March 15th, 2016
Inflammatory Bowel Disease (often referred to as IBD) covers two different conditions – Ulcerative Colitis and Crohn’s Disease.
Ulcerative Colitis affects just the large colon, whereas Crohn’s Disease can cause inflammation anywhere along the gastrointestinal tract (GI tract) from your mouth to your bottom, though it mainly affects the small intestine.
Crohn’s Disease is relatively uncommon with only 115,000 people living with it in the UK. It can affect people of all ages, but it is commonly developed between the ages of 16 and 30.
Ulcerative Colitis is more common with 146,000 people suffering with it in this country. Again it can develop at any age, but is usually diagnosed between 15 and 25 years old.
The two conditions – Ulcerative Colitis and Crohn’s Disease – appear to have different causes.
With Crohn’s Disease the exact cause is unknown but research suggests that a combination of factors may be responsibe. These factors include:
On the other hand, Ulcerative Colitis is thought to be an autoimmune disease. This is when your immune system goes wrong and attacks healthy tissue. The most popular theory is that your immune system mistakes the harmless bacteria in your colon for a threat and attacks the tissue of your colon so that it becomes inflamed.
The main symptoms for both conditions are similar in that the main symptoms will be recurring diarrhoea, with blood and mucus, and abdominal pain. However, in Crohn’s Disease there will generally be fatigue and unintended weight loss as well.
However, the severity of the symptoms will vary depending on how badly your gut is inflamed. There may be periods when there are no symptoms at all, when you are said to be in remission, and then times when symptoms are especially troublesome, otherwise known as ‘flare ups’. You should contact your GP if you have persistent diarrhoea and abdominal pain, especially if there is blood or mucus in the stools.
With Ulcerative Colitis the aim is to relieve your symptoms during a flare up and prevent them from returning – maintaining remission. In most people this is achieved by taking medication such as aminosalicylates (ASAs) and corticosteroids.
Mild to moderate flare ups are usually treated at home but more severe ones will need to be treated in hospital to reduce the risk of serious complications, such as gas becoming trapped inside the colon.
If the drugs do not control your symptoms or your quality of life is badly affected, surgery to remove your colon may be an option. Here your small intestine will either be diverted out of an opening in your abdomen or it will be used to create an internal pouch that is connected to your anus – an ileoanal pouch.
Crohn’s Disease has no cure, so the aim of treatment is to stop the inflammatory process, relieve symptoms and avoid surgery wherever possible. The first treatment offered to reduce your symptoms is usually steroids, but they have significant side effects so the dose will be tapered off once your symptoms start to improve.
If your symptoms flare up twice or more in 12 months, or return when your steroid dose is reduced, an immunosuppressant medication such as azathioprine or mercaptopurine may be suggested.
If you want to know more about Inflammatory Bowel Disease, it’s symptoms and treatments, or you have any other concerns about your medicines then please talk to our pharmacists and ask for a medication MOT (Medicines Use Review).