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Inflammatory Bowel Disease is a term used to encompass a variety of benign inflammatory conditions of the large and small bowel. The severity of these conditions themselves may vary from being no more than a nuisance to an emergency or even a life-threatening condition. Confusingly the terms used to name different conditions are often used interchangeably and in some cases disease may exhibit features of more than one type. In these cases a delay or even a failure to achieve a firm diagnosis is not uncommon.
Broadly speaking when considering Inflammatory Bowel Disease the entities of Ulcerative Colitis and Crohn’s Disease are what clinicians are referring too. Unfortunately both may be called “colitis” (more normally although not exclusively meaning Ulcerative Colitis rather than Crohn’s colitis) and many doctors believe that both are different ends of the spectrum of the same disease. Indeed a number of patients do not satisfactorily fit the criteria necessary to diagnose one condition or other confidently and are labelled as “indeterminant colitis”, neither one nor the other. The causes of these conditions have been exhaustively investigated without any firm evidence yet convincingly demonstrated.“Colitis” may be caused by other recognised insults to the bowel for example infection, radiation or compromised blood supply. These conditions are not considered to be Inflammatory Bowel Disease.
The pharmacological management of both Ulcerative Colitis and Crohn’s Disease is similar and becoming more so. Surgical procedures when needed for these diseases however have quite distinct and important differences.
- Abdominal Pain – Usually cramp-like in nature
- Change in bowel habit – Usually to diarrhoea
- Rectal bleeding- Often mixed into the stools
- Anaemia – Showing a deficiency in the body’s iron stores
- Weight loss
- Skin problems
- Joint pains
Some, none or all of the above may be present in people with inflammatory bowel disease.
Pharmacological treatment of Inflammatory Bowel Disease is undertaken by specialist physicians (gastroenterologists) and consists of anti-inflammatory and immune-modulating drugs as well as nutritional and supportive care. When surgery is required specialist colorectal surgeons seek to remove affected bowel that has not responded to treatment, drain infection and attempt to restore normal bowel function.