Inflammatory bowel disease (IBD)
About one in 2000 people have inflammatory bowel disease (IBD), a chronic problem in which sections of the intestine have recurrent attacks of inflammation. IBD usually starts fairly early in life, most cases appearing between the ages of 15 and 30. Both sexes are affected equally.
There are 2 forms of IBD: ulcerative colitis and Crohn's disease.
Ulcerative colitis
Ulcerative colitis is confined to the lower end of the intestine (colon and rectum) and affects only the surface lining. The main symptom is increasing diarrhoea, usually with blood mixed in with the motions. Abdominal cramps are common, with a painful urge to open the bowels, a sensation called tenesmus. Going to the toilet usually relieves the pain.
Crohn's disease
In Crohn's disease, the symptoms can be less obvious in the early stages and will depend on which part of the bowel is involved. It affects the full thickness of the intestine and can occur anywhere along the length of the digestive system, from mouth to anus. Often there is recurrent abdominal pain, especially after eating, which may go on for months before diarrhoea begins. Mild fever, nausea and vomiting may also occur. If the upper end of the intestine, known as the small bowel, is involved, there may be marked weight loss due to failure to absorb food.
What causes IBD?
The cause of IBD is still being studied, but it appears likely that it is due to an abnormality of the body's immune system. Symptoms may occur in other parts of the body, such as joint pains, skin rashes and sore eyes.
How is IBD diagnosed?
The diagnosis of IBD will depend on a number of tests which may include X-rays of the bowel and direct inspection through a special instrument, known as a colonoscope. A sample of the bowel wall may be taken for microscopic examination.
How is IBD treated?
Treatment consists of tablets to control the symptoms and suppress the inflammation, adequate nutrition if that has been affected, and sometimes surgery. A section of affected bowel may be removed and the healthy ends rejoined. Sometimes, when a lot of bowel is affected, it is necessary to make a permanent opening on the stomach wall for the bowel to empty. This is known as a colostomy or ileostomy. Modern surgical techniques mean that this is less common than it used to be.
With careful attention to their medications and diet, most people with IBD will be able to keep their illness under control most of the time.
Last Reviewed: 10 July 2001
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