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Inflammatory bowel disease or 鈥淚BD鈥� encompasses two major conditions: ulcerative colitis and Crohn鈥檚 disease. Both lead to chronic inflammation in the intestine, though each has specific characteristics. It is not known what causes the inflammation, but it is hypothesized that both genetic factors and environmental exposures are contributors. According to this theory, intestinal inflammation develops in genetically susceptible individuals after an initial environmental or infectious trigger.

What is Ulcerative Colitis?

The term 鈥�-itis鈥� refers to inflammation, thus ulcerative colitis is inflammation of the colon. Unlike Crohn鈥檚 disease, ulcerative colitis or 鈥淯C鈥� affects only the colon (the large bowel) and causes inflammation and ulceration of the lining of the colon. Different amounts of the colon may be affected, but the inflammation is always continuous and always involves the rectum. The inflammation can include the rectum alone (鈥減roctitis鈥�), extend from the rectum up to the left colon (鈥渓eft-sided colitis鈥�), or involve the entire colon (鈥減ancolitis鈥�).

Symptoms of ulcerative colitis often include diarrhea, blood in the stool, and abdominal or rectal pain. Patients often have 鈥渦rgency,鈥� meaning they have to get to a bathroom right away. They may also feel like they haven鈥檛 completely emptied their bowels. Although diarrhea is the most common symptom of ulcerative colitis, some patients may actually experience constipation. Other symptoms include fever, weight loss, or low blood counts (anemia). Inflammation can also affect other parts of the body and cause rashes, joint pains, or eye changes.

What is Crohn鈥檚 Disease?

Crohn鈥檚 disease can affect anywhere along the gastrointestinal tract from the mouth to the anus. Unlike ulcerative colitis, the inflammation is not always continuous and there can be areas of normal bowel in between areas of inflamed bowel. Crohn鈥檚 disease can cause inflammation of just the intestinal lining or can cause deeper inflammation. Deep inflammation can affect the full thickness of the bowel wall and can lead to complications of Crohn鈥檚 disease. These complications include stricture (or narrowing) of the bowel, abscess (or infection), and fistulae, which are abnormal connections between two parts of the body. Fistula can occur between two parts of the intestine, between the intestine and the skin, or between the intestine and other nearby organs like the bladder or vagina.

Symptoms of Crohn鈥檚 disease can be more variable than ulcerative colitis and depend on what part of the bowel is affected. If the colon is involved then symptoms can be very similar to ulcerative colitis, with diarrhea and passage of blood or mucus. If the small intestine is involved, then symptoms may include diarrhea and vitamin or nutrient deficiencies due to decreased absorption in the inflamed intestine. If there is a narrowing or blockage in the bowel then patients may have crampy abdominal pain, nausea, vomiting, weight loss, or decreased bowel movements. If Crohn鈥檚 disease affects the skin near the anus then patients can have drainage, pain, or swelling of the perianal area. Like ulcerative colitis, Crohn鈥檚 disease can cause inflammation of other parts of the body. The most common are inflammation of the joints (arthritis), skin or eyes. Rare sites of inflammation include the liver and bile ducts, pericardium (sac surrounding the heart), pancreas, and blood (leading to blood clots).

What is Indeterminate Colitis or IBD-U?

Sometimes your doctor may use the term 鈥渋ndeterminate colitis鈥� or IBD-U. This means that we鈥檙e not quite sure if the inflammation of the colon is from Crohn鈥檚 disease or ulcerative colitis. About 5-10% of patients with IBD carry the diagnosis of indeterminate colitis or IBD-U. It doesn鈥檛 make a big difference because treatments for both are similar and with time things may become clearer.

Diagnosis

IBD is diagnosed by a combination of patient history, imaging, blood work, stool analyses and endoscopic evaluation (usually colonoscopy and/or upper endoscopy). Your doctor may order blood work to look for signs of inflammation or specific deficiencies (such as iron deficiency) and also exclude an intestinal infection with stool tests. Different types of imaging can also identify inflammation in the intestine. Generally, an upper endoscopy or colonoscopy can be done to look directly at the bowel and take biopsies of the affected tissue. Sometimes, a pill camera test is used to look at the small bowel that is beyond the reach of our endoscopes. Putting together all of the testing can help your doctor make a diagnosis of inflammatory bowel disease.

Treatment

Many treatments for Crohn鈥檚 disease and ulcerative colitis overlap. Medications may be used alone or in combination. Your doctor may choose which medications to use based on type of disease, severity, and other medical conditions you may have. The goals of treatment are to decrease inflammation and improve symptoms and quality of life. For more information on specific medications please see the Crohn鈥檚 and Colitis Foundation .

Some forms of IBD may require surgery due to stricture or narrowing, infection, fistula formation, or severe inflammation unresponsive to medications. The 黑料网 Multidisciplinary Center is designed to facilitate a team approach to your care before, during, and after surgery.

IBD and Pregnancy

Most IBD medications are safe to continue throughout pregnancy and breastfeeding. The American Gastroenterological Association has information and guidelines for treatment of IBD during pregnancy at the . Our providers are here to help if you are pregnant or thinking about becoming pregnant.