What are inflammatory bowel diseases?
The bowel can develop redness and inflammation in these illnesses. Ulcerative colitis involves the lining of the large bowel. Crohn's disease can involve any area of the digestive tract and the bowel wall can become inflamed throughout its full thickness. If the patient has symptoms affecting the colon it is difficult to know if it is ulcerative colitis or Crohn's disease affecting the organ.
The causes of Crohn's disease or ulcerative colitis
The cause or causes are not known. It is possible that affected people have an abnormal defence mechanism against the bacteria which are normally present in the gut. A long-term reaction to a particular bacterium or virus may be important. People in some families are more susceptible than in others, but the chance of passing this tendency on to children is small.
Ulcerative colitis symptoms
The disease can give trouble on and off throughout life. Most of the time most sufferers feel well with no symptoms " this means the disease is inactive (in remission). The disease flares up from time to time and becomes active (a relapse). At each flare-up the symptoms can be better, worse or the same as the time before. The main symptoms are frequent and urgent need to pass blood and mucus with perhaps some stool as well, diarrhoea is more severe cases, abdominal pain often just before a stool is passed and a general feeling of tiredness. If only the final part of the bowel (rectum) is involved, the disease is called proctitis and the usual symptoms are passage of blood and mucus without diarrhoea.
Crohn's disease symptoms
Crohn's disease also tends to occur throughout life with similar inactive remissions and relapsing flare ups as ulcerative colitis. Due to the fact that Crohn's disease can be active anywhere in the bowel the symptoms can be very variable. Most commonly there is:
Abdominal pain caused by direct inflammation which results in pain or results in a stricture (bowel narrowing), causing griping type pains and distension with bloating and wind.
Abdominal pain. The inflammation either causes pain directly or causes narrowing of the bowel (stricture) resulting in gripey pains and bloating (distension) with wind.
Bodyweight loss due to a reduction in appetite when active disease is present along with potential poor nutrient absorption.
Loss of weight. Appetite is reduced when the disease is active and there may also be poor absorption of nutrients.
The inflamed bowel wall can perforate and cause a leak to a nearby organ (a fistula) such as the vagina, bladder or skin.
Local inflammation can cause abdominal pain or cause a narrowing of the bowel (a stricture) with symptoms of abdominal bloating, wind and pain of a gripey nature.
Reasons why the disease relapses
It is not always possible to identify the causes of relapse and even when the trigger occurrence is identified this is not the cause of the condition. Possible reasons are:
Commonly occurring infections such as flu, gastroenteritis and colds.
Anti-arthritis drugs, antibiotics and aspirin.
Stress and personal worries.
Diet. Some patients may react to milk products, in which case they will need a milk-free diet. Some sufferers find that certain foods, such as cereals, can cause problems. These foods can be cut out of the diet and tried again later.
Diagnosing inflammatory disease of the bowel
Your doctor will do a sigmoidoscopy if ulcerative colitis or Crohn's disease of the large bowel (Crohn's colitis) is suspected. An instrument with a light in it is passed through the back passage (anus) to look at the lining (mucosa). A tiny snip (biopsy) of mucosa will be taken and inspected under a microscope. Tests may also include:
An x-ray during a barium enema where the liquid barium is injected into the bowel through the anus.
A colonoscopy is performed by passing an endoscope up the anus to examine the whole of the colon. Done under sedation.
Colonoscopy. In this investigation the patient is sedated and a flexible endoscope is inserted past the anus and up through the whole colon.
Colonoscopy where under sedation a flexible telescope is passed through the anus all round the colon.
If the physician thinks that the upper gut is affected by Crohn's disease:
A barium x-ray examination of the small intestine may be advised.
The stomach and upper intestine may be inspected and sampled for biopsies by an endoscopy of the upper gastrointestinal tract. - 14130
The bowel can develop redness and inflammation in these illnesses. Ulcerative colitis involves the lining of the large bowel. Crohn's disease can involve any area of the digestive tract and the bowel wall can become inflamed throughout its full thickness. If the patient has symptoms affecting the colon it is difficult to know if it is ulcerative colitis or Crohn's disease affecting the organ.
The causes of Crohn's disease or ulcerative colitis
The cause or causes are not known. It is possible that affected people have an abnormal defence mechanism against the bacteria which are normally present in the gut. A long-term reaction to a particular bacterium or virus may be important. People in some families are more susceptible than in others, but the chance of passing this tendency on to children is small.
Ulcerative colitis symptoms
The disease can give trouble on and off throughout life. Most of the time most sufferers feel well with no symptoms " this means the disease is inactive (in remission). The disease flares up from time to time and becomes active (a relapse). At each flare-up the symptoms can be better, worse or the same as the time before. The main symptoms are frequent and urgent need to pass blood and mucus with perhaps some stool as well, diarrhoea is more severe cases, abdominal pain often just before a stool is passed and a general feeling of tiredness. If only the final part of the bowel (rectum) is involved, the disease is called proctitis and the usual symptoms are passage of blood and mucus without diarrhoea.
Crohn's disease symptoms
Crohn's disease also tends to occur throughout life with similar inactive remissions and relapsing flare ups as ulcerative colitis. Due to the fact that Crohn's disease can be active anywhere in the bowel the symptoms can be very variable. Most commonly there is:
Abdominal pain caused by direct inflammation which results in pain or results in a stricture (bowel narrowing), causing griping type pains and distension with bloating and wind.
Abdominal pain. The inflammation either causes pain directly or causes narrowing of the bowel (stricture) resulting in gripey pains and bloating (distension) with wind.
Bodyweight loss due to a reduction in appetite when active disease is present along with potential poor nutrient absorption.
Loss of weight. Appetite is reduced when the disease is active and there may also be poor absorption of nutrients.
The inflamed bowel wall can perforate and cause a leak to a nearby organ (a fistula) such as the vagina, bladder or skin.
Local inflammation can cause abdominal pain or cause a narrowing of the bowel (a stricture) with symptoms of abdominal bloating, wind and pain of a gripey nature.
Reasons why the disease relapses
It is not always possible to identify the causes of relapse and even when the trigger occurrence is identified this is not the cause of the condition. Possible reasons are:
Commonly occurring infections such as flu, gastroenteritis and colds.
Anti-arthritis drugs, antibiotics and aspirin.
Stress and personal worries.
Diet. Some patients may react to milk products, in which case they will need a milk-free diet. Some sufferers find that certain foods, such as cereals, can cause problems. These foods can be cut out of the diet and tried again later.
Diagnosing inflammatory disease of the bowel
Your doctor will do a sigmoidoscopy if ulcerative colitis or Crohn's disease of the large bowel (Crohn's colitis) is suspected. An instrument with a light in it is passed through the back passage (anus) to look at the lining (mucosa). A tiny snip (biopsy) of mucosa will be taken and inspected under a microscope. Tests may also include:
An x-ray during a barium enema where the liquid barium is injected into the bowel through the anus.
A colonoscopy is performed by passing an endoscope up the anus to examine the whole of the colon. Done under sedation.
Colonoscopy. In this investigation the patient is sedated and a flexible endoscope is inserted past the anus and up through the whole colon.
Colonoscopy where under sedation a flexible telescope is passed through the anus all round the colon.
If the physician thinks that the upper gut is affected by Crohn's disease:
A barium x-ray examination of the small intestine may be advised.
The stomach and upper intestine may be inspected and sampled for biopsies by an endoscopy of the upper gastrointestinal tract. - 14130
About the Author:
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapists, physiotherapy, physiotherapists in London, back pain, orthopaedic conditions, neck pain and injury management. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.
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