clinic. March 21, 2025.
  10. Cantoro L et al. Inflammatory Bowel Disease and Rheumatoid Arthritis Share a Common Genetic Structure. Frontiers in Immunology. June 12, 2024.
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  12. Lichtenstein GR et al. ACG Clinical Guideline: Management of Crohn's Disease in Adults. American Journal of Gastroenterology. June 2025.
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Yuying Luo, MD

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Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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Carmen Chai is a Canadian journalist and award-winning health reporter. Her interests include emerging medical research, exercise, nutrition, mental health, and maternal and pediatric health. She has covered global healthcare issues, including outbreaks of the Ebola and Zika viruses, anti-vaccination movements, and chronic diseases like obesity and Alzheimer’s.

Chai was a national health reporter at Global News in Toronto for 5 years, where she won multiple awards, including the Canadian Medical Association award for health reporting. Her work has also appeared in the Toronto Star, Vancouver Province, and the National Post. She received a bachelor’s degree in journalism from Ryerson University in Toronto.

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