General clinical features of Crohn disease are fever, abdominal pain, diarrhea, and fatigability. Weight loss is also associated. Diarrhea and pain are the most common symptoms of colonic involvement. Rectal bleeding is less common. Anorectal complications are fistulas, fissures, and perirectal abscess. Involvement of the small intestine can lead to steady and localized right lower quadrant pain; ileitis is fairly common. Physical examination may reveal right lower quadrant tenderness with an associated fullness or mass. Patients may also have mild anemia, leukocytosis, and an increased erythrocyte sedimentation rate.
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