Inflammatory bowel disease
Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, requires ongoing specialist care. Medicines and monitoring are central to treatment, while surgery may help selected complications or disease that is not adequately controlled. Surgical advice should be coordinated with the team managing your IBD.
In this guide
Overview
Inflammatory bowel disease (IBD) encompasses chronic inflammatory conditions primarily affecting the gastrointestinal tract. The two main types are Crohn’s disease and ulcerative colitis, each presenting distinct characteristics and management approaches:
Crohn’s Disease
- Location: Can affect any part of the digestive tract, commonly involving the small intestine and colon.
- Symptoms: Include abdominal pain, diarrhea, weight loss, fatigue, and complications like strictures and fistulas.
- Diagnosis: Involves medical history, physical examination, imaging (CT scans, MRIs), endoscopy, and biopsy.
- Treatment: Aims to reduce inflammation and control symptoms through medications (anti-inflammatories, immunosuppressants, biologics), dietary adjustments, and surgical intervention if necessary.
Ulcerative Colitis
- Location: Primarily affects the colon and rectum, causing inflammation and ulcers in the digestive tract lining.
- Symptoms: Bloody diarrhea, abdominal pain, urgency to defecate, fatigue, and weight loss.
- Diagnosis: Requires colonoscopy, biopsy, stool tests, blood tests, and imaging studies.
- Treatment: Focuses on reducing inflammation and inducing remission with medications (anti-inflammatories, immunosuppressants, biologics), dietary modifications, and surgery (colectomy) in severe cases.
Common Features of IBD
- Chronic Inflammation: Persistent inflammation in the GI tract leads to symptoms and potential complications.
- Autoimmune Component: Abnormal immune response targeting the digestive tract, resulting in inflammation and tissue damage.
- Flare-ups and Remission: Episodes of active symptoms alternating with periods of minimal or no symptoms.
- Impact on Quality of Life: Significantly affects daily life, work, relationships, and mental health.
- Management and Monitoring:
- Multidisciplinary Approach: Involves gastroenterologists, surgeons, dietitians, and mental health professionals.
- Medication: Key role in managing symptoms, reducing inflammation, and preventing relapses.
- Lifestyle Modifications: Dietary adjustments, stress management, physical activity, and smoking cessation aid symptom management.
- Monitoring and Follow-Up: Regular clinic visits, blood tests, imaging, and endoscopic evaluations crucial for assessing disease activity, treatment response, and detecting complications early.
Conclusion
Inflammatory bowel disease necessitates ongoing management to control symptoms, prevent complications, and enhance quality of life. Tailored treatment strategies incorporating medical therapies, lifestyle adjustments, and multidisciplinary support are essential for optimal care of individuals with Crohn’s disease or ulcerative colitis. Regular monitoring and proactive management are vital components in achieving long-term disease control and improving outcomes for patients with IBD.
A little more clarity
Your questions, answered
Is IBD the same as irritable bowel syndrome?
No. Inflammatory bowel disease involves inflammation of the digestive tract. Irritable bowel syndrome is a different condition, although some symptoms overlap. Persistent diarrhoea, bleeding or unexplained weight loss need assessment rather than a diagnosis based on symptoms alone.
Does everyone with IBD need bowel surgery?
No. Many people are managed with medicines and ongoing monitoring. Surgery may be discussed when symptoms remain severe despite treatment or when complications develop. The reasons and alternatives should be explained for your particular type and pattern of disease.
Does an operation cure Crohn's disease?
Surgery can treat a damaged section of bowel or a complication, but it does not cure Crohn's disease. Inflammation can return and ongoing specialist follow-up remains important. Ask how your surgical plan fits with medical treatment and future monitoring.
Can an anal fistula be part of IBD?
Yes. Crohn's disease can be associated with anal fistulas. If you have IBD and develop perianal pain, swelling or discharge, tell your treating team. Management may involve both medical treatment and surgery, with attention to infection and bowel control.
What should I do if I think my IBD is flaring?
If you already have IBD, contact your IBD team or GP and follow the flare plan they have given you. Do not change prescribed treatment based on this page. Severe abdominal pain or heavy or continuous rectal bleeding needs emergency assessment rather than waiting for a routine appointment.
Patient information and guides
These leaflets provide general information and do not replace individual medical advice. Follow the instructions of your clinical team for your own care.
Laparoscopic high anterior resection of the rectum (PDF, 11 pages)
Information about high anterior resection, a procedure to remove part of the rectum.
Laparoscopic low anterior resection of the rectum (PDF, 11 pages)
Information about low anterior resection, a procedure to remove part of the rectum.
Subtotal colectomy and formation of an ileostomy (PDF, 9 pages)
Information about removal of most of the colon and formation of an ileostomy.
Having a colonoscopy (PDF, 5 pages)
Patient information about preparation for a colonoscopy and the examination.
Having a flexible sigmoidoscopy (PDF, 6 pages)
Patient information about preparation for a flexible sigmoidoscopy and the examination.
Sources & further reading
This guide provides general information, not an individual diagnosis or treatment plan. Your clinical team will advise what is appropriate for you.