Inflammatory Bowel Disease
Nearly a million men and women in the United States are affected by inflammatory bowel disease (IBD). Most cases occur in individuals between the ages of 15 and 30 years old – which is relatively young considering that colon cancer and other colorectal diseases usually present themselves later in life. For this reason, many people live with Crohn’s Disease for years before receiving a proper diagnosis.
Cases of IBD are concentrated in western civilizations, leading experts to believe that IBD is primarily caused by a person’s diet and lifestyle. Genetics and health choices, such as how often you smoke or exercise, also affect your chances of being diagnosed. Inflammatory bowel disease should not be confused with irritable bowel syndrome (IBS), which is not as serious of a condition as it does not affect the actual tissue structure of the bowel.
There are two main types of chronic inflammatory bowel disease: Crohn’s Disease and Ulcerative Colitis (UC). The two conditions are extremely different, but patients affected by either will most likely experience similar symptoms. They may find themselves burdened by severe cases of vomiting, rectal bleeding, diarrhea, cramps and abdominal pain. Many patients lose their appetites and lose weight. A doctor can diagnose a patient with IBD with a colonoscopy, a barium enema or stool tests.
Crohn’s Disease is an autoimmune disease that can occur at various points along the gastrointestinal (GI) tract, from the opening of the mouth to the anus– but the majority of cases happen at the terminal ileum, located near where the small and large intestine meet. Inflammation occurs deep into the tissue of the bowel wall, not only the lining.
In addition to the expected symptoms of inflammatory bowel disease, Crohn’s Disease patients might experience complications elsewhere in or on the body, such as skin rashes, arthritis, fatigue and inflammation in the eyes. Sometimes these external symptoms can be severe, resulting in large, open sores on the surface of the skin.
With Ulcerative Colitis (UC), inflammation is restricted to the inner lining of the intestine. The disease can result in swelling, redness and ulcers. In most cases, inflammation worsens near the rectal area and causes frequent diarrhea. Some affected individuals may detect blood or mucous in their stool— an indicator that part of patient’s colon has been damaged. Unlike Crohn’s disease, Ulcerative Colitis affects only the large bowel. Both of these conditions; however, significantly increase your risk for colorectal cancer, and if diagnosed close followup with a gastroenterologist for surveillance colonoscopies should be undertaken. Treatment
There are few cures for inflammatory bowel disease, but rather practiced measures to keep the disease in remission and suppress symptoms. In most cases, IBD is treated with anti-inflammatory drugs like mesalamine to control the inflammation and discomfort. When mesalamine doesn’t work, your doctor might prescribe to you some immunosuppressant drugs such as prednisone for short term flares. Some patients require longterm use of immunosuppressant drugs such as azathioprine, 6-mercaptopurine, or in cases where those do not work – remicaid or humira.
Unfortunately, almost every IBD patient will experience flare-ups from time to time. These relapses vary from every couple of weeks to every few years, depending on the individual. If left unattended, IBD can lead to intestinal complications such as development of colorectal cancer, fistula formation, blockage and abscesses. Please contact one of our colonoscopy specialists if you think you might be affected by inflammatory bowel disease.
Reviewed 12/12/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014