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We all experience the occasional stomach ache from time to time. Maybe you ate something that didn’t agree with you or caught a stomach bug. While this is often just an unfortunate part of life, frequent and debilitating stomach aches and pain may indicate a more serious illness, such as inflammatory bowel disease (IBD).
IBD is an umbrella term for both Crohn’s disease and ulcerative colitis. Both conditions are characterized by chronic inflammation of the gastrointestinal tract, also known as the GI tract. The GI tract includes the mouth, esophagus, stomach, small intestine, large intestine, rectum, and anus. The CDC estimates that 3 million U.S. adults have IBD.
For some, IBD is mild, but for others, it can lead to life-threatening complications.
What is the difference between Crohn’s disease and ulcerative colitis?
Crohn’s disease can affect the entire GI tract (mouth to anus) but most typically affects the small intestine. When looked at during a colonoscopy or endoscopy, the areas damaged by Crohn’s disease appear patchy, and it causes significant inflammation in the GI tract.
Ulcerative colitis affects the large intestine (also known as the colon) and rectum. When examined, damaged areas are continuous and usually start at the rectum and spread into the colon. Inflammation is only present in the innermost layer of the colon lining.
Causes
Most people with IBD are diagnosed before the age of 30. The exact causes of both IBD conditions are unknown, but IBD often results from a weakened immune system. Many clinicians think that possible triggers are:
- In the past, the immune system responded incorrectly to a virus or bacteria, attacking tissue in the GI tract and causing inflammation
- Gene mutations or a family history of IBD
- Nonsteroidal anti-inflammatory medications (ibuprofen, naproxen sodium), which increase your risk or make the disease worse if you already have it
- Race and ethnicity: white people and Ashkenazi Jews have a higher risk of developing IBD
Symptoms of Chrohn’s Disease and Ulcerative Colitis
Although they affect different parts of your GI tract, both Crohn’s disease and ulcerative colitis cause the same symptoms, including diarrhea, abdominal pain, bleeding ulcers, bowel obstruction, rectal bleeding, bloody stools, loss of appetite, weight loss and malnutrition due to reduced appetite, and fatigue.Diagnosis
Your provider can help determine whether you have Crohn’s disease or ulcerative colitis by obtaining a thorough medical history, a physical exam, and a review of your symptoms. They may also order diagnostic testing, including blood and stool samples, diagnostic imaging, and an endoscopic procedure.Treatment Options
The main goal of IBD treatment is to reduce inflammation, relieve symptoms, reduce potential complications, and hopefully lead to remission.Your clinician might consider several treatment options based on your needs and the severity of your IBD. These include:
- Surgery to remove damaged portions of the GI tract, although this is less effective for Crohn’s disease
- Anti-inflammatory medication
- Short term corticosteroids for ulcerative colitis
- Immune system suppressors, which can suppress the immune response that causes inflammation
- Biologics, which are a new kind of therapy aimed at neutralizing proteins that cause inflammation
- Antibiotics if you’re at risk of infection in the GI tract
- Your provider may also recommend you take:
- Over-the-counter anti-diarrheal medications like Imodium® or fiber supplements such as Metamucil®
- Tylenol® or other generic acetaminophen products as anti-inflammatory medications, such as ibuprofen and naproxen, can worsen symptoms
Complications
While some people experience mild IBD symptoms, others might be at risk of complications. Prolonged inflammation damages the GI tract and can cause a variety of health issues, depending on whether you have Crohn’s disease or ulcerative colitis.If you have either form of IBD, you might be at risk of:
- Colon cancer: You should have regular colon cancer screenings 8-10 years after diagnosis. Ask your Atrius Health provider how often these screenings should be repeated if you’re at risk for colon cancer.
- Skin, eye, and joint inflammation, as well as arthritis
- Blood clots
- Severe dehydration from diarrhea
- Primary sclerosing cholangitis or inflammation in your bile ducts, though this is rare
- Bowel obstruction
- Malnutrition, anemia, or a B-12 deficiency due to a lack of appetite
- Fistulas (holes between different parts of the GI tract)
- Anal fissures (associated with painful bowel movements)
- Toxic megacolon, which happens when inflammation causes all or part of your colon to swell wider than normal, which pushes toxic substances around the body
- Perforated colon, when a hole is torn in the wall of the colon, generally caused by a toxic megacolon
