Crohn’s disease primarily affects your gastrointestinal (GI) tract. But it can impact your health in other ways, too, like causing skin and joint conditions, nutrition issues, and mental health concerns, to name just a few. Knowing which specialist to turn to can help you feel your best from head to toe.
Though your gastroenterologist is in charge of your Crohn’s care, managing Crohn’s disease often requires a team approach, says Adelina Hung, MD, director of the inflammatory bowel disease program at Sinai Chicago. “Working together, this multidisciplinary team can help address the full impact of Crohn’s disease and improve your overall health and quality of life,” she says.
So which doctors should be in your lineup? Depending on your individual symptoms and concerns, here are the experts that gastroenterologists typically recommend.
1. Gastroenterologist
Your gastroenterologist is your main point of contact for all things Crohn’s. In addition to monitoring the health of your GI tract and helping you make decisions about treatment, they’ll refer you to other specialists for any non-GI concerns that may be related to Crohn’s disease, which are typically referred to as extraintestinal manifestations.
Your gastroenterologist will also coordinate with your primary care doctor, who’s typically in charge of preventive care that’s not related to Crohn’s disease, says Eric Molloy, MD, a gastroenterologist with the University of Kansas Health System in Overland Park. That might include things like routine health exams or helping you manage other health conditions like high blood pressure and high cholesterol.
2. Registered Dietitian
A dietitian specializing in inflammatory bowel diseases (IBDs) like Crohn’s can help you put together a personalized eating plan for when you’re feeling good as well as when you’re flaring. They’ll take into account your specific symptoms, medications, surgeries, and complications to make food recommendations that work for you.
Ideally, you should see a dietitian right after you’re first diagnosed and during instances when your nutritional needs might change. That could include during a flare, after surgery, if you’re losing weight, if you have a nutritional deficiency, or if you run into any other food-related concerns, Dr. Hung says.
3. Mental Health Professional
Living with a chronic condition like Crohn’s can be stressful, and it can take a toll on your mental health and well-being. If you’re struggling emotionally, talking with a mental health professional, such as a therapist, counselor, psychiatric-mental health nurse practitioner, or psychiatrist, can make it easier to cope.
Don’t hesitate to ask your gastroenterologist for help or for a referral to someone who specializes in Crohn’s or IBD. “If a patient is contemplating whether they need a mental health professional, then they probably do. I have a low threshold for recommending a mental health professional. There is no harm [in seeing someone],” says Dr. Molloy.
4. Rheumatologist
One of the most common problems caused by Crohn’s outside of your GI tract is joint pain, especially in the knees, ankles, and spine. That can happen when inflammation from your gut begins to attack your joints.
If you’re affected, a rheumatologist should be on your care team roster, Molloy says. That said, you don’t need to see a rheumatologist preemptively if your joints feel fine, he says. Just give your gastroenterologist a heads-up right away, rather than waiting for your next appointment if you start to notice symptoms like joint stiffness, discomfort, and swelling.
5. Dermatologist
Crohn’s disease can increase the risk for developing skin cancer, so it’s especially important to be vigilant. “Most Crohn’s patients should see a dermatologist yearly for screening,” Molloy says.
Specifically, the American Gastroenterological Association recommends that people with IBD avoid excessive sun exposure and that those on certain medications, including immunomodulators, anti-tumor necrosis factor alpha biologics, and small molecule drugs, as well as anyone who’s ever taken thiopurine, get yearly full-body skin checks.
Your dermatologist is also a key ally for managing other Crohn’s-related skin issues. While not everyone with Crohn’s develops skin issues, the condition can sometimes lead to rashes, ulcers, and sores that require urgent attention, as well as skin tags, among other issues.
6. Ophthalmologist
Another part of the body that Crohn’s can impact is your eyes. For some, it can cause dry eyes or inflammatory eye conditions like uveitis and episcleritis. “An ophthalmologist can diagnose these conditions and provide treatment to prevent complications,” Hung says.
You should let your ophthalmologist know immediately if you’re experiencing symptoms like eye pain, redness, sensitivity to light, and vision changes, as untreated inflammation can cause permanent damage. That said, “people with Crohn’s disease who do not have eye symptoms or a history of eye involvement do not need additional, IBD-specific ophthalmology visits beyond routine eye care,” Hung says.
7. Colorectal Surgeon
Not everyone with Crohn’s disease will need surgery. But if the need arises, it can be helpful to be prepared. “Meeting with a colorectal surgeon earlier in the course of Crohn’s disease can be helpful for some patients, like those with complications such as strictures, fistulas, abscesses, recurrent blockages, and symptoms that are not improving with medication,” Hung says.
Having an early conversation with a surgeon can help you understand what situations could lead to surgery down the road and what options are available to you. And that can help you quickly make more informed choices later on. “If surgery is ever needed, decisions can be made by a team that already understands the patient’s history and preferences,” says Hung.
8. Hepatologist
Crohn’s can sometimes lead to liver complications like primary sclerosing cholangitis and metabolic dysfunction-associated steatotic liver disease (formerly known as non-alcoholic fatty liver disease).
“In many cases, a person’s gastroenterologist is also trained to evaluate and manage common liver concerns,” Hung says. But if your liver concerns become more complex, they may refer you to a hepatologist (a gastroenterologist with additional expertise in liver disease) for further care, she says.
