WHAT IS IBD (INFLAMMATORY BOWEL DISEASE)?
Bowel disease means an illness of the intestines. Inflammation is the tougher term to define, because it's a complex process where white blood cells and other chemicals respond to a triggering event by moving to that area. It's easier to picture, because you've seen it as a sore on your finger where it's gotten infected. The area turns red and becomes swollen. The same thing can happen to the intestine.
Because IBD is a chronic condition (meaning that it's ongoing), the inflammation can affect other organs as well. These extra-intestinal manifestations (meaning that areas outside the intestine or bowel) can include joint swelling or arthritis, certain skin sores and in children, as many as 25% have their growth diminished.
The Types of IBD
The most common types of IBD in the Americas and Europe are Crohn's Disease and ulcerative colitis. They are more common in Northern Europe than elsewhere and more common in the north of the United States than in the south. This has led some investigators to suspect that Vitamin D from sun exposure may play a preventive role.
There are other types of IBD. When the large intestine (the colon) is involved, but the disease can't be clearly classified, that is known as IBD-Undetermined. There are also several specific white blood cells that can be prominent in the intestine as part of the inflammatory process and the diseases are named based on the cell type, so we have eosinophilic and lymphocytic colitis (colitis, meaning inflammation of the colon). They tend to be milder conditions. Ischemic colitis occurs when the intestine becomes inflamed when not enough blood flow is getting to a section of the bowel. Radiation-induced colitis is the result of radiation therapy that has been used to treat cancer, but in doing so, has caused intestinal damage). Infectious colitis means an infection has caused the problem, but this is usually a short-term rather than a chronic situation. And in Asia and the Mediterranean area, more so than elsewhere, there is an intestinal inflammation called Behcet's disease, similar to Crohn's disease but it also usually has genital ulcers and / or eye involvement.
IBD in Childhood
Approximately 25% of patients with Crohn's disease begin their disease when they are 20 years old or younger and a significant number of children develop ulcerative colitis. When children under 8 years of age develop either of these diseases, it is often in the large intestine. Of particular note, IBD in children (pediatric IBD) tends to be more severe and in ulcerative colitis, more of the large intestine may be inflamed.
Confusion With IBS (Irritable Bowel Syndrome)
Unfortunately, IBD and IBS easily get confused. IBD is all about the inflammation. IBS has no inflammation but is the result of the bowel being irritable (twitchy, in my mother's words) and is sometimes called a Spastic Colon, which then becomes confused with colitis, which it is not, since colitis means inflammation of the colon. While doctors don't favor the term of Spastic Colon, it does help to remind patients that patients with IBS have spasms in their large intestine (and sometimes they are very painful. For some, that squeezing can result in diarrhea; for other, constipation, or both).
To make it just a bit more confusing, IBD patients can have spasms and symptoms of IBS as a result of their inflammation. But because they are actually very different conditions, IBS and IBD are usually treated differently with their diets and medications, unless someone has both.
This article, as well as all others, was reviewed and edited by a member of our Medical Advisory Board.
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