Inflammatory Bowel Disease (IBD) refers to a chronic inflammation of the intestines not due to infections or other identifiable causes. There are two main types of IBD: ulcerative colitis and Crohn’s disease. Ulcerative colitis affects only the lining of the large intestine (the colon), while Crohn’s disease can involve any part of the intestine, small or large, and irritate not only the lining, but also deeper layers.
Having clear answers to your questions is often the first and most important step when your child has been diagnosed with IBD. We have compiled answers to the questions we hear most often. To read our Q&A, simply click on each of the questions below.
The following information is adapted from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. For more information visit the Children’s Digestive Health and Nutrition Foundation, the Crohn’s and Colitis Foundation of America, the Crohn's & Colitis Foundation of America - Central Ohio Chapter or NASPGHAN.
It is estimated that about 1 million Americans suffer from IBD. Males and females are affected equally. Ulcerative colitis and Crohn’s disease may occur at any age, including young children but occur most often in young adults. Most cases of Ulcerative colitis and Crohn’s disease are diagnosed before age 30. Crohn’s disease tends to occur in families and in certain ethnic groups, such as Eastern European Jews. About 5 percent to 8 percent of patients may have a family member with IBD and about 20 percent to 25 percent of patients may have a close relative with the condition. However, it can occur in any ethnic group and in members of families where no one else is suffering from these diseases.
It is currently believed that IBD occurs in individuals as a result of genetic and environmental factors. For unknown reasons, the immune system becomes abnormally active against the individual’s own system. It targets not only the intestine, but sometimes other organs such as the skin, the eyes or the liver.
The most common symptoms are:
Diarrhea, sometimes with blood and mucus
Loss of appetite and weight loss
Unexplained fever and tiredness
Delayed growth and maturation, particularly with Crohn’s disease
The diagnosis of IBD may be suspected on the basis of the medical history, but the final determination depends on the results of diagnostic tests. The work up may include:
Stool cultures to rule out infection
Endoscopy with biopsy of the upper and lower intestine
The aim of treatment is to decrease the inflammation causing damage to the intestines. Even though a medical cure is not yet possible, control of symptoms can be very effective in most patients. The number of medications available continues to increase and new treatments can be expected in the future. The most common medications used to treat IBD are:
Antibiotics such as metronidazole and ciprofloxacin
ASA anti-inflammatory drugs such as Asacol®, Azulfidine®, Colazol®, and Pentasa®
Steroids, such as prednisone, prednisolone, or budesonide immunodulators such as Imuran®(azathioprine), Purinethol®(6MP), and for Crohn’s disease methotrexate
Biologicals, such as Remicade®
Intensive nutritional therapy can be used for those with Crohn’s disease.
Because there is a high risk of recurrence after surgery, this option is reserved for complications such as an obstruction from a narrowed area of the intestine, chronic pain, bleeding, or when using all other medicine does not work.
Yes. The cure for ulcerative colitis is the complete removal of the large intestine. This is called a total colectomy. It is possible in most patients to reconnect the small intestine to the anus, so that there is no need to wear a permanent bag (ostomy), although a temporary ostomy is generally needed. This second operation is called an ileo-anal pull through, and is expected to offer continence and normal defectation.