Doctor's Notes on Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease (IBD) is a term for a group of diseases that cause inflammation of the intestines believed to be due to autoimmune disease. The two main diseases are Crohn's disease and ulcerative colitis. Crohn's disease (also termed Crohn disease) is chronic inflammation of any part of the digestive tract, although it usually involves the terminal small bowel, cecum, and anus. The most common signs and symptoms of Crohn's disease include
- diarrhea,
- crampy or steady pain in the right lower abdomen (sometimes relieved for a short time by a bowel movement),
- pain or bleeding with a bowel movement, and
- in some individuals, bloating after eating, constipation, and/or infections of the urinary tract or vagina (caused by fistula formation).
The following general symptoms may occur in some patients: fatigue, weight loss, and low-grade fevers. Ulcerative colitis is an acute or chronic inflammation of the colon (large bowel or large intestine). Signs and symptoms include inflammation of colon tissue and it can produce sores and ulcers; it is usually limited to the colon and rarely affects the small intestine, except for the terminal ileum. Common signs and symptoms of ulcerative colitis include
- frequent loose stools (sometimes with blood),
- lower abdominal discomfort and pain,
- fever,
- lethargy,
- appetite loss,
- weight loss,
- bowel incontinence, and
- anemia.
Occasionally, other body organs may be involved (for example, eye problems, joint problems, neck or back pain, skin rashes, liver and bile duct problems and/or kidney problems).
The exact causes of inflammatory bowel diseases are unknown. Theories suggest they may occur due to a combination of genetic (familial), environmental, dietary, blood vessel, and/or psychosocial factors that cause the disease. Other researchers theorize the immune system is the cause by overreacting to a virus or bacterium.
What Are the Treatments for Inflammatory Bowel Disease?
Crohn's and ulcerative colitis are the major inflammatory bowel diseases. There is no cure for Crohn's disease. Treatments are individualized and designed to give symptom relief and, in some, long-term remission. The following are treatments that may be used alone or in combination for Crohn's disease:
-
Anti-inflammatory drugs
- Corticosteroids
- Oral 5-aminosalicylates
- Immune system suppressors
-
Biologics
- Vedolizumab
- Tumor necrosis factor inhibitors
- Ustekinumab
- Antibiotics
-
Other symptom-reducing medications
- Anti-diarrheals
- Pain reducers
- Supplements like vitamins
- Nutrition (diet) therapy
-
Surgery
- Abscess drainage
- Fistula closure
- Removal of a diseased portion of the GI tract with reconnection
The following are some of the treatments for ulcerative colitis that may be used alone or in combination:
-
Anti-inflammatory drugs
- Corticosteroids
- Oral 5-aminosalicylates
-
Immune system suppressors
- Azathioprine
- Cyclosporine
- Tofacitinib
-
Biologics
- Vedolizumab
- Tumor necrosis factor inhibitors like adalimumab
- Ustekinumab
-
Other symptom-reducing medications
- Anti-diarrheals
- Pain reducers
- Supplements like vitamins, iron
- Nutrition (diet) therapy
-
Surgery may eliminate ulcerative colitis in some individuals
- Removal of a diseased portion of the GI tract with reconnection
- Ileoanal anastomosis (does not require a waste collection bag)
- Removal of your entire colon and rectum
- Ileal stoma (requires a bag to collect waste)
You and your doctors may decide what treatments are best for your condition.
Stomach Pain : Nausea & Other Causes Quiz
QuestionBowel regularity means a bowel movement every day.
See AnswerMust Read Articles:
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Abdominal Pain (Adults)
Learn about causes, symptoms, and treatment of abdominal pain in adults and when to seek medical care for related conditions such as pancreatitis, diverticulitis, Crohn's disease, ulcerative colitis, and more. -
Crohn's Disease
Crohn's disease (Crohn disease) is an inflammatory bowel disease (IBD), and is a chronic long-term inflammation of the digestive tract. The cause of Crohn's disease is unknown. Symptoms of Crohn's disease include diarrhea, constipation, abdominal pain, rectal bleeding, bloating, and infections of the urinary tract and vagina. Treatment for Crohn's disease includes lifestyle changes in diet, medication, and surgery. -
Crohn's Disease Anatomy
Crohn's disease is an inflammatory bowel disease (IBD), and any part of the digestive tract can be involved (from the mouth to the anus). Symptoms of Crohn's disease include bloating, constipation, and pain or bleeding with a bowel movement (rectal bleeding). Crohn's disease can cause complications in the digestive system. Nutritional complications are common in people with Crohn's disease. -
Crohn's Disease Diet
People with Crohn's disease have many challenges, particularly their dietary and nutritional needs. Some foods may aggravate symptoms, while other foods may not cause problems. Malnutrition is a concern with people with Crohn's disease. Foods that may aggravate symptoms include high fiber foods like popcorn, nuts, and vegetables, alcohol, milk and other dairy products, spicy foods, fatty foods, and fried foods. Often, a parenteral nutrition (TPN) or elemental diet may be recommended to reduce symptoms of Crohn's disease. -
Crohn's Disease FAQs
Crohn's disease (Crohn disease) is a chronic condition that is characterized by inflammation of the digestive tract. Crohn's disease is considered an inflammatory bowel disease (IBD). Symptoms of Crohn's disease include diarrhea, constipation, abdominal pain, bloating, and fever. Treatment options include diet changes, medication, and surgery. The prognosis for Crohn's disease depends on the patient and the areas affected by Crohn's disease. -
Crohn's Disease in Children and Teens
Crohn's disease is an inflammation of the small intestine. Crohn's disease is also referred to as inflammatory bowel disease. Crohn's disease in children and teens generally develop symptoms before the age of 20. Symptoms include watery diarrhea, abdominal pain, weight loss, appetite loss, and slowed growth. Management of Crohn's disease in children and teens is possible with medication and lifestyle changes. -
Crohn's Disease Treatment Medications (Side Effects, List)
Crohn's disease medications prescribed for the treatment of the disease, and symptom relief include aspirin like anti-inflammatories, for example, mesalamine (Asacol, Pentasa, Apriso, Lialda, Canasa, Rowasa), olsalazine (Dipentum), and sulfasalazine (Azulfidine, EN-Tabs). Corticosteroids, for example, budesonide (Entocort), methylprednisolone (Solu-Medrol), prednisolone (Delta-Cortef), and prednisone (Deltasone, Orasone). Immunosuppressants, for example, azathioprine (Imuran), 6-mercaptopurine (Purinethol), and methotrexate (Folex). Biologic drugs, for example, infliximab (Remicade), adalimumab (Humira), and certolimumab (Cimzia). Review the list of these drugs and their side effects. -
Crohn's Disease: Living With Crohn's Disease
Living with Crohn's disease can be stressful, depressing, and frustrating. Crohn's disease is not curable, but there are a variety of things that can improve the quality-of-life for people with the disease, for example, medications, lifestyle changes, diet, and surgery. -
How Do You Get Crohn’s Disease?
A coworker of mine has Crohn's disease and I’m worried I might contract it. Is Crohn's disease contagious? -
Rectal Bleeding
Read about causes of rectal bleeding, including hemorrhoids, anal fissures, polyps, tumors, trauma, and inflammation of the bowel. Also learn when to see a doctor for medical treatment. -
Rectal Pain
Rectal pain occurs due to many causes, such anal fissures, hemorrhoids, and inflammatory bowel disease. Learn about symptoms, diagnosis, and treatment. -
Stomach Pain (Abdominal Pain) in Children
Abdominal pain in children can range from trivial to life-threatening. Symptoms of abdominal pain range from vomiting, diarrhea, fever, groin pain, urinary problems, or skin rash. The location of the abdominal pain may be around the belly button, occurs only at night, while eating. The pain pain also may be intermittent. Treatment of abdominal pain in children is depends on the cause. Possible causes of abdominal pain in children include infections, food related (food allergy or food poisoning), poisoning from medication, food, household products, appendicitis, diabetes, or spider bites. -
Ulcerative Colitis
Ulcerative colitis (UC) is an acute or chronic inflammation of the membranes that line the colon. Symptoms and signs of UC include abdominal pain, diarrhea, rectal bleeding, urgency for a bowel movement, fever, fatigue, and lack of appetite. Treatment for UC includes medication and lifestyle changes. On occasion, surgery may be a necessary treatment for ulcerative colitis.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.