Inflammatory bowel disease (IBD)is a term used to describe chronic autoimmune inflammation of the large and small bowels. The onset of disease is usually at a young age but may present at any time in life. IBD symptoms include weight loss, diarrhea, hematochezia (blood in stool), anemia, fatigue, bowel obstruction, and arthritis. Diagnosis is made with a combination of history, physical exam, blood testing, and endoscopy (EGD, colonoscopy, and pill cam). IBD falls into two categories, Crohn's disease (CD) and Ulcerative colitis (UC), although some overlap may occur.
Crohn's disease can involve any portion of the GI tract, from the mouth to the rectum; but the most common site of inflammation is the very distal portion of the small intestine (terminal ileum). The hallmark of CD is full thickness inflammation and ulceration of the GI tract. This can lead to unnatural connections (fistulae) of the bowel to other parts of the body (abdomen, skin, bladder, other portions of bowel). Crohn's disease may also lead to painful peri-anal or peri-rectal infections (abcesses) that require antibiotics and expert surgical management. Crohn's may be treated with anti-inflammatory medications, antibiotics and medications that suppress the immune system (immunosuppressives). Resection of portions of disease bowel is commonly required at some point in a patient's course and is not always curative.
Ulcerative colitis involves only the colon as the name suggests. Most often the most distal part of the colon, or rectum, is inflamed. However, the entire colon (pancolitis) is diseased in many patients. UC does not ulcerate the full thickness of the colon; therefore, fistulae do not form. Like Crohn's, UC is treated with anti-inflammatory medications, antibiotics, immunosuppressives, and surgery. Since UC only involves the colon, complete removal of the colon may be curative.
Tulane provides state of the art care for IBD, including innovative therapies in clinic trials. For additional information on about IBD please see www.CCFA.org.
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