Crohn's & Colitis Awareness Week: Understanding IBD

One in 100 Americans live with Crohn’s disease or ulcerative colitis— collectively known as inflammatory bowel disease or IBD. While many people have heard of Crohn's and colitis, most do not fully understand IBD, the impact of their ‘invisible’ symptoms have the lives on others, or even that they are lifelong conditions.

Given December 1-7 is Crohn’s & Colitis Awareness Week, we wanted to shine a light on IBD—what causes it, common symptoms, and strategies for living with it successfully.  

WHAT IS IBD?

IBD is the common name used to describe two chronic diseases of the intestinal tract―Crohn’s disease and ulcerative colitis―that cause inflammation in the intestines:

Crohn’s disease can affect any part of the gastrointestinal tract from the mouth to the anus.

Ulcerative colitis is typically limited to the colon and rectum.

CAUSES OF IBD

The exact cause of IBD is unknown, but IBD is the result of an autoimmune disorder, meaning the body’s immune system attacks healthy tissues.

Researchers are working to understand why IBD develops in some people and not in others. IBD can run in families, but it can also develop randomly even if you do not have a family history of the disease. IBD can affect people in any ethnic or racial group, but statistically, people of Jewish ancestry have a greater risk of developing it.

SYMPTOMS OF IBD

While ulcerative colitis and Crohn's disease may affect different parts of the gastrointestinal tract, they usually present with the same symptoms. These include:

• abdominal pain
• persistent diarrhea
• urgent need to have a bowel movement
• rectal bleeding or bloody stools
• weight loss
• fatigue
• anemia

Some people also experience joint and body aches, lack of appetite, rashes, and redness of the eyes and even problems with vision.

Symptoms of IBD may come and go but are often triggered by something that irritates the intestines, such as a medication (including aspirin, ibuprofen, and antibiotics) or an infection. While the source of irritation typically goes away, the immune system may continue to respond as if the irritant is still present, leading to ongoing symptoms of IBD.

TREATMENTS FOR IBD

Treatment for IBD involves either medication or surgery. The goal of treatment is to reduce inflammation and minimize symptoms with the best-case possible outcome of treatment being long-term remission. 

For most patients, the first line of attack is one (or more) of the following medications.

Anti-inflammatory drugs to reduce inflammation in mild to moderate cases. In some cases, time-limited courses of corticosteroids are also used to induce remission.

Immune system suppressors to prevent the body from attacking itself and causing inflammation. 

Antibiotics may be used is an infection is suspected or of concern.

Biologics work to neutralize proteins that may be contributing to inflammation.

If medication doesn’t provide relief, surgery may be recommended.

Surgery for ulcerative colitis involves removal of the entire colon and rectum. In some cases, an internal pouch will be created that allows bowel movements without a bag. When an internal pouch is not possible, a permanent opening will be cut into the abdomen through which stool is passed for collection in an attached bag.

Surgery for Crohn's disease involves removing the damaged portion of your digestive tract and reconnecting the remaining healthy sections.  While up to two-thirds of people with Crohn's disease undergo at least one surgery in their lifetime, the benefits of surgery are usually temporary.

Because there’s currently no cure for IBD, patients need to work with their doctor to develop a treatment plan that provides long-term symptom relief. Landing on the best treatment option requires time and patience. However, once you find what works—and you commit to sticking with it—it is possible to improve both your outlook on and the quality of your life.

If you suffer from IBD, visit the #IBDVisible page of the Crohn’s & Colitis Foundation website for information on navigating life with IBD, tips for families and kids managing IBD, fellow patient stories, and support. 

If you have concerns about recurring abdominal or GI issues, contact your doctor to determine next steps for diagnosing and treating your condition.

David Furman, MD,  is a gastroenterologist at Southwestern Vermont Medical Center.