Digestive Problems
Diseases: Small Bowel: Inflammatory Bowel Disease
Find out about the Charleston area Crohn's & Colitis support group.
There are two major forms of inflammatory bowel disease (IBD); Crohn's disease and ulcerative colitis. The small bowel and colon are primarily involved in Crohn's disease, with inflammation extending deeply into the intestinal wall, causing thickening which may narrow or even block the intestinal channel. In ulcerative colitis, the major focus is large intestinal mucosal inflammation originating in the rectum and lower colon and spreading to the entire colon. The inflammation causes frequent colonic emptying resulting in diarrhea, and as colonic surface cells die and are cast off, bleeding ulcers develop; a distinct and common sign of ulcerative colitis is blood in the stool.
Men and women are equally affected by IBD, and the disease may run in families. In children, Crohn's disease slows growth and may delay sexual development. Complications of Crohn's disease may arise as bowel obstructions, or as inflamed ulcerous tracts or fistulas which form channels into adjacent intestinal segments or even into nearby organs such as urinary bladder, vagina or surface skin. In these cases, surgical treatment may be indicated; however, inflammation often returns to sites of surgical intervention.
Together these disorders affect more than 500,000 Americans, and although a compromised immune response is implicated in the typical inflammatory reactions in the intestinal wall, the triggering event, possibly a bacterial or viral infection, is as yet unknown. The disorders are diagnosed through physical exam, including tests for anemia resulting from blood loss in the stool, increased white blood cells indicative of an inflammatory condition, and endoscopy, whereby the intestinal lining is viewed directly through a flexible tube inserted through the anus. Samples of inflamed intestinal tissue may also be taken at the same time for microscopic examination.
Abnormal inflammation, thickening or constriction of the intestine can also be seen by X-ray. Symptoms are persistent abdominal pain, bowel sores, diarrhea, intestinal bleeding, or weight loss. In some cases, the inflammatory processes associated with Crohn's disease and ulcerative colitis trigger skin lesions, joint pain, inflammation of the eyes, and liver disorders.
Treatment for both disorders includes dietary adjustments, medication, and surgery. No specific dietary regimens have proved efficacious, although avoidance of foods which exacerbate inflammation is recommended. Both Crohn's disease and ulcerative colitis are initially treated with sulfasalazine and mesalamine. More serious cases of Crohn's disease are treated with prednisolone, metronidazole or azathioprine. With ulcerative colitis, surgery becomes necessary in one in four patients, for whom the prognosis is usually good. While medication, diet, and surgery may lead to temporary remission, both disorders persist throughout the patient's lifetime.