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What is Inflammatory Bowel Disease?

Inflammatory bowel disease, or IBD, describes two similar yet distinct conditions called Crohn's disease and ulcerative colitis. These diseases affect the digestive system and cause the intestinal tissue to become inflamed, form sores and bleed easily. Symptoms include abdominal pain, cramping, fatigue and diarrhea.

Crohn's disease can affect any part of the gastrointestinal tract, from the mouth to the anus. Patches of inflammation occur, with healthy tissue between the diseased areas. The inflammation can extend through every layer of affected bowel tissue. Crohn's disease can not be cured by drugs or surgery, although either or both can help relieve symptoms.

Ulcerative colitis affects only the inner layer of the colon, or large bowel. It always starts in the rectum and may extend as a continuous inflammation from there into the rest of the colon. Usually ulcerative colitis can be controlled with medication. The disease can be completely eliminated by surgically removing the colon, but afterward, waste material may have to be stored and expelled through an external appliance

There is no known cause or cure for IBD. In Canada, an estimated 170,000 Canadian men and women suffer from IBD. People are most frequently diagnosed between the ages of 15-25, or 45-55. IBD is particularly difficult for children and young adults since it often affects a person's self-concept, body image and lifestyle at a time when "being like everyone else" is so important. IBD is unpredictable.

Most people experience periods of remission and flare-ups of the disease, often requiring long-term medication, hospitalization or surgery. Although IBD is found throughout the world, it seems to be more common in North America and northern Europe. Canada is believed to have one of the highest incidence rates of IBD in the world.

Extra-intestinal manifestations of IBD

Although the symptoms associated with IBD generally consists of abdominal pain and diarrhea, it should not be overlooked that patients may experience symptoms outside of their intestinal tract. These signs and symptoms are referred to as the extra-intestinal manifestations of IBD. Up to one-third of patients will have one or more of these extra-intestinal manifestations. Virtually any organ may be affected but most commonly these involve joint, skin and eye problems.

The most common of these manifestations is peripheral arthropathy or arthritis. The arthritis is migratory and affects mainly large and medium-size joints. The joints are usually sore during an active flare of the disease. Arthritis involving the spine and lower back can also be present and can run its own course even when the bowel disease is under control.

Skin manifestations occur in up to 15% of patients with IBD. Erythema nodosum, which presents as tender, red nodules over the anterior surfaces of the legs, is more commonly seen in Crohn's disease. Pyoderma gangrenosum manifests as larger ulcers over the lower part of the legs and is more common in ulcerative colitis than it is in Crohn's disease. Generally, these lesions parallel the bowel disease activity and treating the bowel disease often resolves the skin lesions. Interestingly some patients present with these skin lesions without the diagnosis of IBD and on careful questioning often the patient reports a change in his or her bowel habits and/or abdominal pain leading toward the diagnosis of either ulcerative colitis or Crohn's disease.

The eyes can also be affected by IBD. The two most common eye problems in IBD are episcleritis and uveitis. This is often confused with recurrent "pink eye". Episcleritis is a painless inflammation of the white part of the eye and surrounding tissue and is often mistaken for pink eye. Uveitis, inflammation of the iris, (coloured part of the eye), is generally very painful, and can be associated with both visual changes and sensitivity to light. Untreated, uveitis can progress to irreversible blindness.

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Books:

*Straight from the Gut: Living with Crohn’s Disease & Ulcerative Colitis - Cliff Kalibjian

The Complete Crohnie Handbook: A Comprehensive Guide for the Crohn's Disease Patient - Robert R. Pilkington

The Crohn's Disease and Ulcerative Colitis Fact Book – CCFA

The First Year---Crohn's Disease and Ulcerative Colitis: An Essential Guide for the Newly Diagnosed - Jill Sklar

Coping With Crohn's Disease: Manage Your Physical Symptoms and Overcome the Emotional Challenges - Amy B. Trachter

Heroes:

Anyone who lives their daily life with these horrible diseases. I live in awe every day at how strong these people are for carrying on.