Inflammatory bowel disease, or IBD, is a general term that reflects an abnormal immune response resulting in inflammation of the intestinal tract.
Inflammatory bowel disease, or IBD, is a general term that reflects an abnormal immune response resulting in inflammation of the intestinal tract. The two most common forms of IBD are ulcerative colitis and Crohn’s disease. Both diseases are believed to be caused by an abnormal response in the body’s immune system so that the digestive tract mistakes food and other materials as foreign substances. This stimulates a response to attack the cells of the intestines by sending white blood cells to the area to produce inflammation.
Ulcerative colitis is a chronic condition that affects the colon or large bowel only and is limited to the inner layer of the colon. The lining of the colon becomes inflamed and develops tiny, open sores (ulcers) that produce pus and mucus.
Symptoms of Ulcerative Colitis
One of the first symptoms of ulcerative colitis is loosening of the stool, which usually is bloody and may be accompanied by abdominal cramping and the severe urge to have a bowel movement (tenesmus). Other symptoms of ulcerative colitis include:
- Decreased appetite
- Weight loss
- Anemia (from intestinal bleeding)
- Skin lesions
- Joint pain
- Eye inflammation
- Liver disorders
- Failure to thrive (in children)
Ulcerative colitis may present some or all of these symptoms, and symptoms can be sporadic or consistent. In about half of all patients with ulcerative colitis, the disease is mild. Months or even years of remission may separate flare-ups. This makes it challenging for doctors to decide the best course of treatment. In the most severe cases of ulcerative colitis, patients may experience significant bleeding, severe abdominal pain and may require removal of the colon (colectomy).
Types of Ulcerative Colitis
There are four major types of ulcerative colitis:
This is a milder type of ulcerative colitis, which has fewer complications and affects about 30 percent of patients with ulcerative colitis. Inflammation is isolated to the rectum.
This colitis involves the rectum and the lower segment of the colon called the sigmoid colon.
Increasing in severity, this colitis involves continuous inflammation from the rectum to the bend in the colon under the stomach.
This condition affects the entire colon. Generally speaking, this is the most severe form of colitis, which may ultimately require colectomy.
Treatment Options for Ulcerative Colitis
There are four classes of medication used to treat ulcerative colitis: mesalamines, steroids, immune modifiers and biologics. Approximately half of patients will have disease control with mesalamines. Ten to 15 percent of patients will eventually require surgery.
When medications and diet are not successful, surgery is required to remove the colon. In many patients, surgeons can create an internal pouch from the small bowel and attach it to the anal sphincter muscle. This eliminates the need for the patient to wear an external ostomy appliance, where wastes are emptied into a pouch on the exterior of the abdomen. The advantage of removing the colon is that once the colon is eliminated, ulcerative colitis cannot recur again.
Named for Dr. Burrill Crohn who described the disease in 1932, Crohn’s disease produces chronic inflammation, which may involve any portion of the gastrointestinal tract. This disease affects at least 700,000 Americans. Most often, it affects the small bowel and the beginning of the colon, but it may affect any part of the digestive system from the mouth to the anus. There is also a wide range of severity in Crohn’s disease. It may affect all layers of the intestine, and frequently there may be healthy bowel tissue located between tissues.
Symptoms of Crohn’s disease may include:
Loss of appetite
Delayed growth and development in children