What is IBD?
The term inflammatory bowel disease (IBD) is commonly used to refer to Crohn’s disease and ulcerative colitis. These chronic diseases cause inflammation and ulceration in the inner lining of the gastrointestinal (GI) tract. Crohn’s disease and ulcerative colitis afflict people of all ages, but more that 25 percent of cares are diagnosed before the age of 20.
Crohn’s disease can affect any part of the GI tract from the mouth to the anus. However, the lower part of the small intestine (ileum) and the large intestine (colon) are most often involved. The lining of the intestines becomes raw and ulcerated with inflammation that can extend through the entire thickness of the intestinal wall.
Ulcerative colitis is a disease of the colon. Intestinal inflammation is similar to Crohn’s in that the inside lining of the colon is diseased, but the bowel injury occurs n the inner lining of the colon and does not extend deeper into the intestinal wall.
Symptoms
IBD symptoms (which are similar for both Crohn’s and ulcerative colitis) can develop gradually or suddenly.
The symptoms of Crohn’s disease vary depending on the severity and location of the inflammation, and include:
- Abdominal pain
- Lack of appetite
- Diarrhea
- Weight loss
- Rectal bleeding
Anal sores, extra folds of skin around the anus, and anal fistulas are other signs of Crohn’s disease.
Ulcerative colitis symptoms include:
- Bloody, loose stools
- Abdominal pain with cramps
- Persistent urge to have a bowel movement
Some children with Crohn’s disease and ulcerative colitis may also experience rashes, mouth sores, joint pain and growth failure.
Diagnosis
In addition to a thorough medical history and physical examination, three tests are used to identify IBD:
- Blood tests
- Barium X-rays
- Endoscopies
Treatment
Often, the same drugs are used to treat Crohn’s disease and ulcerative colitis:
- Drugs containing 5-aminosalicylic acid (5-ASA) to reduce inflammation in the intestine
- Corticosteroids
- Immunosuppressive agents
- Antibiotics
Dietary therapy can have the same effects as drug therapy. IBD dietary therapy may include consumption of predigested formula by mouth or feeding tube. It may also involve not eating altogether, but receiving nutrition through an intravenous line (total parenteral nutrition/TPN). Dietary therapies are mostly used in treating Crohn’s disease when drug therapies have not been effective or have caused too many side effects.
Surgery may be necessary in Crohn’s disease when medications no longer control symptoms or when an intestinal obstruction or other complication arises. In most cases, surgery involves removing the irreversibly diseased segment of the bowel and then rejoining the two ends of the healthy bowel together.
For ulcerative colitis, surgically removing the entire colon and rectum is a permanent cure. A small opening called an ileostomy is created in the front of the abdomen, where the remaining small intestine is attached, to drain liquid waste into a small bag attached to the skin. Later, the lowest part of the small intestine may be reattached to the anal opening. Once healed, the ileostomy is closed and feces will move normally through the anus.