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Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease

What is inflammatory bowel disease (IBD)?

Inflammatory Bowel Disease (IBD) is an umbrella term used to describe disorders of the digestive tract that involve chronic inflammation.

There are two main types of IBD: Ulcerative colitis and Crohn’s disease.

What causes inflammatory bowel disease (IBD)?

Despite extensive research, the cause of both Ulcerative Colitis (UC) and Crohn's disease remains elusive, although both are considered autoimmune conditions. An abnormal immune response seems responsible for the inflammation, and diet and stress aggravate the condition. Genetics also seems to play a role. Smoking is associated with a worse prognosis for people with Crohn's disease, but not for those with UC.

Both conditions affect men and women equally and most people are diagnosed during their teenage years, although the disease can occur at any age.

One in ten people with IBD display features of both Crohn's disease and UC and are usually diagnosed with indeterminate colitis.

What are the symptoms of inflammatory bowel disease?

Symptoms are so similar with both disorders that a doctor cannot tell if you have Crohn's or UC based on symptoms alone. Further medical investigations are needed.

Symptoms may include:

  • Abdominal pain
  • Anal tears and fistulas
  • Diarrhea and the frequent need to have a bowel movement
  • Fever
  • Loss of appetite
  • Night sweats
  • Poor appetite
  • Pus or mucus in the feces
  • Rectal bleeding or blood in the stools
  • Sometimes constipation
  • Tiredness
  • Weight loss.

Up to 25% to 40% of people with IBD develop extraintestinal manifestations (EIM) – these are conditions that affect the skin, eyes, muscles, joints, liver, and kidneys.

Common EIMs include:

  • Arthritis
  • Episcleritis (inflammation of the thin membrane that covers the white of the eye)
  • Musculoskeletal pain
  • Nephrolithiasis
  • Primary sclerosing cholangitis (an inflammatory disorder that affects the bile ducts)
  • Skin conditions, such as erythema nodosum and pyoderma gangrenosum.

Although Crohn’s disease can affect any part of the digestive tract, it more commonly affects the area where the ileum (small intestine) joins the colon (large intestine). Only certain parts of the intestine are affected. Inflamed areas exist in patches and may be located anywhere between the mouth and the anus. The inflammation also tends to extend through multiple, if not all, layers of the bowel wall. However, significant areas of the intestine remain healthy.

Most people with Crohn's disease have periods of active, symptomatic disease and periods of remission (no symptoms at all).

Symptoms of UC are like those of Crohn's disease but UC affects only the innermost lining of the colon. Although the colon is the only part of the bowel affected, the whole of the colon is inflamed.

How is inflammatory bowel disease (IBD) diagnosed?

See your doctor if you have symptoms that are suggestive of either UC or Crohn’s disease.

Your doctor will ask you about your symptoms and any relevant personal or family history. To help confirm the diagnosis and to rule out other conditions, they may perform blood tests, a fecal occult blood test, a colonoscopy, endoscopy, or other tests including x-rays and scans.

How is inflammatory bowel disease (IBD) treated?

Medications used to treat both Ulcerative Colitis (UC) and Crohn’s disease are similar, with a few exceptions. There is no cure for either disease, but treatments can help manage symptoms and may include:

  • Medications, such as 5-aminosalicylates, antibiotics, antidiarrheal agents, biologics, corticosteroids, immunomodulators
  • Nutritional supplements
  • Dietary restrictions
  • Surgery