Crohn's is a chronic inflammatory disease that causes swelling and irritation in the tissues of the digestive tract. This condition can cause multiple symptoms, including abdominal (belly) pain, severe diarrhea, fatigue, weight loss, and malnutrition.
Although it sometimes comes with common conditions like diarrhea or abdominal pain, people who have it know that its impact goes far beyond the digestive system. This is because, besides the physical symptoms, many people who have Crohn's face high levels of stress and depression.
In a recent WebMD AMA (Ask Me Anything) on Reddit, Reezwana Chowdhury, MD, a gastroenterologist and assistant professor at Johns Hopkins School of Medicine, discussed the challenges faced by people diagnosed with this medical condition.
During the session, several users shared their experience living with an "invisible" chronic illness, whose symptoms that come and go are often misunderstood by those around them.
"[It's] unfortunate that patients and folks with chronic illnesses are made to feel that way," Chowdhury says.
"I would recommend continuing to advocate and educate folks that symptoms are not only GI related, but patients can have extraintestinal manifestations. As physicians, we should also do a better job at educating."
The Stigma of an 'Invisible' Illness
"Invisible illness" is a term used for conditions whose symptoms are not obvious at first glance but significantly affect daily life. Crohn's disease often falls into this category.
"Unlike other conditions that are obvious due to physical signs, patients with IBD can appear healthy while silently managing debilitating fatigue, urgent bowel symptoms, abdominal and joint pains," says Joanna Lopez, MD, a gastroenterologist at Baptist Health South Florida.
People with this medical condition can have unpredictable flare-ups or relapses of the disease, but they can also have symptom-free periods or remission.
"At this time, [there is] no cure, but patients can live normal lives when in clinical remission," Chowdhury says.
Stress Management and Emotional Balance
Living with a chronic and often painful illness can affect mental health and emotional well-being. The rates of depression and anxiety among those with inflammatory bowel disease are higher than in people without the condition. A recent study suggests that up to 32% of people with this diagnosis may have symptoms of posttraumatic stress.
Although flare-ups are often linked to stressful periods, there is no evidence that stress causes Crohn's disease. It is much more likely that emotional distress is a reaction to the symptoms of the disease. "I do think stress, lack of sleep, and a lack of a healthy diet can precipitate a flare," Chowdhury says.
Many people with this condition have emotional and psychological responses including:
- Sadness, anxiety, or a sense of emptiness
- Hopelessness and negative feelings
- Denial of the disease
- Dependent behaviors
- Feelings of guilt and helplessness
- Lack of energy and fatigue
- Loss of interest
- Agitation, insomnia, and crankiness
Although episodes of sadness and stress may happen occasionally, it's important to talk to a mental health professional if several of the symptoms mentioned above continue for weeks or if you need help with your daily activities.
Experts recommend different strategies to avoid feeling overwhelmed when facing your daily routine:
- Plan something special you like to do, like a walk or breakfast with your partner or a friend.
- Take your time when doing your daily activities.
- Make your plans for the day ahead of time.
- Schedule time to rest.
- Work with a cognitive behavioral therapist.
- Put moderate physical exercise into your routine.
- Include relaxation techniques in your daily life.
- Make time to meditate.
- Reach out to family members, friends, and your community for support.
- Plan fun activities that you truly enjoy.
- Set realistic goals that you can achieve without stressing.
Challenges and Strategies to Cope With the Disease
A lack of awareness can lead to feelings of isolation, guilt, or frustration. Some people feel pressure to prove they are really sick, while others prefer to hide their symptoms to avoid questions or judgment. Some also mention a fear of incontinence, a sense of loss of control, and a lack of understanding.
People with Crohn's disease may have challenges in their romantic relationships, friendships, and academic or professional life. Some limit their social activities, avoid new relationships, or adjust their expectations at work. According to a recent study, some have considered early retirement or self-employment to manage symptoms due to the constant fear of having a flare-up in a public place.
According to Lopez, "precisely because they 'look fine' to others, including co-workers, employers, and family members, they feel the need to constantly explain themselves and apologize for their symptoms when these lead to canceled events, a change in plans, or require accommodations."
One of the most difficult aspects of Crohn's is its unpredictability. Here are some ways to help you feel less stressed when you're away from home:
- Before going out, figure out where the restrooms are.
- Avoid unfamiliar places.
- Plan your trips carefully.
- Bring extra clothing in case you need it.
- Stay close to your support group.
- Avoid using public transportation.
- Avoid eating foods that can irritate your stomach.
Lopez also suggests "using specific examples as to how the disease affects [your] life, as opposed to general statements. Sharing 'I had to use the bathroom 12 times today' as opposed to 'I had a bad day' stirs a different, more relatable reaction. This can close the gap between the reality of living with this disease and the invisible nature of it."
Support and Understanding From Others
Social networks, support groups, and mentoring programs help reduce the feeling of isolation for those diagnosed with this disease. Showing empathy is a way to provide emotional support, so if you know someone in your social circle with Crohn's disease, you can show support through these small actions:
- Listen without judging.
- Avoid minimizing the symptoms.
- Don't assume they're OK based on their appearance.
- Ask how you can help.
- Be flexible with plans or activities.
- Learn about the disease.
Communicating With Your Health Care Team
Taking care of your mental health and emotional well-being is as important as treating physical symptoms. Chowdhury shared an encouraging message at the end of her WebMD AMA on Reddit. "There are many treatment options for Crohn's disease these days, and there is lots of hope for patients to live a normal life in both clinical and endoscopic remission. It is important to build a good relationship with your GI [gastroenterologist] and always advocate for yourself."
During medical appointments, it's important that you talk to your doctor about your physical symptoms and any emotional or psychological changes. You should also ask about the best treatments for your condition and schedule an appointment with a mental health professional if you think it's necessary. Asking questions and talking about your concerns can help you adopt strategies to help cope with your Crohn's disease.
When you live with a chronic illness, it's crucial to focus on your achievements, one day at a time, and make your physical and emotional well-being a priority.
"Ultimately, having an invisible illness does not make their condition any less real. They have to acknowledge the legitimacy of their disease themselves as much as others need to respect their experiences, symptoms, and concerns," Lopez says.
Show Sources
Photo Credit: Moment/Getty Images
SOURCES:
Reezwana Chowdhury, MD, gastroenterologist, Johns Hopkins Endoscopy and Surgery Center, Columbia, Maryland.
Joanna Lopez, MD, gastroenterologist, Baptist Health South Florida.
Reddit AMA (Ask Me Anything) Q&A, WebMD: "I’m a gastroenterologist – Ask Me Anything About Crohn’s disease," with Reezwana Chowdhury, MD, May 19, 2026.
Mayo Clinic: "Crohn's disease."
Cleveland Clinic: "Crohn's Disease."
Crohn’s & Colitis Foundation: "What is Crohn’s Disease?" "Being IBDVisible," "Mental and Emotional Well-being," "Mental Health and IBD: Depression and Anxiety," "Living with IBD: Pain and Fatigue," "Find a Support Group," "Coping Strategies to Improve Mental Health," "Navigating Daily Life with IBD," "Talking to Your Healthcare Team," "Supporting Someone with IBD."
Oxford Academic: "Initial Assessment of Post-traumatic Stress in a US Cohort of Inflammatory Bowel Disease Patients.”
Crohn's & Colitis 360: "Reactions, Reality, and Resilience in Adults with Crohn’s Disease: A Qualitative Study."
Internal and Emergency Medicine: "Stigmatisation and resilience in inflammatory bowel disease."
Journal of Clinical Medicine: "Resilience and Self-Care in Patients with Inflammatory Bowel Disease: A Multicentre Cross-Sectional Study in Outpatient Settings."
