What Is Inflammatory Bowel Disease?

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Ulcerative colitis and Crohn's disease are chronic diseases of the intestinal tract. The two diseases are often grouped together under the umbrella term inflammatory bowel disease (IBD) because of their similar symptoms. While there is no cure for either form of IBD, there are effective treatments. Medical and surgical advancements are occurring every year, and most people with IBD achieve remission and are able to preserve their quality of life.

As many as 5 million people worldwide (including 1.6 million Americans) live with a form IBD. IBD is not the same as irritable bowel syndrome (IBS) and is treated very differently.

Common Symptoms of IBD
 Verywell / Brooke Pelczynski

Types of Inflammatory Bowel Disease

Crohn's disease and ulcerative colitis present with similar symptoms, but there are some key differences. These include the location of inflammation in the digestive tract, where the inflammation begins, layers of the intestinal wall that are impacted, if granulomas are present on biopsy, and intestinal complications associated with the individual disease.

  Ulcerative Colitis Crohn's Disease
Location Large intestine Anywhere
Starting Point Rectum Anywhere
Intestinal Wall Impact Inner layer All layers
Granulomas No Yes
Complications

Bowel perforation, colorectal cancer, and toxic megacolon

Abscesses, bowel obstructions, fissures, and fistulas

The effect of smoking on IBD also varies depending on the type. Smoking cigarettes may worsen Crohn's disease, but some people with ulcerative colitis only develop the disease after they stop smoking.

Inflammatory Bowel Disease Symptoms

The most common symptoms of IBD include, but are not limited to:

Crohn's disease and ulcerative colitis are also associated with complications such as:

  • Itchy, red, or painful eyes
  • Mouth sores
  • Joint swelling and pain
  • Skin bumps, rashes, and ulcers
  • Kidney stones
  • Liver problems such as cirrhosis (rare)

Causes

The root causes of IBD are poorly understood, but both Crohn's disease and ulcerative colitis are immune disorders. In a healthy immune system, the body protects itself against foreign organisms, such as bacteria and viruses. However, in IBD, the immune system attacks otherwise harmless environmental triggers, resulting in inflammation in the gastrointestinal tract.

There are also hereditary factors that contribute to IBD. Researchers have identified hundreds of genes that may be associated with the disease. First-degree relatives of people who have IBD are significantly more likely to also have it. That said, the majority of people who are diagnosed with IBD have no such family history.

Other risk factors for developing IBD include:

  • Smoking
  • Ethnicity: Whites and Ashkenazi Jews have a higher risk of IBD.
  • Age: While people of any age can be diagnosed with IBD, it usually starts before age 35.
  • Living in an urban area

Poor diet and stress do not cause IBD, but they may contribute to a flare-up of symptoms.

Diagnosis

Several diagnostic tests are normally completed and studied by a digestive specialist (gastroenterologist) before a diagnosis of IBD is made. The "gold standard" for diagnosis is considered the colonoscopy.

During this test, a fiber optic tube is inserted into the rectum while you are sedated to allow the doctor to inspect the lining of the large intestine and to take biopsies.

Other tests that may be used for diagnosis include:

If you are diagnosed with IBD, you will need regular care from a gastroenterologist and support from other healthcare providers such as a dietitian/nutritionist, a primary care provider, or other specialists as needs arise.

Treatment

Intervals of active disease (flare-ups) and periods of no disease activity (remission) are typical of IBD. Prescription drugs referred to as maintenance drugs are frequently used to prevent inflammation or to control an existing flare.

Conventional medicines used to treat IBD include:

Surgery is also sometimes used to treat IBD, and the procedure options vary based on the type of IBD and what part of the digestive tract is inflamed.

In Crohn's disease, symptoms and complications sometimes require surgery. The most common is a resection, during which surgeons remove a diseased piece of the intestine and reconnect the two cut ends. Ostomy surgery, including colostomy and ileostomy, are other surgical procedures that are sometimes recommended.

Most people with ulcerative colitis are able to manage their condition with medication and do not require surgery. However, if surgery is needed, it always involves the removal of the entire colon (colectomy). Additional surgical procedures include an ileostomy or ileal pouch-anal anastomosis (IPAA), more commonly called a J-pouch.

Diet can help you maintain proper nutrition and tame inflammation, but there is no one plan that works for all people with IBD.

Coping

Having IBD can impact your life in many real ways. Not only can the symptoms be painful, but they can, at times, be embarrassing. Learning new ways to cope with and manage your disease can help improve your daily life and your emotional well-being.

Be Prepared

It helps to have a plan for worst-case scenarios, like not being able to find a restroom or having a bathroom accident. Consider keeping a kit with wipes and a change of clothes handy—in your car, purse, or desk drawer, for example—so you can easily grab it if needed.

Talk to Your Friends and Family

Few people enjoy discussing their bowel habits with others, but letting the people close to you know about your gastrointestinal problems can help them understand what you're going through on a daily basis and make it easier for you to ask for help when you need it.

Try to be clear about what you need from loved ones during a flare-up, whether it be more help around the house or simply someone to vent to when things get rough.

Find a Support Group

Support for people with IBD is also accessible via online and in-person support groups. Finding a group of people who understand what you're going through can make you feel less alone. Community support resources are available on the Crohn's and Colitis Foundation website.

A Word From Verywell

While most people with IBD live fulfilling lives, the diagnosis changes things and, for some, can go so far as being debilitating. There is currently no cure for ulcerative colitis and Crohn's disease, but ongoing research continues to develop new treatments to address symptoms and improve remission rates. Managing IBD through a close relationship with your gastroenterologist can help you feel your best and keep complications at bay.

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