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What Is IBD or Inflammatory Bowel Disease?

February 18, 2015
Inflammatory Bowel Disease (IBD) is a chronic inflammation of the intestines of unknown cause. The two main types of IBD are Crohn’s disease and ulcerative colitis, both of which have similar symptom. IBD can cause extreme fatigue and anemia, and if left untreated can lead to life-threatening complications, such as colorectal cancer. 


Symptoms

Both Crohn’s disease and ulcerative colitis have similar symptoms, including:  
  • Abdominal cramps or tenderness
  • Fever
  • Anemia (decrease in the number of red blood cells)
  • Fatigue
  • Weight loss 
  • Chronic diarrhea
Diarrhea is a common symptom. In severe cases, a patient may pass stool more than 10 times a day and be woken up in the night by the need to go to the toilet, sometimes with blood in the stool. 
 
It is difficult to differentiate between Crohn’s disease and ulcerative colitis from symptoms only. The main differences are as follows:
 
  Crohn’s disease Ulcerative colitis
Location of Inflammation Inflammation may occur anywhere along the digestive tract from the mouth to the anus, although it most commonly affects the lower part of the small intestine and the colon. The large intestine (colon) is the only affected area.
Characteristics There are 3 differences in characteristics:
  • The inflammation extends through the bowel wall leading to the formation of abscesses and a narrowing of the bowel and possible blockages.
  • Inflammation penetrates directly into adjacent organs.
  • Inflammation can spread all the way through the intestinal wall.
The colon wall is the only affected area. Other associated conditions include arthritis, conjunctivitis, and cholangitis.

 

Causes

The exact cause of IBD is not known. However, the condition occurs more frequently in the West and Middle East, and less frequently in Asia. 


Diagnosis

If you have been suffering from gastrointestinal problems such as chronic diarrhea and blood in your stool for more than two weeks, you should seek medical attention immediately for accurate diagnosis and treatment. In addition to checking your complete medical history, the doctor will request a stool sample. If no infection is found, the doctor will use a CT scan or colonoscopy to examine your intestines. This allows the doctor to analyze tissues and determine the location of the disease, while the colonoscopy also enables a small sample of tissue to be extracted for analysis and to confirm the diagnosis. 


Treatment

Treatment of both Crohn’s disease and ulcerative colitis usually involves taking mesalamine and steroids to reduce inflammation. The doctor will arrange routine appointments to monitor and control the disease.   
 
If the disease cannot be managed through medication or if severe complications develop, surgery may be required in the case of ulcerative colitis. However, surgical treatment is rarely used for Crohn’s disease because it is not curative and the disease commonly affects both the small and large intestines making surgery more difficult. Surgery will only be performed in cases of Crohn’s disease when the patient has suffered from the symptoms for a long time, has an intestinal obstruction caused by fibrous bands, or health problems associated with undernutrition.
 
By Dr. Sin Anurat, a gastrointestinal and liver specialist, Gastrointestinal and Liver Center, Bumrungrad Hospital
 
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