What is IBD?

What is Inflammatory Bowel Disease? 

 

The main forms of IBD are Crohn's disease and ulcerative colitis (UC). Inflammatory bowel diseases are considered autoimmune diseases, in which the body's own immune system attacks elements of the digestive system.

Accounting for far fewer cases are other forms of IBD, which are not always classified as typical IBD:

• Collagenous colitis
• Lymphocytic colitis
• Ischaemic colitis
• Diversion colitis
• Behçet's disease
• Indeterminate colitis

The main difference between Crohn's disease and UC is the location and nature of the inflammatory changes. Crohn's can affect any part of the gastrointestinal tract, from mouth to anus (skip lesions), although a majority of the cases start in the terminal ileum. Ulcerative colitis, in contrast, is restricted to the colon and the rectum. Microscopically, ulcerative colitis is restricted to the mucosa (epithelial lining of the gut), while Crohn's disease affects the whole bowel wall ("transmural lesions").

Finally, Crohn's disease and ulcerative colitis present with extra-intestinal manifestations (such as liver problems, arthritis, skin manifestations and eye problems) in different proportions.

Signs and Symptoms

Although very different diseases, both may present with any of the following symptoms: abdominal pain, vomiting, diarrhea, rectal bleeding, severe internal cramps/muscle spasms in the region of the pelvis and weight loss. Anemia is the most prevalent extraintestinal complication of inflammatory bowel disease. Associated complaints or diseases include arthritis, pyoderma gangrenosum, and primary sclerosing cholangitis. Diagnosis is generally by assessment of inflammatory markers in stool followed by colonoscopy with biopsy of pathological lesions.

Treatments 

Both Crohn’s disease and ulcerative colitis are treated with medications such as corticosteroids, which help reduce inflammation, and immunosuppressants, which block the harmful activities of the immune system.

Surgery may be required in cases that fail to respond to medication. Surgery usually involves removing an inflamed section of the digestive system. If you are diagnosed with Crohn’s disease, your care team will draw up a treatment plan for you. There are three goals in treating the condition. 

These are:

• to treat the active disease to relieve your symptoms
• to prevent your symptoms returning using maintenance therapy
• to treat any returning symptoms with relapse therapy
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Outlook 

 The outlook for most people with ulcerative colitis is usually quite good. Symptoms are often mild to moderate and can usually be controlled using medication.

However, an estimated one in five people with ulcerative colitis have severe symptoms that often respond less well to medication. In these cases, it may be necessary to surgically remove the colon.

The outlook for Crohn’s disease is highly variable. People can have long periods of remission that last for weeks or months where they have no, or very mild, symptoms, followed by periods where their symptoms flare up and are particularly troublesome.

There is currently no cure for Crohn’s disease. However, medication is available that can be used to treat the symptoms and prevent them from returning. About four out of five people with Crohn’s disease will require surgery to relieve their symptoms, repair damage to their digestive system and treat complications of the condition.