Ulcerative colitis and Crohn’s disease

IBD is a collective term for diseases in which a faulty immune system triggers chronic inflammation in the digestive system. There are two main kinds of IBD: ulcerative colitis (UC) and Crohn’s disease. There are many ways to manage IBD, primarily through medication and surgery. These treatments work together to soothe your symptoms, reduce flare-ups, and help you better cope with your condition. This report provides insight into the possible causes and complications of IBD, how you are diagnosed, and the steps you can take for better care so you can live your best life.

Ulcerative colitis and Crohn’s disease Cover

People experience bowel problems all the time. The cause could be something they ate, stress, or something else. Most of the time these episodes pass, and you can get back to your regular life with no problem.

But for millions of people, constant bowel issues are a way of life. They suffer flare-ups that can last for weeks and cause pain, diarrhea, fatigue, bloody stools, loss of appetite, and weight loss. These episodes may go away for long periods and return with no explanation. They cause missed workdays and keep people from going out with friends. Even more frustrating for people with this problem is that they often don’t know why it happens or what they can do about it.

If this sounds familiar, you could be among the estimated 1.6 million to 3 million adults who suffer from inflammatory bowel disease, or IBD.

IBD is a collective term for diseases in which a faulty immune system triggers chronic inflammation in the digestive system. There are two main kinds of IBD: ulcerative colitis (UC) and Crohn’s disease.

These two conditions share many symptoms and risk factors, yet they are quite different. One difference is where they occur. UC affects only the large intestine (colon or large bowel). Crohn’s can affect any part of your gastrointestinal tract, though it most often involves the last part of the small intestine (ileum) and often the beginning of the colon (cecum). Also, UC occurs only in the inner lining of the colon (mucosa), while Crohn’s disease can involve all four layers of the intestinal wall. UC tends to affect a continuous section of the bowel, whereas Crohn’s often appears in patches.

Almost anyone can get UC or Crohn’s disease. They affect men and women about equally. Symptoms typically begin between the ages of 20 and 30. However, about 25% of IBD patients are teenagers or younger when diagnosed, and some may be in their 50s or 60s. IBD can even begin before age 10 or after age 70.

You cannot prevent IBD, nor can you cure it. No one knows exactly why someone gets it, although it tends to run in families. All this makes IBD challenging to diagnose and treat. And yet you don’t necessarily have to suffer with IBD for the rest of your life. The goal is to manage symptoms, reduce their severity, and, if possible, keep the disease in remission for long periods. When you are in clinical remission, symptoms go away. Treatment can help control or end inflammation, leading to remission.

As this report explains, there are many ways to manage IBD, primarily through medication and surgery. These treatments work together to soothe your symptoms, reduce flare-ups, and help you better cope with your condition. This report also provides insight into the possible causes and complications of IBD, how you are diagnosed, and the steps you can take for better care so you can live your best life.

Goals of care for IBD should include, at a minimum, clinical remission. Some studies suggest that people with IBD, even those in clinical remission, do better over the long term if a colonoscopy also shows healing inside the intestine. You and your doctor should discuss and decide on your individual goals. How long remission lasts depends on how you respond to treatments and how long you continue them. Remission can last for years.

Prepared by the editors of Harvard Health Publishing in conjunction with Adam Cheifetz, MD, Professor of Medicine,Harvard Medical School and Director, Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center. (2019)

About Harvard Medical School Guides

Harvard Medical School Guides delivers compact, practical information on important health concerns. These publications are smaller in scope than our Special Health Reports, but they are written in the same clear, easy-to-understand language, and they provide the authoritative health advice you expect from Harvard Health Publishing.

  • What is IBD?
  • The digestive system
  • Causes and risk factors of IBD
  • Complications of IBD
  • Ulcerative colitis
    • Symptoms
    • Diagnosis
    • Medications for IBD
    • Surgery for UC
    • Preventing flare-ups and coping
  • Crohn’s disease
    • Symptoms
    • Other complications of Crohn’s disease
    • Diagnosis
    • Medications for Crohn’s disease
    • Surgery for Crohn’s disease
    • Preventing flare-ups and coping
  • Resources

IBD vs. IBS: What’s the difference?

IBD should not be confused with a similar-sounding condition called irritable bowel syndrome (IBS). Here are the differences between the two.

Inflammatory bowel disease (IBD) is an umbrella term for diseases caused by an overreactive immune system that triggers chronic inflammation in the digestive system. There are two main kinds of IBD: ulcerative colitis (UC) and Crohn’s disease. 

Symptoms: With UC, symptoms include abdominal pain and cramps, often on the lower left side; diarrhea; blood in the stool; and more-urgent bowel movements. Crohn’s disease has many of the same symptoms as UC, but is more likely to cause abdominal pain and less likely to include rectal bleeding. It can also occur along with fevers, fatigue, and loss of appetite.

Irritable bowel syndrome (IBS) is a gastrointestinal disorder in which your gut becomes more sensitive and the muscles of your digestive system have abnormal contractions that affect your bowel movements. It’s not believed to be caused by a faulty immune system. There’s no inflammation involved, and severe complications or the need for surgery are uncommon. However, up to one-third of patients with IBD also have IBS. The two conditions are treated very differently. 

Symptoms: Abdominal pain and cramps; bloating and gas; and changes in bowel movements, such as hard or loose stools, diarrhea, constipation, or a combination.

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