Crohn’s and Colitis: Unraveling the Mystery of IBD

With Irritable Bowel Disease (IBD) affecting over 1 million Americans today, increasing our understanding of its two major types, Crohn's and Colitis, could not be more important. The cost to our healthcare systems alone is immense but it pales in comparison to the real burden of diminished quality of life for those who live with irritable bowel disease.

For those who suffer from Crohn's or colitis, the diagnosis alone can be a highly emotional event. For some, it can come as a relief after months or years of testing with no clear explanations for their symptoms. For others, the diagnosis can be devastating as they grapple with the accompanying lifestyle and diet changes that the disease demands.

Difference between IBS and IBD

It is easy to get IBS and IBD confused. Generally considered manageable through careful diet and lifestyle changes, Irritable Bowel Syndrome (IBS) is considered a chronic but relatively mild to moderate condition in comparison with IBD. It is a condition that primarily affects the large intestine, including the colon and symptoms typically include chronic bloating, gas, diarrhea and/or constipation. Very few people experience severe symptoms that need to be treated with strong medication. While challenging to live with, IBS typically does not cause severe damage to the intestines.

Irritable Bowel Disease, including ulcerative colitis (UC) and Crohn's disease, on the other hand, is described as severe and chronic inflammation of the intestines that does ultimately result in damage of the intestinal lining. Very often, symptoms include diarrhea, fatigue, abdominal pain or cramping, reduced appetite, blood in the stool and acute weight loss.

IBS & IBD and Anxiety & Depression

Both IBD and IBS significantly affect quality of life and both have strong links to anxiety and depression. It has been found that patients with IBD are 20% more likely to have anxiety and 15% more likely to have depression than healthy individuals. And there seems to be an almost cyclical relationship to IBS or IBD and anxiety and depression.

Worrying about whether or not a meal can send you to the hospital or make you miss a week of work tends to be a daily concern for IBD patients. And yet anxiety and depression have also been known to make symptoms of IBS and IBD symptoms worse.

What is Crohn's Disease?

Named after one of the doctors who first identified the condition back in 1932, Crohn's Disease is chronic inflammation of the digestive tract and that can affect deeper tissue layers of the large intestine (colon). Different people can experience Crohn's in different areas of the digestive tract, affecting any part of the small or large intestine. There can be periods of time where the disease is in remission with no active symptoms.

These symptoms can develop gradually but often come on suddenly, without warning and can often end with the individual needing to be admitted to the hospital. It's also not uncommon for individuals suffering from Crohn's Disease to develop inflammation of other organs such as the liver, bile ducts, joints, skin and eyes.

What is Ulcerative Colitis?

Similar to Crohn's disease in that it involves inflammation of the large intestine (colon) but unique in that it is often accompanied by sores or ulcers. This tends to lead to bloody diarrhea and mucus in the stool. Besides this the symptoms are very similar and can make it difficult to distinguish. But while Crohn's can affect any part of the digestive tract, ulcerative colitis typically affects the colon.

Present Therapies & Management

While the cause of Crohn's disease and ulcerative colitis are unknown, there is some speculation that it may be a possible combination of a few factors. These include an individual's genetic background, environmental triggers like foods or food poisoning, and the overreaction of the immune system. This has led researchers to focus on calming the overactive immune system down with steroids or antibody therapy. Other research has been done to identify over 215 genes that are linked to developing IBD.

While most patients are able to manage their IBD by carefully avoiding trigger foods and doing everything they can to keep their anxiety and stress levels low, if flares do occur, novel treatments are usually the next step. And while we're only now beginning to learn about what the gut microbiome of those affected with IBD looks like, the more research we do, the more we can open doors to new therapies and eventually a cure.