What is inflammatory bowel disease?
Inflammatory bowel disease (IBD) refers to a chronic (long term/ lifelong) inflammation or irritation of the stomach, small intestine and/or colon (large bowel). Inflammatory bowel disease should not be confused with irritable bowel syndrome (IBS). There are two types or categories of inflammatory bowel disease, Ulcerative Colitis and Crohn’s disease. Patients can have either type but not both. Occasionally one type of inflammatory bowel disease is diagnosed and with further testing or time the disease may be re-diagnosed as the other type.
What is the difference between ulcerative colitis and Crohn’s disease?
Ulcerative colitis and Crohn’s disease differ primarily in the portions of the bowel that they each involve and also the layers of the bowel wall that are involved. Ulcerative colitis involves only the large bowel. It can involve a part of the large bowel only or the entire large bowel but it does not have “skip” areas. Skip areas are areas of the intestine that are normal with abnormal areas on either side of them. Ulcerative colitis only involves the innermost layer of the bowel (the lining of the bowel) known as the mucosa. It does not involve deeper layers of the bowel.
Crohn’s disease on the other hand can involve any area of the gastrointestinal tract from the mouth to the rectum (the last portion of the colon) and the anus. Crohn’s disease involves not only the lining of the bowel, but can and usually does involve the deeper layers of the bowel. Even though Crohn’s disease can involve any portion of the gastrointestinal tract it typically does not involve every portion of the gastrointestinal tract. The most common sites of involvement are the end of the small intestine known as the terminal ileum, involved in up to 80% of patients, involvement in the colon in approximately 50% of patients, with approximately 5% of patients having disease in their stomach or first part of the small intestine known as the duodenum.
What are the symptoms of Ulcerative Colitis?
The most common symptoms of ulcerative colitis are diarrhea, blood in the bowel movements and pain in the abdomen. Patients with this condition may have pain prior to a bowel movement that improves after a bowel movement, and frequent bowel movements up to 10 times per day or more. Patients may also feel that they need to have a bowel movement immediately or they are going to have an accident. Having bowel movements at night is not uncommon in patients with ulcerative colitis, especially when the colon is more inflamed. Other symptoms can include anemia (a low blood count) and weight loss.What are the symptoms of
How is the diagnosis made of ulcerative colitis?
After a careful history and physical examination your doctor can order blood work to screen for ulcerative colitis Blood work that would be abnormal in these conditions can include a blood count demonstrating anemia, especially if the iron level is low, an increased white blood cell count which may indicate inflammation or infection, an increased platelet count (the part of the blood that is responsible for helping blood clot), decreased blood levels of proteins such as albumin and an elevated sedimentation rate, or CRP value, nonspecific markers of inflammation.
There are additional blood tests available that detect certain antibodies found more commonly in patients with inflammatory bowel disease. However, testing positive or negative for these antibodies does not establish or rule out the diagnosis of inflammatory bowel disease and therefore expert interpretation of these blood tests is required.An x-ray called an upper GI with small bowel follow through can be obtained to look for irregularity in the small intestine.Endoscopy with biopsy (taking samples of tissue) also known as performing a scope test is the definitive way to diagnose inflammatory bowel disease and also to determine how much of the colon is involved.
Dr. Arturo Bravo is a digestive disease specialist trained in the most advanced endoscopic techniques. He is a diplomat of the American Board of Gastroenterology, the American Board of Transplant Hepatology and the American Board of Internal Medicine. For more information on treatment options, or to schedule a consultation, call us at 281.970.6027.
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Author(s) and Publication Date(s)
Marsha H. Kay, MD, The Cleveland Clinic, Cleveland, OH, and Annette E. Whitney, MD, Digestive Health Associates of Texas, Dallas, TX – Updated December 2012.
Marsha H. Kay, MD, The Cleveland Clinic, Cleveland, OH, and Vasundhara Tolia, MD, Children’s Hospital Of Michigan, Detroit, MI – Published September 2004.