New Diagnosis of Crohn's Disease
Your Role — Doctor
Gastroenterology Clinic
Your 24-year-old patient has been diagnosed with Crohn's disease after months of abdominal pain, diarrhoea and weight loss, confirmed on colonoscopy and biopsy. The patient is upset to learn it is a lifelong condition and worried about their future, work, and having children. You need to explain the diagnosis, that it is manageable, respond to distress, and outline treatment and support.
- •Explain what Crohn's disease is in plain terms and how the diagnosis was reached.
- •Be honest that it is a long-term condition while emphasising that it is manageable and most people live full lives.
- •Respond with empathy to the patient's distress and fears about the future, work, and fertility.
- •Outline treatment aims and options (controlling inflammation, medication, diet, monitoring) at an overview level.
- •Offer support (IBD specialist nurse, written information, follow-up, patient organisations) and check understanding.
The Interlocutor
Played by the actor / assessor
You are 24 and have been unwell for months with tummy pain, diarrhoea and weight loss. You've just been told it's Crohn's disease. You're upset that it's lifelong, frightened about what it means for your career and social life, and worried whether you'll be able to have children one day.
- •Say you're relieved to have an answer but shocked and upset that it's a lifelong condition.
- •Ask whether this means you'll be ill forever or need surgery.
- •Worry about how you'll manage a demanding job and social life with this.
- •Ask whether you'll still be able to have children in the future.
- •If the doctor is empathetic and explains that it's manageable with support, feel more hopeful and agree to the treatment plan and specialist nurse contact.
Sample Role-play
Hello Mr Abara, I'm Dr Lund. Thank you for coming back in. I know you've had a rough few months — I'd like to go through what the tests found and what it means. Is that okay?
Yes. Honestly I just want to know what's wrong with me.
That's completely fair, and we do have an answer now. The colonoscopy and biopsies confirm a condition called Crohn's disease. It's a form of inflammatory bowel disease, where parts of the gut become inflamed, and that's what's been causing your pain, the diarrhoea and the weight loss.
Crohn's… isn't that something you have for life? So I'll never be rid of it?
I want to be honest with you: yes, it's a long-term condition, and there isn't a cure as such. But — and this is the important part — it is very manageable. The aim is to calm the inflammation and keep it settled, and most people with Crohn's live full lives: they work, travel, have relationships and families. It doesn't have to define you.
Will I need surgery? Am I going to be ill all the time?
Not necessarily. Many people control it well with medication and never need surgery, and the goal of treatment is exactly to avoid you feeling ill all the time. It can come in flare-ups, but the plan is to get you into a settled state, called remission, and keep you there. We have good treatments to do that.
I've got a demanding job. How am I supposed to cope with all this?
That's a very reasonable worry, and you won't be doing it alone. Once things are settled, many people manage busy careers with Crohn's. You'll have an IBD specialist nurse as a direct contact, we can help with things like workplace adjustments if ever needed, and there are excellent support organisations. Let's focus first on getting you well.
And… this might sound silly, but will I still be able to have children one day?
That's not silly at all — it's an important question and I'm glad you asked. For most people, Crohn's does not prevent having children, and the best thing for a healthy pregnancy is having the condition well controlled beforehand. When the time comes, we'd plan it with you and choose medications that are safe. So yes — this doesn't take that away from you.
That's a huge relief. So what do we actually do now?
We'll start treatment to bring the inflammation down and get you feeling better, look at diet and your nutrition since you've lost weight, and monitor how you respond. I'll introduce you to the IBD nurse today, give you clear written information, and point you to a reputable support group. We'll review you closely at first.
Okay. I came in dreading this and I actually feel a bit hopeful now.
That means a lot to hear. This is a big adjustment, and it's okay to take time with it. You've got a whole team behind you, and we'll take it step by step together.
Useful Phrases
Clinical Background
Crohn's disease is a chronic, relapsing-remitting inflammatory bowel disease diagnosed via endoscopy, histology and imaging. Management aims to induce and maintain remission using agents such as corticosteroids (for flares), immunomodulators, and biologics, plus nutritional support. Many patients avoid surgery; some require it. Address the psychosocial impact in young adults: career, relationships, body image, and fertility (Crohn's generally does not impair fertility; conception is best planned during remission with pregnancy-safe medications). IBD nurse specialists and patient organisations (e.g., Crohn's & Colitis UK) provide vital support.
Common Mistakes to Avoid
- ✕Stating it is lifelong without balancing this with the strong message that it is manageable.
- ✕Overlooking the young patient's specific concerns about career and fertility.
- ✕Failing to connect the patient with an IBD specialist nurse and reputable support resources.