An Overview of Inflammatory Bowel Disease (IBD)

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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.


Crohn's disease and ulcerative colitis have similar symptoms but are different in the manner in which they affect the digestive tract.

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


Several diagnostic tests are normally completed and studied by a digestive specialist 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 the patient is 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:

People diagnosed with IBD will need regular care from a digestive specialist (gastroenterologist) and support from other healthcare providers such as a dietitian/nutritionist, a primary care provider, or other specialists as the need arises.

Among the reasons for this, Crohn's disease and ulcerative colitis can be associated with complications both inside and outside the digestive tract. People with IBD are also at an increased risk of developing other conditions.


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

Conventional medicines used to treat IBD include:

Surgery is also sometimes used to treat IBD, and the type of surgery used will vary considerably based on the type of IBD and where in the digestive tract any inflammation is located.

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

Crohn's Disease vs. Ulcerative Colitis

Treatment for IBD is currently based on having a diagnosis of either Crohn's disease or ulcerative colitis, so it is important to define the differences between them.

Here are some key differences:

  • In ulcerative colitis, inflammation is in the large intestine, while in Crohn's disease, inflammation could appear anywhere in the digestive tract.
  • The inflammation in Crohn's disease affects all layers of the intestinal walls, while in ulcerative colitis only the inner layer is affected.
  • Smoking cigarettes may worsen Crohn's disease, but some people with ulcerative colitis only develop the disease after they stop smoking.
  • Biopsies from the intestine of a person with Crohn's disease may show granulomas, which are not found in people with ulcerative colitis.
  • In ulcerative colitis, inflammation begins at the rectum and moves up in a continuous manner through the large intestine, while in Crohn's disease, inflammation can begin anywhere and appear in patches separated by healthy tissue.
  • Many extra-intestinal and intestinal complications are similar between the forms of IBD, but abscesses, bowel obstructions, fissures, fistulas are more common in people with Crohn's disease and bowel perforation (especially during the first flare-up), colorectal cancer, and toxic megacolon are more common in people with ulcerative colitis.

Basics of Crohn's Disease

Crohn's disease can affect the small and large intestine as well as other organs in the digestive tract. Unlike ulcerative colitis, which only affects the inner layer of the large intestine, Crohn's disease commonly involves all layers of the intestinal wall.

Several types of surgery can be used to treat the symptoms and complications of Crohn's disease, yet none are a cure. The most common is the 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 used.

Basics of Ulcerative Colitis

In ulcerative colitis, the inner lining of the large intestine (colon) and rectum are inflamed. This disease does not affect the small intestine. Surgery for ulcerative colitis always involves removal of the entire colon.

Surgical options include an ileostomy or ileal pouch-anal anastomosis (IPAA), more commonly called a j-pouch. Most people with ulcerative colitis do not require surgery, but are able to manage their condition with medication.


Having IBD can impact your life in many real ways. Not only can the symptoms be painful, but 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 a bathroom accident. Consider keeping a kit with wipes and a change of clothes in a bag you can easily grab it and take to the restroom with you when needed. You can stash this at your desk, in your trunk, locker, or anywhere it's easily accessible to you.

Talk to Your Friends and Family

You may feel embarrassed to talk to your loved ones about your gastrointestinal problems, but you need to let the people close to you know what you're going through on a daily basis. And don't be afraid to ask for what you need, whether it be more help around the house when you're experiencing a flare up, or simply someone to vent to when things get rough.

Find a Support Group

Support for people with IBD is also more accessible, both online and offline, as the stigma of the condition is being broken down. Finding a group of people who understand what you're going through can make you feel less alone.

A Word From Verywell

Unfortunately, the cause of each of these intestinal disorders is poorly understood and neither of them has a cure. The symptoms are distressing, embarrassing, and even debilitating. Research and awareness are necessary in the fight to overcome IBD.

The good news is that treatments are improving every year. There are new medications being tested and approved that have better remission rates and fewer adverse effects than ever before.

Being diagnosed with IBD is difficult and life-altering. However, most people with it live fulfilling lives, get married, have children, and enjoy successful careers. Managing IBD through a close relationship with a gastroenterologist is going to be the key component to achieving remission and avoiding related complications.

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