The Centers for Disease Control and Prevention (CDC) reports that more than 1.4 million people in the U.S. live with inflammatory bowel disease (IBD), a group of diseases that affect the intestines in people from 15 to 35. IBD describes disorders that cause recurring inflammation of the intestines, or "relapses." The two most common types of IBD are ulcerative colitis and Crohn's disease. There are other causes of intestinal inflammation, but IBD disorders have a specific set of features that unite them.
Symptoms
The main symptoms of IBD, Merck Manual explains, relate to the inflammation and ulceration of the intestinal lining. Symptoms present in both ulcerative colitis and Crohn's patients include fever, abdominal pain and cramping, weight loss, extreme tiredness and diarrhea (frequent, soft or fluid-like stools). Features of inflammation in other parts of the body are also present. These include inflammation of the joints, eyes, skin and liver. The severity of symptoms varies from patient to patient.
Ulcerative colitis is always associated with rectal bleeding or bloody diarrhea and anemia from blood loss. Another indicator of ulcerative colitis is the constant desire to defecate, with little stool passage, because the intestine is empty. This is called tenesmus.
Causes
The Merck Manual says a specific cause for IBD has yet to be identified. It is thought that the body's immune system turns against itself. Normal bacteria living in the colon usually do not trigger the immune system. In the case of IBD, it appears possible that the body attacks this normal bacteria, thereby attacking itself in the process. Other theories exist, but none has undeniable proof.
Diagnosis
After a physical exam, the best way to diagnose inflammatory intestinal disease and distinguish between ulcerative colitis and Crohn's is an endoscopic exam. When all other causes of intestinal inflammatory disease are ruled out, a tube with a camera is used to inspect the lining of the stomach. Ulcerative colitis sores present differently than Crohn's sores.
Ulcerative colitis sores and ulcerations are confined to a smaller area of the intestine, the colon (large intestine). Under the microscope, ulcerative colitis sores are continuous along the surface of the intestinal lining.
Crohn's sores are present throughout the entire intestine in both the large and small intestine, as well as the rectum (though less commonly) and the anus. Under the microscope, the blisters and ulcerations are described as discontinuous or patchy areas that extend through the entire intestinal wall.
Complications
The intestines are essentially a tube. Constant inflammation and repair to the lining of the intestines eventually lead to blockage from scar tissue. Both ulcerative colitis and Crohn's patients are at risk of nutritional deficiencies.
The National Digestive Disease Information Clearinghouse (NDDIC), reports that 5 percent of ulcerative colitis patients develop cancer. Patients with ulcerative colitis are at higher risk for disease of the liver and gallbladder.
Crohn's patients often develop holes in the lining of the stomach, creating an abnormal connection between other structures or organs in the body. These are called fistulas.
Treatment
Severity of symptoms and complications directs treatment options. Treatment is required for controlling pain and inflammation, healing damage, maintaining nutritional status, reducing flare-ups and preventing complications.
Medications used to treat IBD are drugs that help reduce and control inflammation, including aminosalicilylates (sulfasalzine), corticosteroids and immune modulators (azathioprine and 6-mercapto-purine (6-MP).
Hospitalization is required in a few patients with severe complications. During hospitalization, a depletion in nutrition can be addressed effectively.
Surgery is recommended in approximately 40 percent of the cases, according to The Cleveland Clinic. These patients have severe symptoms or are at risk for cancer.
