Inflammatory Bowel Disease (IBD)

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Overview

Crohn’s Disease and Ulcerative Colitis

Crohn’s disease and ulcerative colitis are inflammatory bowel diseases that involve chronic inflammation of the digestive tract. Crohn’s disease can affect any part of the GI tract from the mouth to the anus, and typically involves the small intestine with, or without, involvement of the colon. Crohn’s disease can be painful and debilitating, and can range from mild to severe symptoms. The exact cause of Crohn’s disease is unknown although there are several factors that can increase your risk, such as:

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Heredity

Crohn’s is more common if you have a family member with the disease.

Age

You are more likely to develop Crohn’s if you’re younger although it can occur at any age.

Ethnicity

Crohn’s can affect any ethnic group, although it occurs more often in whites, especially those of Eastern European Jewish descent (Ashkenazi).

Cigarette smoking

puts you at a higher risk of developing Crohn’s disease.

Non-steroidal anti-inflammatory medications

can lead to bowel inflammation and aggravate your Crohn’s disease.

Ulcerative colitis typically only occurs in the colon and the rectum. It causes inflammation and ulcers in the lining of your large intestine. It is a chronic condition that may have periods of normalcy and exacerbations, but it can be managed with the right treatment. Ulcerative colitis begins when your immune system mistakes your good gut bacteria and cells lining your colon as intruders and attacks them. This then causes inflammation and ulcers as your white blood cells, which usually protect you, attack the lining of your colon. Doctors don’t know why people get the disease, but it sometimes runs in families.

You should see your Saint John’s Physician Partners doctor if you have persistent change in bowel habits or if you have any symptoms of Crohn’s disease or ulcerative colitis. With proper diagnosis and treatment, we can help you get your life back on track.

Symptoms

Crohn’s Disease and Ulcerative Colitis Symptoms

Symptoms may range from mild to severe and can have periods of active inflammation followed by periods of remission. Signs and symptoms that are common to both Crohn’s disease and ulcerative colitis include:

Abdominal cramps and pain

are the most common symptoms of inflammatory bowel disease (IBD)

Diarrhea or altered bowel functions

are among the most common symptoms of Crohn’s disease and ulcerative colitis

Rectal bleeding and bloody stools

are more common in ulcerative colitis; however, you may experience bleeding from the rectum during bowel movements with Crohn’s disease as well

Reduced appetite

is common, but sometimes you may experience an increased appetite or intense hunger

Unintended weight loss

is not unusual

Fatigue

is common in Crohn’s disease, but sometimes fatigue, usually associated with anemia due to blood loss, can also occur in ulcerative colitis

Iron deficiency anemia due to blood loss

is a common problem when you have Crohn’s disease or ulcerative colitis, causing anemia

Diagnosis

Crohn’s Disease and Ulcerative Colitis Diagnosis

Your doctor may use the following tests to aid in the diagnosis of IBD:

Colonoscopy

is an effective tool in diagnosing Crohn’s disease

Sigmoidoscopy

is an outpatient procedure like a colonoscopy that uses a long thin tube with a light and camera at the end inserted into your rectum to look inside your colon

Upper endoscopy

is an outpatient procedure that uses a tiny camera on the end of a long flexible tube inserted down your throat and into your esophagus, stomach, and into the top of your small intestine (duodenum) to help identify Crohn’s disease and ulcerative colitis

Wireless capsule endoscopy

is non-invasive and uses a capsule you swallow with a camera that takes thousands of pictures as it travels through your digestive tract; the pictures are transmitted to a recording device for your doctor to review later

Stool testing

is an important tool in identifying Crohn’s disease and ulcerative colitis and is usually conducted at home

Blood testing

looks for antibodies or other markers that indicate you may have Crohn’s disease or ulcerative colitis

Imaging

such as magnetic resonance imaging (MRI) is a practical, non-radiating, non-invasive method for evaluating Crohn’s disease and ulcerative colitis

Complications

Crohn’s Disease and Ulcerative Colitis Complications

Crohn’s disease and ulcerative colitis can have serious complications in the intestines if untreated, including:

Perforation of the bowel
Profuse intestinal bleeding from the ulcers
Narrowing of, and obstruction, of the bowel
Fistulae (abnormal passage) and perianal disease, which is disease of the tissue around the anus
Anal fissure, a small tear in the tissue that lines the anus
Toxic megacolon, which is extreme dilation of the colon and is life-threatening
Malnutrition
Severe dehydration

Other long term complications may include:

Colon cancer
Skin, eye and joint inflammation
Arthritis
Kidney disorders
Bone loss
Blood clots
Primary sclerosing cholangitis, which is scarring within the bile ducts and can cause liver damage

If you experience any of the above signs and symptoms, you should see your doctor immediately to verify the cause and receive appropriate treatment.

Treatments

Crohn’s Disease and Ulcerative Colitis Treatments

There is no known cure for Crohn’s disease or ulcerative colitis. The primary goal of treatment is to reduce the inflammation that brings on the signs and symptoms. In some cases, treatment may not only relieve symptoms that restore the quality of life, but also bring about long-term remission. Treatments may also reduce the chance of complications from your treatment, which is usually involves drug therapy and possibly surgery.

Drug Therapy

Drug therapy may include anti-inflammatory drugs, immune system suppressors, biologics, antibiotics and other medications such as pain relievers.

Anti-inflammatory drugs are often the first step in treating Crohn’s and ulcerative colitis and will depend on the area of the colon affected.
Immune-suppressors work in a variety of ways to suppress immune response that releases inflammation-inducing chemicals.
Biologics are a form of therapy that is directed towards neutralizing proteins in the body that are causing inflammation.
Antibiotics may be used when infection is a concern.
Other medications may be recommended such as:
- Anti-diarrheal medications.
- Pain relievers.
- Vitamins and supplements.
Additionally, your doctor may recommend nutritional support to improve your overall nutrition.

Surgery

If diet, drug therapy and other treatments don’t relieve your Crohn’s and ulcerative colitis signs and symptoms, your doctor may recommend surgery:

Surgery for ulcerative colitis involves the removal of the entire colon and rectum. Your surgeon may create a permanent opening in your abdomen through which stool is passed for collection in an attached bag.
Surgery for Crohn’s disease involves removing your damaged portion of your digestive tract that is then reconnected to the healthy sections. You surgeon may also close fistulas and drain abscesses.

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