Inflammatory bowel diseases are chronic inflammatory diseases of the gastro-intestinal tract, and include Crohn 's disease and ulcerative colitis.
Crohn's disease, a chronic gastro-intestinal inflammation
Crohn´s disease is a chronic inflammation of the entire gastro-intestinal tract, which evolves in spurts, affecting mostly the small intestine and the colon, but able to affect the entire gastro-intestinal tract. Crohn’s disease causes scarring, stenosis and fistulas.
Ulcerative colitis, an inflammation of the mucous membranes of the rectum and colon
Ulcerative colitis (formerly known as ulcero- hemorrhagic recto-colitis), on the other hand, consists of a continuous inflammation limited to the mucous membranes, i.e. the lining, of the rectum and colon.
Intestinal and extra-intestinal symptoms
Inflammatory bowel diseases usually start between the ages of 15 and 30 years, or between 50 and 80 years. Symptoms usually include diarrhea, bloody stool (especially with ulcerative colitis), abdominal pain, fever, fatigue, and weight loss. These conditions can also have extraintestinal manifestations, such as mouth ulcers, skin and joint lesions, ophthalmological manifestations, and others.
Diagnosis is made by colonoscopy and biopsy
Generally, these diseases progress by relapses alternating with phases of remission. Their diagnosis requires blood tests, stool sampling and, most importantly, colonoscopy with biopsies.
Regular follow-up is essential
Due to an increased risk of colorectal cancer, regular colonoscopy follow- up is recommended. Abdominal CT scan can be done in case of acute presentation and/or to rule out any potential complications. In selected cases, a dedicated MRI may also be necessary.
Immunosuppression therapy
The Division of Gastroenterology is in charge of the management of patients suffering from inflammatory bowel diseases. Treatment is based on immunosuppressive drugs and depends on the frequency and severity of disease recurrences.
Surgical management of complications
Surgical management may be necessary in the event of a complication (such as strictures, abscess, fistula, etc.), resistance to drug treatment, or in case of cancer.