I was having lunch with a friend of mine and we started discussing foods on the menu we could and could not eat, which led him to tell me that he has Crohn’s disease. A week or two later, I was with another friend and she mentioned that she had digestive problems and began talking about ulcerative colitis. I realized that although I have heard of both of these diseases, I did not know much about either of them, so I decided to do some research.
Crohn’s disease and ulcerative colitis have similarities, but they are different disorders. One similarity is that they are both inflammatory bowel diseases (IBD). Patients with IBD have areas in the gastrointestinal (GI) tract that can become inflamed. Crohn’s disease and ulcerative colitis are the two main types of IBD, however, in addition to inflammation, the areas affected also form ulcers. As a side note, IBD is different than irritable bowel syndrome (IBS). IBS is due to either an increase or decrease of muscular contraction in the wall of the digestive tract; inflammation is not involved.
The differences between Crohn’s disease and ulcerative colitis exist in where and how the GI tract is affected. In Crohn’s disease, named after one of its discoverers, Dr. Burrill B. Crohn, any part or parts of the GI tract spanning from the mouth to the anus can become inflamed and develop ulcers. In most cases, it is the small intestine and part of the large intestine. The inflammation can occur in patches throughout the GI tract, leaving areas in between normal. Additionally, ulcers can form deep through all the layers of the wall of the GI tract. In ulcerative colitis, inflammation occurs consistently throughout the large intestine. Ulcers also develop in the large intestine, but only in the innermost lining.
Researchers and doctors do not know the exact causes of Crohn’s disease or ulcerative colitis, but it is thought that they are both triggered by abnormalities within the body’s immune system. Normally, the immune system produces white blood cells to protect against foreign substances (bacteria and viruses) in the body, which results in inflammation and the destruction and removal of the unwanted “bug”. Once the foreign substance is eradicated, the inflammation subsides. With Crohn’s disease and ulcerative colitis, it is thought that the immune system is mistakenly triggered by bacteria within the gut that are not pathogenic, but rather normal and essential residents that facilitate proper digestion and absorption of nutrients. Moreover, once the immune system is triggered in these diseases, it has a difficult time shutting down leading to chronic inflammation and subsequent ulcers. While the root cause of these symptoms is not known, both genetics and the environment are also thought to play roles.
In addition to the above, patients with Crohn’s disease and ulcerative colitis may suffer from abdominal pain, cramping, the frequent need to go to the bathroom, diarrhea, constipation (more common in Crohn’s disease), bloody stools, rectal bleeding (ulcerative colitis), a loss of appetite, weight loss, energy loss, fatigue, and delays in growth and development in younger children. Other side effects may be inflammation and other issues in the joints, eyes, and skin. And additional complications with the intestinal tract can occur including bowel obstruction (Crohn’s disease), fissures, and colon cancer.
There are currently no known cures for either Crohn’s disease or ulcerative colitis, but symptoms can be reduced or can subside through diet, nutritional supplements, and medications that reduce inflammation or diarrhea. Although these are both chronic and serious diseases, with proper treatment, patients can have periods of mild or no symptoms for months and even years at a time.
If you have an IBD, how do you manage your symptoms?
Photo found on PEXELS