Inflammatory Bowel Disease (Ulcerative Colitis and Crohn’s Disease)

These are inflammatory disorders of the bowels where the lining of the bowel becomes red and inflamed.  Ulcerative colitis affects mainly the lining of the rectum and colon.  In Crohn’s disease any part of the digestive tract can be affected and the inflammation affects the whole thickness of the wall.  Crohn’s disease can affect the small and large bowel and sometimes can be difficult to separate from ulcerative colitis if it affects the colon.

 The cause of these diseases is not known but there are a multitude of theories about an unknown virus or bacterial infection.  The symptoms are mainly of frequent and urgent need to pass motion, blood and mucous, diarrhoea a few times a day, abdominal pain and weight loss and generally feeling unwell and tired.  In Crohn’s disease there are similar symptoms if it is affecting the colon, if it is affecting the small bowel then there are more symptoms of abdominal pain, bowel obstruction, weight loss and sometimes abnormal connections (fistulas) between the small bowel and other organs. 
Inflammatory bowel disease is diagnosed mainly by taking a history; by endoscopic assessment of the bowels either colonoscopy or sigmoidoscopy. Various X-rays with contrast for small bowel and large bowel could be used. Also more recently CT and MRI scans are used for diagnosing small and large bowel inflammatory bowel disease.  In severe cases of colitis other parts of the body can be affected such as the skin, the lower back joints and the eyes and what is known as extra intestinal manifestations of inflammatory bowel disease. 

Inflammatory bowel disease is treated medically mainly by a gastroenterologist by using various anti-inflammatory drugs and in some cases immunosuppressants and steroids.  Surgical intervention is required if there is a suspicion of cancer or failure of medical treatment and usually requires removal of the colon or the part of the small bowel affected and in many cases patients end up having a stoma such as ileostomy or a colostomy. 

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