What is inflammatory bowel disease?

Related conditions:


Colon cancer, irritable bowel syndrome (IBS)

Definition:
Inflammatory bowel disease is a chronic inflammation of the intestinal tissue. The two main conditions are Crohn disease and ulcerative colitis.

Risk factors: Inflammatory bowel disease may be at least partially inherited, as studies have shown that 20 to 25 percent of IBD patients have a close relative with the disease. Race and ethnicity may also be important determinants in the formation of inflammatory bowel disease, and American Jews of European descent are particularly prone to developing Crohn disease. For unknown reasons, higher socioeconomic status seems to predispose for IBD.

Etiology and the disease process: The development of inflammatory bowel disease is still undetermined, but it is thought to be the result of an abnormal immune response to an unknown antigen. In genetically susceptible individuals, this immune activation is prolonged, resulting in an inflammatory response that leads to intestinal tissue damage.

Incidence: Nearly 1 million Americans are estimated to be affected by inflammatory bowel disease, with an equal prevalence of ulcerative colitis and Crohn disease. Men and women are equally affected.

Symptoms: The symptoms of inflammatory bowel disease depend on the severity of the disease. Ulcerative colitis and Crohn disease patients may both complain of diarrhea, although bloody diarrhea is more characteristic of ulcerative colitis. Weight loss, nausea, vomiting, and fever are also common symptoms.

Screening and diagnosis: Because the symptoms associated with inflammatory bowel disease are common to many other gastrointestinal disorders, a colonoscopy is used both to confirm a diagnosis of inflammatory bowel disease and to differentiate between ulcerative colitis and Crohn disease.

Treatment and therapy: Treatment of inflammatory bowel disease depends entirely on the severity of the disease. The chronic nature of inflammatory bowel disease causes patients to experience extended periods of symptom-free living, interrupted by inflammatory “flares.” These flares are treated with a variety of agents, including anti-inflammatory drugs, steroids, and immunosuppressants. Some biological therapies have proven effective in inflammatory bowel disease. Most of these biological therapies are antibodies that inhibit proinflammatory molecules within the intestine. The goal of therapy is to induce and maintain remission.

Prognosis, prevention, and outcomes: The quality of life of patients with inflammatory bowel disease depends on the severity of their disease. Severe gastrointestinal symptoms can cause patients to restrict their lifestyles. Patients with inflammatory bowel disease are at an increased risk for developing colon cancer, although more than 90 percent of inflammatory bowel disease patients never develop intestinal cancers. Inflammatory bowel disesase is rarely fatal, but death can occur if serious complications are not properly treated.