AMITA Health Endoscopy Center Lincoln Park

Inflammatory Bowel Disease (UC/Crohn’s Disease)

Overview

Inflammatory bowel disease (IBD) refers to chronic digestive tract inflammation. There are two main types:

  • Ulcerative colitis (UC). UC is characterized by ulcers (open sores) along the shallow or superficial lining of your colon (large intestine) and rectum.
  • Crohn’s disease. Crohn’s involves inflammation which can affect the entire digestive tract and even the deeper layers.

Both UC and Crohn’s are usually characterized by abdominal pain, diarrhea and other symptoms in common. IBD can be incapacitating and lead to severe, life-threatening complications.

Risk factors for developing IBD include cigarette smoking, excessive use of non-steroidal anti-inflammatory medications (NSAIDs) such as naproxen and ibuprofen, and family history. Most patients with IBD develop it before the age of 30, but others can be diagnosed into their 50s or 60s.

The cause of IBD is unknown, but an abnormal immune response is a possible mechanism. Researchers believe your own immune system attacks the cells in the digestive tract when trying to fight off an invading bacterium or virus. Genetics or heredity may also play a role even though most people with IBD do not have a family history of IBD.

Diagnosis is through a combination of lab tests and endoscopic procedures. Endoscopic procedures are non-surgical procedures utilizing a long tube with a light and a camera on the end, as well as tools for taking tissue samples (biopsies). They can examine the colon (colonoscopy) or the upper gastrointestinal tract (upper endoscopy, which investigates down to the upper small intestine).

Symptoms

  • Abdominal pain and cramping
  • Diarrhea
  • Rectal bleeding and blood in stool
  • Fatigue
  • Reduced appetite and unintentional weight loss
  • Complications of UC:
    • Toxic megacolon. A rapid widening and swelling of the colon.
    • Severe dehydration. From excessive diarrhea.
    • Perforated colon. A hole or perforation in the colon. May develop on its own or be associated with toxic megacolon.
  • Complications of Crohn’s disease:
    • Malnutrition. Your small intestine may not be able to absorb enough nutrients and vitamins due to inflammation and diarrhea. Anemia may develop due to poor iron or vitamin B-12 absorption. Also, abdominal pain and cramping may make it difficult for you to eat.
    • Bowel obstruction. Crohn’s disease can affect the full thickness of the intestinal wall causing it to thicken over time. This thickening may block the flow of digestive contents, and you may require surgery to remove the thickened portions of your bowel.
    • Anal fissures. Anal fissures are small tears in the tissue that lines the anus, often associated with painful bowel movements. Infections can occur near fissures.
    • Fistulas. A fistula is an abnormal connection between different body parts. They can form in Crohn’s due to inflammation that extends entirely through the intestinal wall. They may become infected and form abscesses. Most common area is perianal fistulas (near and around the anal area).

Treatments

Medications. Treatment can be oral or intravenous (IV) medications. Medication classes include anti-inflammatory drugs, antibiotics, immune system suppressors, biologics and various other medications and supplements. Pain relievers such as acetaminophen (Tylenol) may help, and fiber supplements can help slow diarrhea.

Surgery. Surgery for UC involves removal of the entire colon and then either reattachment to the anus via a pouch to avoid an external bag, or a connection through the abdominal wall (ileal stoma) to an external bag for stool collection. Surgery for Crohn’s disease involves removing the damaged section of the digestive tract and connecting the good ends, but this procedure is not a cure. The disease often recurs. Up to two-thirds of Crohn’s patients will require surgery in their lifetime.

Prevention

Diet. Certain foods may worsen your flare-ups, especially dairy products, and they should be limited. You should also eat smaller meals more often, consider multivitamins, drink plenty of fluids to avoid dehydration and talk to a dietitian for an overall diet plan.

Stop smoking.

Decrease stress. Relaxation and breathing techniques, exercise and biofeedback.

Support. Join a support group and talk to a therapist.