Inflammatory Bowel Disease (IBD)

IBD: Crohn’s Disease and Ulcerative Colitis

Inflammatory bowel disease (IBD) is a condition that develops from inflammation inside an individual’s digestive system. Inflammatory bowel disease affects approximately one million Americans and can affect any age group. Although the disease can begin in early childhood, it most commonly beings between the ages of 15-30. There are two types of IBD: Crohn’s disease and ulcerative colitis.

Both of these inflammatory bowel diseases can range from extremely mild to very severe. You may have long periods without any intestinal discomfort at all followed by episodes of flare-ups of symptoms. In some people, this can be a lifetime cycle of good periods and bad periods. Other individuals may show symptoms for a short period of time and be disease-free for the rest of their lives.

Crohn’s Disease

Crohn’s disease and ulcerative colitis are inflammatory bowel diseases that are very similar. Which of these two disease is diagnosed depends on which part of the digestive system is involved. In Crohn’s disease, the most commonly involved area is the small intestine, but Crohn’s disease can involve any area of the digestive system – the mouth, esophagus, stomach, colon, or anus.

Crohn’s disease can be diagnosed in all age groups, from young children to older adults. The disease usually begins, however, in the teenage years or in the twenties. It does appear that Crohn’s disease may run in families.

The Cause

Crohn’s disease seems to be an imbalance of the body’s own immune system (called an autoimmune reaction). The digestive system may be exposed to a virus or bacteria, triggering the body’s immune system to attack the invader, leading to an inflammatory response in the digestive system. It is thought that the immune system continues this inflammatory reaction after the virus or bacteria has been eliminated, resulting in persistent inflammation.

People with Crohn’s disease also seem to have other problems with their immune systems, such as food and environmental allergies, so that allergic reactions may also play a role in this disease.

Symptoms

Possible symptoms, which can vary greatly from person to person, are:

  • diarrhea
  • recurrent lower abdominal pains
  • blood in the stools
  • bleeding from the anus
  • weight loss
  • recurrent fevers
  • fatigue
  • reluctance to eat
  • nutritional deficiencies

Diagnosis

If your doctor suspects that your symptoms may be due to Crohn’s disease, he may take blood and stool samples for testing. Certain blood tests can show evidence of an inflammatory process going on in the body, and stool tests can rule out infections by parasites or bacteria.

If Crohn’s disease or ulcerative colitis is suspected, your doctor will most likely refer you to a gastroenterologist for further testing. This specialist may want to perform two procedures known as endoscopy and colonoscopy and may also do abdominal X-rays known as an upper-gastrointestinal series.

Endoscopy is a test that uses a small tube with a camera at the end. It is placed down through the mouth into the esophagus and stomach. This allows the doctor to visualize these areas for signs of inflammation. The doctor can also take tissue samples for biopsy that will show evidence of Crohn’s disease if you are affected.

Colonoscopy is essentially an endoscopy from the other end of the body – passing a small, thin tube with a camera at the tip through the rectum and up into the colon. Again, this allows for direct visualization of the colon, along with the ability to collect tissue samples for biopsy.

Treatment

While currently Crohn’s may not be completely cured, it can be treated so that you can lead a normal life. Your doctor is likely to prescribe anti-inflammatory medicines if a diagnosis is given after the appropriate GI tests. You can support your gut health through diet and nutrition and lifestyle choices as well while taking medications. Surgery may be performed in small numbers of cases in individuals with sever IBD. Performing surgery will not cure Crohn’s disease, but it may help the symptoms. This is usually done only if all other treatment options mentioned above have failed.

Ulcerative Colitis

Ulcerative colitis is caused by inflammation of the inner lining of an area of the digestive tract. The main difference between ulcerative colitis and Crohn’s disease is where in the digestive system the inflammation occurs. Unlike Crohn’s disease, which can affect any part of the digestive tract from mouth to anus, the inflammation of ulcerative colitis is limited to the colon and/or the rectum.

The Cause

Like Crohn’s disease, it is thought that the body’s own immune system reacts to an invading bacteria or virus, causing inflammation, and that this inflammatory reaction cannot stop itself, leading to the development of ulcerative colitis.

Symptoms

Again, ulcerative colitis shares similar symptoms with Crohn’s disease. These include:

  • lower abdominal pain
  • bloody diarrhea
  • loose bowel movements
  • bleeding from the rectum or blood in the stools
  • nutritional deficiencies
  • loss of appetite
  • fatigue
  • weight loss
  • occasional join pain or skin rashes may develop

See your doctor if you begin exhibiting the above symptoms.

Diagnosis

The process of diagnosing ulcerative colitis is essentially the same as diagnosing Crohn’s disease. (See above.)

Treatment

As with Crohn’s disease, treating ulcerative colitis is performed on an individual basis. Not everyone will receive the exact same treatment for ulcerative colitis. There is no known cure for ulcerative colitis. The main goal of treatment is to help control severe flare-ups of the disease along with the symptoms.

Medication treatment usually begins with using anti-inflammatory medications that will help to control the symptoms. These are used in mild cases of ulcerative colitis. In moderate to severe disease, steroid medications may be used as these have more powerful anti-inflammatory abilities. These are usually used on a short-term basis to control severe flare-ups. In more severe cases, powerful medications that help alter the body’s own immune system may be used. Steroids and immune system-altering medications can have many side effects and should be used only under direct care of a treating physician. (See above section on treating Crohn’s disease for further tips on other treatments for ulcerative colitis. One important aspect of treatment is to avoid malnutrition or nutritional deficiencies.)

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