What is IBD?
Crohn’s Disease and Ulcerative Colitis are two of the most important diseases in a group of illnesses known collectively as Inflammatory Bowel Disease (IBD).
Although they are different diseases they are difficult to tell apart, and indeed are often treated in a similar manner. When there is definite evidence of chronic inflammation but it is not possible, at least at first, to decide whether it is Crohn’s Disease or Ulcerative Colitis it is referred to as Indeterminate Colitis and in rare cases may remain ‘indeterminate’ for a considerable length of time.
Crohn’s Disease is characterised by inflammation of one or more areas of the digestive tract, with normal areas of gut between, and can occur anywhere from the mouth to the anus but most commonly in the large and small intestine. This inflammation may lead to ulceration, abcesses and strictures in the bowel. Additionally, Oral Crohn’s affecting the mouth and lips is being seen frequently in children. There may also be inflammation of the joints, skin and eyes.
Ulcerative Colitis is characterised by inflammation, causing severe ulceration and bleeding, but it only affects the large intestine. As with Crohn’s Disease there may also be inflammation of the joints, skin and eyes.
Both conditions are chronic (long lasting) and very debilitating. They should not be confused with irritable bowel syndrome (IBS), a far less serious unrelated condition.
Inflammatory Bowel Disease can appear at any time and does not discriminate. It can affect young or old, male or female, rich or poor and any race, colour or creed.
Severity of the illness varies between individuals, some suffer constantly while others have long periods in remission.
Symptoms can include constant abdominal pain, loss of blood, vomiting, fever, diarrhoea (to the point of incontinence) or constipation, loss of appetite leading to malnutrition, weight loss and severe lethargy.
Treatment is tailored to suit each patient. In some cases a special liquid feed or less powerful drugs may bring about a remission but often large doses of steroids or some of the newer biological drugs, such as azathioprine or infliximab, become necessary. Sometimes surgery is needed to remove the diseased area but this is not a cure in Crohn’s Disease but can be so in Ulcerative Colitis. A resection, where a small part of the bowel is taken out and the ends joined together, may be all that is needed, or in the worse case the bowel is removed and an opening made on the surface of the stomach with a bag fitted to collect body waste (ileostomy). Sometimes an ileostomy can be formed to rest the bowel and reversed at a later date. In some cases of Ulcerative Colitis an internal pouch can be formed. Keyhole surgery is now bringing a new dimension to bowel surgery.
At present there is no known cause or cure for IBD (other than removing the whiole large bowel in patients with Ulcerative Colitis) but research is producing more effective treatments.