Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease (IBD) is an umbrella term that refers to both ulcerative colitis and Crohn’s disease. However, about 10% of patients cannot reliably be put into either category based on their evaluation, and are characterized as having indeterminate colitis.
Ulcerative colitis is a chronic disease of the colon in which inflammation of the mucosa (lining) of the large intestine occurs.
Crohn’s disease can cause chronic inflammation of the lining and wall (transmural) of the large and/or small intestine. Additionally, a small percentage of patients can have Crohn’s of the upper gastrointestinal system (mouth, esophagus, stomach).
The most common symptoms of ulcerative colitis, which occurs in the lining of the colon (large intestine) and/or rectum only, are diarrhea, rectal bleeding—often with mucous—and abdominal pain.
Patients who suffer from Crohn’s disease, an inflammatory and ulcerative process that often extends to the deep layers of the intestinal wall, may experience pain in the abdomen, often in the lower right side, diarrhea, weight loss and occasionally bleeding. Some Crohn’s patients present with obstructive symptoms, specifically sudden onset of uncontrollable nausea, vomiting, and abdominal pain.
Both Crohn’s disease and ulcerative colitis are chronic illnesses with periods of remission (when your disease is inactive and you feel well) and relapse (when your disease is active and you feel ill). Many patients with IBD will also have irritable bowel syndrome (IBS), which may mimic certain symptoms of IBD, but in IBS there is no bleeding or other evidence of tissue inflammation. Occasionally, patients may have a superimposed bacterial infection which may mimic IBD symptoms, with bleeding, diarrhea, and pain. Your doctor will work with you to discern between these, which have very different treatment plans.
There are many different types of treatment plans that your doctor can prescribe to control the symptoms and improve patient outcomes of those living with IBD, and each of these has specific therapeutic actions and potential risks. Fortunately, the last two decades have been a time of incredible advancement in developing effective and safe treatments to control IBD.
Causes
IBD occurs most frequently in people in their late teens and twenties. However, there are also cases in children and in older adults in their seventies and eighties.
The cause of IBD is likely a combination of genetics, environment, and altered immune system activity. Genetics is the most common identifiable reason for developing IBD. There are over 200 genes that can increase the risk of developing IBD. About 15 percent to 30 percent of patients with IBD have a relative with the disease.
Another theory suggests dysregulation of the body’s intestinal immune system (body’s natural defense system against disease) is a major cause of IBD. What is still unknown is why this occurs. There are some environmental factors that may increase the risk such as smoking, antibiotic use, urban living, cesarean section, and diets high in processed foods. Contrary to this, being active, exposure to farms and animals in childhood, and having been breastfed may reduce the risk of getting IBD.
Stress or certain foods do not independently cause IBD. As with other illnesses, stress may aggravate symptoms of IBD or IBS and require a specific treatment program.