Inflammatory Bowel Disease, Including Crohn’s Disease and Ulcerative Colitis

Inflammatory Bowel Disease Treatment

Inflammatory bowel disease (IBD) is a blanket term for disorders that inflame the digestive tract chronically. Types of IBD include ulcerative colitis (UC), and Crohn’s disease, both of which affect different parts of the colon in different ways. A patient can have either UC or Crohn’s disease, or they may be diagnosed with both. Read on to learn more about these different forms of IBD, how IBD differs from IBS, and how to manage this chronic inflammation with inflammatory bowel disease treatment.

What Is Inflammatory Bowel Disease?

As mentioned, IBD refers to UC, Crohn’s disease, or both. While these two disorders present differently, both inflame the digestive tract. There is disagreement among the medical community on whether IBD is an autoimmune disorder or a disease that, instead of attacking itself, is attempting to attack bacteria, food in the stomach, or viruses, which can cause bowel injury and inflammation. Inflammatory bowel disease also has periods of flare-ups, where the GI tract is most inflamed, and periods where the condition is dormant. It is during flare-ups that patients can experience severe symptoms without proper inflammatory bowel disease treatment.

IBD vs. IBS

IBD and irritable bowel syndrome (IBS) are often confused with each other, perhaps because of the similarity in acronyms. However, these are two distinctly different conditions.

It’s important to remember that inflammatory bowel disease is a disease, while irritable bowel syndrome is just that—a syndrome, which refers to a group of symptoms. While both conditions require lifelong symptom management and treatment, IBD is much more serious than IBS.

IBS mainly affects bowel function. You may have a change in bowel movements, such as sudden diarrhea and/or constipation. However, IBS does not inflame the colon and does not increase your risk of colorectal cancer, as IBD does. Patients rarely need serious treatment for IBS; it is managed through diet, lifestyle changes, and medication. People with IBD, however, may require more serious treatment, like strong medicines to suppress the immune system and surgery.

Types of Inflammatory Bowel Disease

Ulcerative colitis and Crohn’s disease are the two types of IBD, and they affect different areas of the colon and rectum. Crohn’s disease can cause inflammation throughout the entire GI tract, from the mouth to the anus. While it can affect part of the small intestine, it is most commonly found throughout the small intestine and the top of the large intestine (colon). This amount of swelling and inflammation can vary between a few scattered patches to large parts of the small and/or large intestine.

In contrast, ulcerative colitis causes patchy sores and ulcers in the large intestine only (including the rectum). It does not affect the small intestine and is usually uniform starting in the rectum and affecting other parts of the colon.

There is also a third, less common form of IBD called microscopic colitis. The inflammation is so minute that it needs a microscope to detect it for diagnosis.

What Are the Symptoms of IBD?

Even though UC and Crohn’s disease affect different parts of the digestive tract, they share many common symptoms. The symptoms of inflammatory bowel disease are erratic—they can come and go, they can be mild or severe during flare-ups, and you may have a sudden onset or experience symptoms gradually. However, the symptoms are noticeable. Symptoms of IBD may include:

• Abdominal pain
• Bloating and gas
• Mucus or blood in the stool
• Upset stomach
• Unexplained weight loss
• Loss of appetite
• Diarrhea 

Rarer symptoms of IBD include:

• Nausea and vomiting
• Itchy or red eyes
• Unexplained fatigue 
• Fever
• Skin rashes
• Ulcers (sores)
• Vision problems
• Joint pain 

If you are experiencing several of these symptoms, whether regularly or intermittently), you should consult your gastroenterologist, particularly if you find blood in the stool, as it can be a symptom of more serious GI diseases. These symptoms warrant inflammatory bowel disease treatment.

Risk Factors of Inflammatory Bowel Disease

Physicians and researchers do not know the exact cause of inflammatory bowel disease. However, certain proven risk factors can increase the risk of developing IBD. These include:

• Family history of IBD This includes first-degree relatives, such as parents, siblings, and children with IBD
• Smoking. Cigarette smoking greatly increases the chance of developing Crohn’s disease.
• Ethnicity. Caucasians have a greater risk of developing IBD.
• Age. The majority of IBD diagnoses occur before the age of 30. However, it is possible to develop inflammatory bowel disease later in life.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). If you use NSAIDs regularly, it increases the risk of developing IBD.

When to Call a Doctor About IBD

If you have several symptoms of IBD or you notice blood in the stool, you should consult your gastroenterologist for a diagnosis. IBD is a long-term, lifelong disease that requires proper inflammatory bowel disease treatment to manage symptoms.

Diagnosing IBD may take several diagnostics. Because UC and Crohn’s disease share the same symptoms, it is difficult to diagnose if both diseases are present, or just one.

First, our physician will ask about your family history and conduct a complete blood count (CBC) blood test. They may also perform a fecal occult stool test.

For a proper diagnosis and subsequent inflammatory bowel disease treatment, your physician needs to get a closer look at your small intestine and colon. They may perform:

• Colonoscopy. A thin, flexible tube is inserted into the anus and rectum to examine the large and small intestines. A camera is at the end of the tube to provide photos.
• Flexible sigmoidoscopy. This is similar to colonoscopy, however, it only examines the sigmoid (lower) portion of the colon, and the rectum and anus.
• Upper GI endoscopy. This uses a thin, flexible tube with a camera attached at the end to examine the digestive tract from the mouth to the top of the small intestine (duodenum).
• Capsule endoscopy. You swallow a capsule with a camera attached that lets your provider see your digestive tract.
• Endoscopic ultrasound (EUS). This uses endoscopy to perform an ultrasound. The test looks for ulcers and swelling in the GI tract.

Treating IBD becomes the next topic of discussion if you receive a diagnosis. Treatment varies on the severity of the disease and which disease has been diagnosed. The goal of inflammatory bowel disease treatment is to keep it in remission so the patient doesn’t have flare-ups. Unfortunately, there is no cure, but IBD can be well-controlled.

Doctors may prescribe medications first to arrest symptoms. These can include:

• Aminosalicylates, which can control irritation in the intestines
• Antibiotics
• Corticosteroids
• Biologics, which can disrupt inflammatory signals from the immune system
• Immunomodulators, which can control an overactive immune system
• Antidiarrheals 
• Supplements, such as pre-and probiotics

Medications can keep symptoms at bay for some time, but for many with IBD, they stop working or cause additional unwanted side effects. According to the Crohn’s and Colitis Foundation, 23 to 45 percent of patients with ulcerative colitis will eventually need surgery, and roughly 75 percent of those with Crohn’s will require surgical inflammatory bowel disease treatment.

Surgery could include removing an inflamed bowel section, anastomosis (connecting healthy bowels), colectomy (complete removal of the colon), proctocolectomy (complete removal of the colon and rectum), and connecting the small intestine with the anus.