Ulcerative Colitis and Crohn's Disease

Ulcerative colitis and Crohn’s disease are types of inflammatory bowel diseases where the lining of the bowel becomes red and inflamed.  Ulcerative colitis affects mainly the lining of the rectum and colon.  In Crohn’s disease, any part of the digestive tract can be affected and the inflammation can affect the whole thickness of the wall.  Crohn’s disease can sometimes be difficult to separate from ulcerative colitis if it affects the colon.  The cause of these diseases is not known.

What are the symptoms?

The symptoms are mainly of frequent and urgent need to pass motion, blood and mucous, diarrhoea, abdominal pain and weight loss and generally feeling unwell and tired.  If Crohn’s disease is affecting the small bowel then there are more symptoms of abdominal pain, bowel obstruction, weight loss and sometimes abnormal connections (fistulas) between the small bowel and other organs.

How is it diagnosed?

Inflammatory bowel disease is diagnosed mainly by taking a history, and by endoscopic assessment of the bowel either by colonoscopy or sigmoidoscopy.  Various X-rays with contrast for small bowel and large bowel could be used.  Also, more recently, CT and MRI scans are used for diagnosing small and large bowel inflammatory bowel disease.  In severe cases of colitis, other parts of the body can be affected such as the skin, the lower back joints and the eyes.

How is it treated?

A gastroenterologist treats inflammatory bowel disease medically by using various anti-inflammatory drugs and in some cases immunosuppressants and steroids.  Surgical intervention is required if there is a failure of medical treatment and usually requires removal of the colon or the part of the small bowel affected.  In some cases patients end up having a stoma (an opening created surgically which connects a portion of the body cavity to the outside environment) such as ileostomy or a colostomy.  Patients requiring a colectomy for ulcerative colitis might be suitable to have a reconstructive operation called an ileal pouch procedure.  Our surgeons have experience of performing this surgery laparoscopically (keyhole) to minimize scars and speed recovery.

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