Inflammatory bowel disease causes lifelong symptoms
Q: What is inflammatory bowel disease?
A: Inflammatory bowel disease (IBD) usually refers to two conditions: Crohn's disease and ulcerative colitis. Both cause ongoing inflammation of the digestive tract.
In both types of inflammatory bowel disease, the body's immune system starts attacking the intestinal tissue. This attack may be an example of "collateral damage." The immune system may be attacking bacteria in the intestine, and cause inflammation of the intestine as a result.
Whatever the reason, the immune system does what it shouldn't do: attacks normal intestinal tissues. That's why inflammatory bowel disease is called an "autoimmune" disease.
In Crohn's disease, inflammation injures the small intestine, although it also can affect the large intestine (and other parts of the body). As a result, the inside lining and deeper layers of the intestinal wall become inflamed and irritated. The lining thickens or wears away in spots. This creates ulcers, cracks, fissures and pockets of pus. Abnormal connections between organs in the digestive tract often form as well.
Once Crohn's disease begins, it causes lifelong symptoms that come and go. Symptoms may include:
• abdominal pain
• diarrhea
• sores around the anus
• drainage of pus or mucus from the anus
• pain during bowel movements
• loss of appetite
• joint pain
• back pain
• eye pain or vision changes
• weight loss
• fever
• weakness or fatigue
Most medications for Crohn's disease prevent inflammation in the intestines. This helps improve symptoms.
Surgery may also be done to remove a section of the bowel, particularly when the disease keeps recurring.
Ulcerative colitis is also a lifelong condition. It usually begins in the rectum, then worsens to involve some or all of the large intestine. In ulcerative colitis, the lining of the rectum and colon wears away in spots, bleeds and oozes mucus or pus.
A person with ulcerative colitis may not always have symptoms. When symptoms occur, they may include:
• cramping abdominal pain
• bloody diarrhea
• little warning before needing to have a bowel movement
• fever
• fatigue
• decreased appetite
• weight loss
• dehydration
Most medications for ulcerative colitis prevent inflammation in the intestine. Others decrease colon spasms to make symptoms less painful. Surgery is an option for some people. Sometimes avoiding certain foods, such as spicy foods and milk products, helps improve symptoms.
Both types of IBD - Crohn's disease and ulcerative colitis - can increase your risk of getting colon cancer. If you have IBD, ask your doctor how often you should be tested for colon cancer.
• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.