Can affect anywhere from mouth to anus. Diagnosis is frequently delayed, and stopping smoking genuinely changes the course.
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Prescriptions, sick notes and referral letters included
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Crohn's disease is a lifelong inflammatory bowel disease that can affect any part of the digestive tract, from the mouth to the anus.
Three features distinguish it from ulcerative colitis: it occurs in patches with normal bowel in between, it involves the full thickness of the bowel wall rather than just the lining, and it most often affects the end of the small bowel and the start of the colon.
Because it goes through the whole wall, it causes complications colitis does not — strictures that narrow the bowel, fistulas that tunnel between the bowel and other structures, and abscesses.
Diagnosis is frequently delayed, often by years. The symptoms overlap with IBS, the bleeding that prompts investigation in colitis is often absent, and small bowel disease is not visible on a standard colonoscopy.
Smoking makes Crohn's significantly worse — more flares, more surgery, worse outcomes. That is the opposite of ulcerative colitis, and it is the most powerful thing a patient can change.
Skin tags, fissures, abscesses and fistulas around the anus are strongly suggestive of Crohn's, and are sometimes the first sign. They are also the symptom people are most reluctant to mention, which contributes to the delay in diagnosis.
Poor growth or delayed puberty may be the only sign, without much in the way of bowel symptoms.
An abnormal immune response to gut bacteria in someone genetically susceptible. The specific cause is not known.
Smoking roughly doubles the risk of needing surgery in Crohn's, increases relapse, and reduces how well treatment works.
Stopping smoking has been described as being about as effective as some drug treatments in Crohn's, and it is free. If you take one thing from this page, take that one.
Diet and stress do not cause Crohn's disease. They can influence symptoms; they did not give you the condition.
A stool test measuring bowel inflammation, and the key test in primary care. A raised result in someone with these symptoms warrants referral rather than an IBS label. NICE supports its use precisely to make this distinction.
We have marked this as not treatable online. Crohn's is diagnosed with endoscopy and cross-sectional imaging and managed by gastroenterology, frequently with immunosuppressants, biologics and surgery. It is not a condition for a remote GP service to manage.
We will avoid NSAIDs where Crohn's is suspected or known, and we will not suppress diarrhoea with loperamide in an undiagnosed or flaring picture.
A prescription is never guaranteed. This page is information, not an offer to supply.
Fewer flares, less surgery, better response to treatment. In Crohn's specifically, this is not general health advice — it directly changes the course of the disease. NHS stop smoking services are free.
Stopping when well is the commonest avoidable cause of a flare, and repeated flares mean more bowel damage over time.
Crohn's is NHS territory, and the NHS does it well. Endoscopy, MRI, gastroenterology, IBD specialist nurses, biologics, dietitians and surgery are all free, and biologic drugs are not obtainable outside specialist pathways at any price that makes sense.
The IBD specialist nurse helpline is genuinely one of the best things about NHS IBD care — direct access during a flare without a GP appointment in between.
Exclusive enteral nutrition, which can induce remission particularly in children, is provided free with dietetic support and has no private equivalent worth buying.
Where private care genuinely helps:
This page follows NICE NG129 on Crohn's disease: management, including the approach to inducing and maintaining remission and the role of enteral nutrition.
Faecal calprotectin to distinguish inflammatory bowel disease from irritable bowel syndrome follows NICE DG11.
The emphasis on smoking cessation reflects consistent evidence that smoking worsens disease course, relapse rate and surgical risk in Crohn's — in contrast to ulcerative colitis — and it is stated prominently because it is the most effective modifiable factor available to patients.
The caution that a normal CRP and a normal colonoscopy do not exclude small bowel Crohn's reflects standard gastroenterology practice and is included because it is a recognised contributor to diagnostic delay.
Bone protection with repeated corticosteroid courses follows NICE guidance on osteoporosis risk assessment.
Crohn's can affect anywhere from mouth to anus, in patches, through the full bowel wall. Ulcerative colitis affects only the colon, continuously, and only the lining. That difference is why Crohn's causes strictures and fistulas and why surgery is not curative.
Because bleeding is often absent, CRP can be normal, symptoms overlap with IBS, and small bowel disease does not show on a standard colonoscopy. Delays of several years are common and well documented.
No. A colonoscopy cannot see most of the small bowel. If the story fits, MRI or capsule endoscopy may be needed.
Yes — more than almost anything else you can control. Smoking increases flares, roughly doubles the likelihood of needing surgery, and reduces treatment response. Stopping is the most powerful single change available.
Not without dietetic advice. There is no Crohn's diet, and restrictive eating causes real harm in a condition already associated with deficiency. A known stricture is the exception, where lower fibre reduces obstruction risk.
Because the part of the small bowel that absorbs B12 is commonly affected or surgically removed in Crohn's. It is a frequently missed and easily treated cause of fatigue.
Please do — they matter a great deal. Fissures, abscesses, skin tags and fistulas strongly suggest Crohn's and often make the diagnosis. Embarrassment about mentioning them is a genuine cause of delay.
September 8, 2026
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Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
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20 minutes
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Yes, and told why
£40 for 20 minutes
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Typically 10 minutes
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Usually
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Same day
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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