New research is drawing attention to the practical, everyday challenges faced by people with Crohn’s disease, a long-term condition that falls under the wider category of inflammatory bowel disease (IBD). A global review of how common IBD is around the world, alongside separate research into workplace experiences of people with conditions that are not visible to others, together highlight why access to care and understanding from schools and employers can shape whether someone with Crohn’s disease is able to study, work and live independently.
What is Crohn’s disease
Crohn’s disease is a long-term condition in which the immune system causes ongoing inflammation in the digestive tract. It most often affects the end of the small intestine and the start of the colon, although it can appear anywhere from the mouth to the back passage. Symptoms such as abdominal pain, diarrhoea, fatigue and weight loss tend to come and go in cycles of flares and calmer periods known as remission. There is no cure, but corticosteroids, immunosuppressants, biologic medicines and sometimes surgery can help many people manage the condition with fewer interruptions to daily life. Because symptoms are not always visible to others, Crohn’s disease is widely described as an invisible disability.
What the research found
Where Crohn’s disease is most common
A large review of population studies, reported by Ng and colleagues in The Lancet, looked at how common IBD is in different parts of the world. The researchers reported that the highest number of people living with Crohn’s disease was in Germany, followed by Canada. For ulcerative colitis, a related condition, the highest rates were seen in Norway and the United States. The review also found that while rates of Crohn’s disease have levelled off or fallen in many long-established Western countries, they are rising quickly in newly industrialised nations, with particularly fast increases reported in Brazil and Taiwan.
Disclosing an invisible disability at work
Separate research published in the Journal of Business and Psychology, by Mastrella and colleagues, examined what happens when employees tell their employer about a disability that cannot be seen. The study authors reported that people in this situation often face a difficult position. Colleagues or managers may not recognise that a condition is affecting someone’s ability to work, which can make it harder for that person to be believed or to receive adjustments, even when their symptoms are genuinely limiting.
Why this matters
Taken together, these findings suggest that living with Crohn’s disease involves more than managing symptoms alone. Where someone lives can affect how familiar doctors, employers and the wider public are with the condition, and whether appropriate care is affordable or covered by insurance. At the same time, because Crohn’s disease does not always look like an illness from the outside, people may be expected to perform as if nothing is wrong, even during a flare. Researchers suggest that clearer workplace and education policies, along with wider recognition of invisible disabilities, may help reduce these pressures, although any accommodations or care decisions should be made with relevant professionals, such as doctors, disability services or human resources teams.
What to keep in mind
These two pieces of research looked at different questions using different methods, and neither was designed to measure the exact financial or emotional impact of living with Crohn’s disease. The geographical patterns identified by Ng and colleagues reflect reported rates of diagnosis rather than access to treatment, and the workplace research by Mastrella and colleagues was not specific to IBD. Further research would be needed to understand how these factors interact for individual patients, and anyone with concerns about their own symptoms, treatment or workplace rights is encouraged to speak with a healthcare professional or appropriate support service.
References
Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390(10114):2769-2778. doi:10.1016/S0140-6736(17)32448-0.
Mastrella SJ, Powell DM, Bonaccio S, O’Doherty KC. Not an ideal worker, not a disabled worker: the experience of disclosing invisible disabilities at work. Journal of Business and Psychology. 2026.
This article is a journalistic summary for informational purposes only. It does not constitute clinical advice or a recommendation to alter treatment decisions.