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Topic Overview
What is inflammatory bowel disease (IBD)?
Inflammatory bowel disease (IBD) is a group of disorders that cause inflammation or ulceration of the digestive tract.
Depending on the type of IBD, any part of the digestive tract from the mouth to the anus may be affected. The small and large intestines, the rectum, and the anus are affected most often.
Ulcerative colitis and Crohn's disease are the most common types of inflammatory bowel disease. Ulcerative colitis is more common than Crohn's disease. Doctors may use other names, such as proctitis (inflammation of the rectal lining), to describe inflammatory bowel disease in a specific part of the intestine.
What causes IBD?
The cause of IBD is not known. However, it is believed to develop in people who have a genetic tendency. In these individuals, the immune system may overreact to normal intestinal bacteria, causing inflammation.
Disease-causing bacteria and viruses also may play a role in triggering inflammatory bowel disease.
What are the symptoms of IBD?
The main symptoms are abdominal pain, rectal bleeding, and diarrhea. Constipation, fever, and loss of appetite also may occur.
In some cases complications develop outside the intestines. These include problems with the eyes, liver, blood, and bones.
Inflammatory bowel disease is a long-term (chronic) condition that may flare up many times in your life. You may have long periods without symptoms, or you may have only mild symptoms. A few people have symptoms that are persistent and severe.
Many people who develop IBD are between the ages of 10 and 30. Children may have the same symptoms as adults. In addition, children with IBD may grow more slowly than normal and go through puberty later than expected.
Some people who have IBD also have irritable bowel syndrome (IBS), which is not as serious as IBD. IBS causes abdominal pain along with diarrhea or constipation.
How is IBD diagnosed?
A doctor looks for inflammation using lighted scopes—a flexible sigmoidoscope in the lower portion of the large intestine or a colonoscope in the entire large intestine.
Crohn's disease may not be seen using a sigmoidoscope or colonoscope because it may occur only in the small intestine. Therefore, a doctor may use your symptoms and other tests to distinguish ulcerative colitis from Crohn's disease. These include blood tests and imaging tests such as barium enema, upper gastrointestinal (GI) series, abdominal X-ray, and computed tomography (CT) scan.
How is IBD treated?
Treatment depends on your age and the severity and extent of the disease. Options range from antidiarrheal medication or a change in diet for mild IBD to strong medications or surgery in severe cases. Some people with IBD may have nutritional problems that require additional care.
Many of the same medications are used to treat ulcerative colitis and Crohn's disease. The type of medication depends on the severity of the disease, the part of the intestines affected, and whether you have complications. Medications include those to reduce inflammation and suppress the immune system. You also may be given antibiotics to fight an infection.
If you have Crohn's disease that is causing abnormal connections, or fistulas, between structures in the anal area, you may take an antibody (infliximab) that promotes healing of fistulas. You also may take this medication if you do not respond to corticosteroids for Crohn's disease.
Surgery may be done to remove affected parts of the intestines. Removal of the entire colon (total colectomy) cures ulcerative colitis. However, surgery cannot cure Crohn's disease. It tends to come back in previously unaffected areas.
How will IBD affect my life?
Inflammatory bowel disease affects everyone differently. People who have only mild symptoms that respond to home treatment may cope well with the disease. But for others, IBD can be a frustrating and depressing condition. The persistent diarrhea that often occurs with IBD may make you feel as if your life revolves around the bathroom. You may feel isolated, be embarrassed by the symptoms, and have a poor body image. These feelings may keep you from participating in work, social, and sexual activities.
Medication and in some cases surgery can help you live a normal life. Seek support from family, friends, clergy, or a professional counselor. IBD can cause psychological stress, which in turn may affect the course of the disease. A strong social network may reduce stress and make the disease less active.
