Written by Dr. Mahesh Cheryala, Internal Medicine Resident, The Wright Center for Graduate Medical Education
There are many unanswered questions and concerns about Crohn’s disease and ulcerative colitis, two forms of inflammatory bowel disease (IBD), especially if someone close to you has been diagnosed. Let us look and identify the symptoms, treatments and tips for living with these diseases.
Crohn’s disease and ulcerative colitis are chronic disease conditions affecting the lining of the gastrointestinal tract. Both Crohn’s disease and ulcerative colitis are caused by chronic inflammation in the lining of the bowel mucosa, constituting major disease entities of IBD. Crohn’s disease can manifest anywhere within the digestive tract and ulcerative colitis is typically localized in the colon (large intestine) and rectum (end of the large intestine).
According to Centers for Disease Control and Prevention, there has been a significant increase in the disease burden from almost 1 to 1.3 percent during the past 15 years with about 3 million people currently suffering from IBD. Approximately 70 to 150 new cases are diagnosed per 100,000 people. Historically, males and females are equally affected, but recent trends show males are slightly more affected by ulcerative colitis. Both Crohn’s disease and ulcerative colitis are more common in Caucasians, compared to African American and Hispanic populations.
Causes and risk factors:
The exact cause of both Crohn’s disease and ulcerative colitis is unclear, but several risk factors have been identified as significant. In IBD, the patient’s immune system activates inappropriately against foreign triggers causing inflammation in the lining of gastrointestinal tract, which directly, or indirectly, contributes to the clinical symptoms and complications.
Important risk factors shown to increase risk of IBD include:
Signs and symptoms:
Patients with IBD have a wide variety symptoms and signs, with most symptoms common in both Crohn’s disease and ulcerative colitis.
These symptoms may occur in waves, can vary in severity and patients may be symptom-free for some time. If any of these symptoms occur, see a primary care physician for review and assessment. The provider will organize basic tests before referring to a gastroenterologist. The gastroenterologist may run a specialized blood test and endoscopy or colonoscopy depending upon the patient’s symptoms.
The goal of treatment is to keep patients in remission while preventing flare-ups and future complications. Most patients with IBD are treated with anti-inflammatory medication, steroids or more potent medications like immunomodulators and biologics.
Is there any cure?:
Crohn’s disease and ulcerative colitis are chronic conditions. Symptom control and remission can be achieved with medications, but a complete cure is difficult to achieve.
Tips for living with IBD: