Family Health
Crohn's disease|Inflammatory Bowel Disease|ulcerative colitis

Inflammatory Bowel Disease (IBD)

Last Updated January 2021 | This article was created by editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is the name of a group of disorders that cause the intestines to become inflamed (red and swollen). The inflammation lasts a long time before subsiding, but it usually comes back over and over again. Approximately 1.6 million Americans have some kind of inflammatory bowel disease.

The two primary types of inflammatory bowel disease are Crohn’s disease and ulcerative colitis.

What is Crohn’s disease?

Crohn’s disease is an IBD that causes ulcers to form in the gastrointestinal (GI) tract anywhere from the mouth to the anus. Crohn’s disease can have “skip” areas that are normal. These normal areas lie in between areas that are affected. Some people who have Crohn’s disease have severe symptoms. Others have symptoms that are not as severe. Some people who have the disease have long periods without symptoms, even without getting treatment. Others who have more severe symptoms will need long-term treatment or even surgery.

What is ulcerative colitis?

Ulcerative colitis is an IBD that causes your colon (large intestine) to become red and swollen. The redness and swelling can last for a few weeks or for several months. Ulcerative colitis always involves the last part of the colon (the rectum). It can go higher up in the colon, up to involving the whole colon. Ulcerative colitis never has the “skip” areas typical of Crohn’s disease. Symptoms may come and go. These occurrences are called flare-ups. Flare-ups can last many months and may come back at different times throughout your life.

Symptoms of Inflammatory Bowel Disease

What are the symptoms of Crohn’s disease?

The symptoms of Crohn’s disease vary, depending on which part or parts of the gastrointestinal (GI) tract is/are affected. Common symptoms include:

  • Diarrhea
  • Stomach cramps
  • Abdominal pain that comes and goes
  • Blood in your stool
  • Low appetite
  • Unintended weight loss

Other less common symptoms may include fever, joint pain, eye problems, skin problems, and feeling tired (called fatigue). The symptoms of Crohn’s disease may be mild or severe. Symptoms may also come and go. They can start suddenly or gradually.

What are the symptoms of ulcerative colitis?

Symptoms of ulcerative colitis vary. Symptoms depend on how severe your case is and how much of your large intestine is affected. Common symptoms include:

  • Rectal pain or bleeding
  • Frequent, small bowel movements
  • Feeling an urgent need to have a bowel movement
  • Diarrhea
  • Blood in the stool
  • Abdominal cramping and pain
  • A strong feeling that you need to have a bowel movement, but not being able to do so (called tenesmus)
  • Pain on the left side of the abdomen
  • Unintended weight loss
  • Fatigue

In most people who have ulcerative colitis, these symptoms tend to come and go. You may have periods where you have no symptoms, followed by periods where you do have symptoms.

What causes inflammatory bowel disease?

It is not yet known exactly what causes Crohn’s disease and ulcerative colitis. These diseases seem to run in families, which means that genetics play a role. Many researchers believe that inflammatory bowel diseases are caused by a problem with the immune system. Normally, the immune system protects your body from infection. In people who have an inflammatory bowel disease, the immune system mistakes food, healthy bacteria, and other substances for an infection. This causes the immune system to attack the cells of the intestine, which leads to inflammation.

How is inflammatory bowel disease diagnosed?

Your doctor will give you a physical exam and listen to you describe your symptoms. To help diagnose the problem your doctor may order a number of tests, including blood tests and stool samples. Your doctor may also order one or more procedures to help them view your colon. Lower GI endoscopy procedures include colonoscopy and flexible sigmoidoscopy. During these procedures, your doctor uses a narrow, flexible tube to look directly inside your large intestine. Upper GI endoscopy allows a look at your stomach and small intestine for ulcers. For this type of endoscopy, you may swallow a small camera (called capsule endoscopy). If not, your doctor inserts a scope into your GI tract through your mouth.

Your doctor may also order other imaging tests such as X-rays, a CT scan, or an MRI.

Can inflammatory bowel disease be prevented or avoided?

IBD cannot be prevented, but there are lifestyle changes you can make to minimize symptoms. The best thing you can do is to take good care of yourself. It’s important to eat a healthy diet. Depending on your symptoms, your doctor may ask you to reduce the amount of fiber or dairy products in your diet. It also may be necessary to limit or avoid caffeine, alcohol, and carbonated beverages. In addition to eating well, you need to get enough rest and exercise regularly. It’s also important that you learn to manage the stress in your life. When you become overly upset by things that happen at home or at work, your intestinal problems can get worse.

Inflammatory bowel disease treatment

The goal of treatment is to get rid of the inflammation that causes your symptoms. Many types of medicine can help reduce inflammation.  Talk to your doctor about anti-inflammatory drugs and drugs that suppress the immune system. Some medicines are needed only during flare-ups. You may need long-term medicines to suppress your immune system. Depending on your symptoms, your doctor may also recommend these medicines and supplements:

  • Antibiotic
  • Anti-diarrheal
  • Laxative
  • Pain reliever
  • Vitamin supplements

In severe cases of inflammatory bowel disease, you may need to go to the hospital for intravenous (IV) fluids or surgery.

During your treatment, you will most likely be treated by a team of doctors. This team may include your family physician, a gastroenterologist (a specialist in stomach and intestinal disorders), and, possibly, a surgeon.

Living with inflammatory bowel disease

If you have inflammatory bowel disease, you are at an increased risk of colon cancer. Talk to your doctor about when to start screening for colon cancer and how often to have screening.

Crohn’s disease and ulcerative colitis keep coming back and their symptoms can be unpredictable. This can cause patients who have these illnesses to become depressed. If you feel depressed, talk with your family doctor. An antidepressant medicine could help you feel better.

How can I get more information?

Ask questions. Read about IBD. Discuss treatments with your doctor. You’ll be able to understand your illness and manage it better. Patient support groups are helpful, especially if you have severe symptoms.

Questions to ask your doctor

  • How will my inflammatory bowel disease be treated?
  • Will I need surgery? Are there other options?
  • What lifestyle changes can I make to help inflammatory bowel disease?
  • What are some medicines used to treat inflammatory bowel disease and what are the possible side effects?
  • Are my children at risk of inflammatory bowel disease?
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