UNDERSTANDING INFLAMMATORY BOWEL DISEASE – IBD
socioeconomic period of life. The severity of symptoms
Inflammatory bowel disease (IBD) is at least two, separate
may prevent those with IBD from realizing their career
disorders that cause inflammation (redness and swelling)
and ulceration (sores) of the small and large intestines. These
two disorders are called ulcerative colitis and Crohn's disease. SymptomsMany of the symptoms of IBD are similar. Symptoms outside
Ulcerative colitis causes ulceration and inflammation of the
the gut may include aching, sore joints, skin and mouth
lining of the large bowel only, beginning at the rectum
(proctitis) and extending upwards varying distances. Crohn's
disease can occur anywhere in the digestive tract but is
The most common symptom of ulcerative colitis is bloody
common in the lower small bowel (ileum) or large bowel.
diarrhea. There may also be weight loss, fatigue, fever and
abdominal pain. The most common symptoms of Crohn's
Malnutrition and blood disorders are common conditions
disease are abdominal pain (often in the right, lower area
in IBD patients found to be caused by avoiding food items
of the abdomen) and diarrhea. There may also be rectal
either because of existing symptoms or concern that they
bleeding, weight loss and fever. Children may suffer
may bring on symptoms. Almost half of IBD patients have
additional health issues affecting their joints, skin, eyes, and
biliary tract that may be more debilitating than the bowel
Tests are needed to determine whether the patient has
Canada has one of the highest incidence and prevalence
ulcerative colitis or Crohn's disease and to rule out other
rates of IBD in the world with more than 200,000 Canadians
causes. To diagnose these disorders the doctor will take a
living with the disease. These disorders are expensive and
complete history and perform a physical examination. In
can be debilitating. The total direct and indirect costs of
addition, blood tests are used to find out if you are anemic
IBD are $1.8 billion with the main indirect cost being related
(low blood count) as a result of blood loss, or if there is an
to long-term work loss. The average age for people
increased number of white blood cells in your body,
developing IBD often coincides with the most important
IBD – INFLAMMATORY BOWEL DISEASE
Stool samples can tell your doctor if there is blood loss
immunosuppressives (methotrexate and azathioprine) and
or if an infection by a parasite or bacteria is causing some
immunomodulatory agents (infliximab). Some of these may
be given by different methods including oral, rectal and
intravenously. Antibiotics may be useful in certain
The doctor may also look inside your rectum and large bowel
through a long, flexible video camera called an endoscope.
During this safe procedure, samples of the lining of the
intestine (biopsies) may be taken to be looked at under the
People with both Crohn's disease and ulcerative colitis may
need surgery at some point in their lives.
On some occasions an X-ray exam may be required. This is
Surgery is less common in ulcerative colitis than in Crohn's
done by putting barium (a white chalky solution) into the
disease and is often performed when ulcerative colitis is
upper intestine (swallowing barium) or by putting the barium
no longer responding to medical treatment. Unlike Crohn's
into the bowel by inserting a tube into the anus.
disease, surgery will cure ulcerative colitis by removing all
diseased bowel. With the colon being completely removed
the patient may require an ileostomy (bag outside the body
to collect waste) or a second operation to form a new
Although several drugs are useful in controlling these
conditions, as yet a cure has not been found. Since the
disease is not curable, long-term treatment is often required.
Despite all of the advances in medical research over the
last several decades, we still do not know the cause of
IBD and much further research is required.
Specific medications are used to treat diarrhea and abdominal
cramps. Anti-diarrheal drugs slow the muscles of the intestine
which in turn slow the passage of stool through the body
For more information about protecting and enhancing
and help with diarrhea. While abdominal pain often occurs
your digestive health, please visit www.CDHF.ca
with IBD, it is important to note that the pain is a consequence
of the disease and, if treated appropriately, the pain should
subside. People with IBD should be careful to avoid taking an
excess of pain killers and anti-diarrheal drugs since this may
Diet alone is not effective in treating Crohn's disease or
ulcerative colitis. However, it is important that patients with
IBD have a well-balanced diet. Calcium is important to protect
bones. Fibre may not be tolerated during flare ups. Certain
vitamins (for example, B12) may be required. Selected patients
may sometimes be helped by a registered dietitian.
These include anti-inflammatory drugs (sulfasalazine/5-ASA),
corticosteroids (prednisone and budesonide),
Over 20 million Canadians suffer from digestive
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Health Professions Council Council, 31st May 2007 Approval of programmes leading to entitlements under the Prescription Only Medicines (Human Use) Order 1997 Executive Summary and Recommendations Introduction At its meeting on 29th March 2007, the Education and Training Committee considered a paper from the Executive about the Approval of programmes leading to entitlements
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