Digestive Health

Crohn's & Ulcerative Colitis Treating and Managing Life with Chronic IBD

What are Crohn's and Ulcerative Colitis?

Crohn’s and Ulcerative Colitis are both types of chronic, Inflammatory Bowel Disease (IBD) thought to be the product of an overactive immune system, wherein the body mistakenly attacks healthy cells in the intestines.

In Crohn’s patients, the disease can affect any part of the gastrointestinal (GI) tract but it most commonly presents in the small intestine and the colon separately or in combination. As opposed to Crohn’s, which can present anywhere from mouth to anus, the disease is limited to the colon in Ulcerative Colitis patients.

Although there is no cure that medication can provide for IBD, many people live with the disease in remission. If you think you may be suffering from Crohn’s or Colitis, talk to your doctor about which treatment or combination of treatments will work best for you.

Symptoms of IBD

IBD affects people in different ways. A patient suffering from it may exhibit several of these symptoms or just a few:

  • Abdominal pain
  • Anemia
  • Diarrhea
  • Fistulas
  • Rectal bleeding
  • Ulcers
  • Vomiting
  • Weight loss
  • Treatment

According to the Crohn’s and Colitis Foundation website the following five types of medication are most commonly used to treat IBD:

  • Aminosalylates – Treats mild to moderate flare-ups and can be effective for maintaining remission.
  • Corticosteroids – Used for short-term treatments of acute flare-ups, but cannot prevent flare-ups and is not recommended for long-term, repeated use. Immunomodulators – Used to treat patients who do not respond to other drugs or who have certain medical conditions.
  • Antibiotics – Believed to control bacteria production in the intestines and suppress the immune system. Can be an effective, long-term treatment for some patients.
  • Biologic Therapies – This is the newest class of drug currently being used to treat IBD. The drugs interfere, at the molecular level, with the body’s inflammatory response process.

All of these medications can have potential side effects. Patients should visit their doctor for regular checkups and report any adverse side effects immediately.

Although medication is typically the first line of treatment for Crohn’s, many who suffer from the disease will undergo surgery as a part of their treatment at some point. It can often relieve pain or the need for steroids and patients can go on to lead healthy lives. Unfortunately, after surgery, Crohn’s can come back to affect a previously healthy part of the intestine, and 50 percent of patients who undergo surgery will experience a flare-up within five years of the operation.

Common surgeries for Crohn’s include:

  • Strictureplasty -Widens the diseased area that is blocking the passage of digested food so that food can pass through without cramping.
  • Resection – Removal of the diseased part of the intestine and connection of the two healthy sections. Disease sometimes recurs at or near the site of the resection.
  • Colectomy or Proctocolectomy – removal of the colon or removal of the colon and rectum. In a colectomy, the entire colon is removed. The small intestine can sometimes be connected to the rectum, facilitating normal bowl movements. In a proctocolectomy both the colon and rectum are removed. The end of the small intestine is then pushed through a hole in the abdominal wall for waste removal. An external bag must be worn and emptied throughout the day but is virtually unnoticeable under clothes.
  • Surgery for Abscesses and Fistulas – Sometimes surgery is necessary to drain an abscess or to remove fistulas (abnormal tunnels connecting the intestines to other organs in the body) that are not responding to medication. To remove fistulas, a resection is performed.

Between 25 and 40 percent of Ulcerative Colitis patients will eventually opt for surgery. However, unlike Crohn’s, once the diseased portion is removed from a Colitis patient, they are considered to be cured. The usual surgery performed is a proctocolectomy which removes the colon and rectum.

Restorative proctocolectomies are becoming increasingly popular because it allows patients to preserve bowel integrity and does not require an external bag to collect waste.

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