Inflammatory bowel disease (IBD) affects approximately 90,000 people across Australia and New Zealand. IBD describes a group of disorders with chronic inflammation of the gastrointestinal tract. The two major IBD conditions are ulcerative colitis and Crohn’s disease.
IBD should not be confused with irritable bowel syndrome (or IBS). IBS is a condition related to bowel function rather than inflammation, which is the cause of ulcerative colitis and Crohn’s disease.
What’s the Difference between Ulcerative Colitis and Crohn’s Disease?
The major difference between these two conditions is that they affect different areas of the gastrointestinal (GI) tract. This GI tract, also called the digestive tract, includes the mouth cavity, throat, oesophagus, stomach, small intestines and large intestines (or colon), rectum and anus.
With ulcerative colitis, inflammation occurs only in the large intestine (or colon). It also affects only the innermost layers of the colon wall.
In Crohn’s disease, inflammation may occur anywhere along the entire digestive tract. There may be patches of inflammation as well as patches of healthy intestine. The inflammation also generally extends into all layers of the intestinal wall.
What are the Signs and Symptoms?
Though there are some differences between ulcerative colitis and Crohn’s disease symptoms, they can be somewhat similar. Symptoms that are shared by both conditions include:
- Diarrhoea with blood and mucus
- Abdominal pain and cramping
- Pain and rectal bleeding with bowel movement
- Urgent need to have a bowel movement
With both disorders, it is common to have disease flare-ups, which are periods of active illness followed by periods when symptoms are mild or not present. Other IBD symptoms may also include loss of appetite, weight loss, and malnutrition. Some complications of IBD include anaemia, inflammation of the skin, eyes joints and liver. More severe complications include bowel perforations, and colorectal cancer.
What Causes IBD? And Who’s at Risk?
The exact cause for ulcerative colitis or Crohn’s disease is not known; however, doctors believe it is due to an abnormal immune response. The cause of this abnormal response is unclear but it may result from exposure to bacteria, viruses or other foreign matter that causes inflammation and damage to the intestine. Diet and stress do not cause IBD but they may worsen symptoms.
Possible risk factors for both ulcerative colitis and Crohn’s disease may include:
- Family history – you have a higher chance of having IBD if your family member has it
- Age – they are most commonly diagnosed in people less than 30 years of age; however, it can be diagnosed at any age
- Environmental factors – IBD is more common in developed countries and urban areas
How is it Diagnosed?
There is no specific test for ulcerative colitis or Crohn’s disease. Your doctor will ask you about your symptoms, and your family history. In addition to conducting a physical exam, your doctor may order tests or procedures – these may include: blood or stool test, X-ray, MRI, CT scan, colonoscopy or endoscopy (this involves a flexible tube inserted through the anus or the opening of the mouth through to the small intestine).
How is it Treated?
IBD is a chronic condition and requires long-term treatment. There is no cure for IBD; however, with the combination of medicine, diet/nutritional and emotional support, and possibly surgery, you may be able to help reduce your symptoms, be in remission for longer periods of time and prevent flare-ups.
Some people with ulcerative colitis and Crohn’s disease do not respond or lose response to medication and surgery may be required. With ulcerative colitis, it may be possible to eliminate the disease with surgery – but this involves removal of the entire colon and is therefore a serious undertaking.
Crohn’s disease, on the other hand can be more progressive. Many patients with Crohn’s disease will no longer respond to medication and will require surgery. Unlike ulcerative colitis, in which surgery can result in possibly eliminating the disease, patients with Crohn’s disease will not have the disease eliminated after surgery, because Crohn’s disease can occur anywhere along the GI tract and the surgery is only for sections of the bowel that have either a blockage or severe disease.
What to Do If You Have IBD?
Make an appointment with your doctor or a specialist such as a gastroenterologist. Some things you can do to prepare for your visit include:
- Keep a record of your symptoms
- Make a list of the medications you take
- Write down any medical conditions that you have
- Write down any questions that you might have for your doctor
Because there is no specific test for IBD, getting the right diagnosis may be frustrating or time consuming for many people. However, it is important to speak with your doctor. With proper medical care, you and your healthcare team can work together to find a treatment that works for you and to ultimately help keep you in remission. So don’t give up!
Amy S. Marren, MD is the lead for inflammatory bowel disease in Global Medical Affairs at Pfizer.
- 1. Price Waterhouse Coopers. Improving Inflammatory Bowel Disease Care Across Australia. 2013. Crohn’s & Colitis Australia. Accessed 6/2/2017.
- 2. NZ Ministry of Health. Accessed 6/2/2017.