May 23, 2024
Inflammatory Bowel Disease

Understanding Crohn’s Disease, Ulcerative Colitis, and Their Management: A Comprehensive Overview

Crohn’s Disease

Crohn’s disease is a chronic inflammatory condition that can affect any part of the gastrointestinal tract from mouth to anus. With Crohn’s disease, all layers of the gastrointestinal tract can be involved in the inflammatory process from the inner lining to the outermost layers. The inflammation involved in Crohn’s disease is intermittent but persistent. Some key facts about Crohn’s disease include:

Common symptoms of Crohn’s disease include abdominal pain, diarrhea, rectal bleeding, weight loss, and fever. The symptoms vary greatly depending on which part of the gastrointestinal tract is affected. For example, if the small intestine is involved, it may cause diarrhea, abdominal pain, weight loss and malnutrition. If the large intestine is affected, it can lead to diarrhea with blood, abdominal pain and possible complications like anal fistulas or abscesses.

The exact cause of Crohn’s disease is unknown but it is believed to be due to a combination of genetic, immunological and environmental factors. Genetic factors play a major role as Crohn’s disease seems to run in families. Abnormal immune response to intestinal bacteria is also believed to trigger inflammation in Crohn’s disease. Smoking and stress are some environmental factors linked to exacerbation of symptoms.

The diagnosis of Crohn’s disease involves physical examination, laboratory tests, endoscopy and biopsy of the intestinal lining to determine inflammation and rule out other causes. A colonoscopy and esophagogastroduodenoscopy (EGD) allows viewing of the intestine and taking biopsies. Other tests like CT enterography, MRI enterography and small bowel follow through can be done to see inflammation in small intestine.

There is no cure for Crohn’s disease and treatment focuses on inducing and maintaining remission of symptoms. Mild disease is treated with medications that dampen the immune system like aminosalicylates and corticosteroids. For moderate to severe disease, immunomodulators and biologic medications that target tumor necrosis factor are commonly used. In severe refractory cases, surgery may be required to remove diseased portions of the intestine.

Ulcerative Colitis

Ulcerative colitis is a chronic Inflammatory Bowel Disease that typically only involves the large intestine or colon. Unlike Crohn’s disease, only the innermost lining of the colon and rectum are involved in ulcerative colitis. Some key facts about ulcerative colitis are:

The hallmark symptoms of ulcerative colitis are altered bowel habits involving diarrhea mixed with blood, mucus or pus. Abdominal discomfort, cramping and urgency to have a bowel movement are also common. Symptoms usually develop gradually over time. However, some people may experience a worsening of symptoms where they experience severe diarrhea, fever, rapid heartbeat and anemia, a condition known as fulminant colitis.

The exact cause of ulcerative colitis is unknown, but it is believed to involve an abnormal response of the immune system to intestinal bacteria in a genetically susceptible host. Genetics plays a role as those with family history have higher risk. Environmental factors like smoking, infection and stress may also contribute to disease onset or exacerbation.

Diagnosis involves an evaluation of symptoms along with colonoscopy and biopsies of the colon and rectum. Biopsies show inflammation only affecting the inner lining of the colon. Blood tests may reveal anemia or elevated inflammatory markers. Imaging tests like CT scans are sometimes done to check for any complications.

The goal of treatment is induction and maintenance of remission through medications, nutrition therapy and sometimes surgery. Mild to moderate disease is usually treated with medications like aminosalicylates and corticosteroids. Immunomodulators and biologics are given for moderate to severe disease. Total colectomy or removal of the entire colon may be required in some severe ulcerative colitis cases that do not respond to medical therapy or have complications.

Complications of IBD

Although treatment aims to control symptoms and induce remission, IBD can sometimes lead to complications if not managed properly. Some potential complications of both Crohn’s disease and ulcerative colitis include:

– Strictures: Narrowing of the bowel lumen due to chronic inflammation resulting in blockages. Can occur in Crohn’s disease.

– Fistulas: Abnormal connections between intestines and internal organs or skin surface. Common in Crohn’s disease.

– Abscesses: Collection of pus occurring commonly around anus and rectum in Crohn’s disease.

– Hemorrhage: Bleeding occurring along the intestinal tract due to ulcerations and inflammation. Seen in both Crohn’s and ulcerative colitis.

– Colon cancer: People with extensive ulcerative colitis involving pancolitis over many years have increased risk of colon cancer.

– Nutritional deficiencies: Anemia, vitamin B12 deficiency, osteoporosis due to malabsorption and inadequate nutrition intake.

– Treatment side effects: Adverse effects from long-term use of steroid medications like osteoporosis and infections. Immunosuppressants increase infection risk.

*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it