As we progress into this new month, we recognize Crohn’s and Colitis Awareness Week (December 1-7), and distinguish what these conditions are, how they are different and learn their symptoms and treatments. If you or your loved one has been diagnosed with Crohn’s disease or ulcerative colitis (UC), you may become filled with anxiety, concern, and lots of questions. Even many health care professionals are unfamiliar with Crohn’s and UC. It’s important to begin learning all that you can about what Crohn’s disease and ulcerative colitis is so that you can better understand these conditions and learn how to manage their symptoms.
It becomes confusing when trying to identify the differences between the two. The short explanation is that Inflammatory Bowel Disease or IBD is the umbrella term for the condition under which both Crohn’s disease and ulcerative colitis fall.
Both Crohn’s and UC are marked by an abnormal response by the body’s immune system, and they may share some symptoms. However, there are important differences as well. These distinctions primarily include the location of the conditions in the gastrointestinal (GI) tract and the way each disease responds to treatment. Understanding these features is key to obtaining a proper diagnosis from a gastroenterologist.
Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract and may affect any part from the mouth to the anus.
Ulcerative colitis is a chronic inflammatory condition limited to the colon, otherwise known as the large intestine.
It is often difficult to diagnose which form of IBD a patient is suffering from because both Crohn’s Disease and ulcerative colitis cause similar symptoms:
- Rectal bleeding
- Urgent need to move bowels
- Abdominal cramps and pain
- Sensation of incomplete evacuation
- Constipation (can lead to bowel obstruction)
- General symptoms that may also be associated with IBD:
- Loss of appetite
- Weight Loss
- Night sweats
- Loss of normal menstrual cycle
Both illnesses do have one strong feature in common. They are marked by an abnormal response by the body’s immune system. The immune system is composed of various cells and proteins. Normally, these protect the body from infection. In people with Crohn’s disease, however, the immune system reacts inappropriately.
However, in people suffering from IBD, the immune system reacts inappropriately, mistaking benign or beneficial cells and bacteria for harmful foreign substances. When this happens, your immune system can do harm to your gastrointestinal tract and produce the symptoms of IBD.
Note that IBD should not be confused with irritable bowel syndrome (IBS). IBS is a much less serious affliction than either Crohn’s disease or ulcerative colitis. It doesn’t involve inflammation or appear to have a physiological basis.
Unfortunately, there’s currently no cure for IBD. This is a lifelong disease, with alternating periods of remission and flare-up. Modern treatments, however, allow people to live relatively normal and productive lives.
The primary goal in treating ulcerative colitis is to help patients regulate their immune system better. While there is no known cure for ulcerative colitis and flare ups may recur, a combination of treatment options can help you stay in control of your disease and lead a full and rewarding life. Treatment for ulcerative colitis and other IBD varieties is multifaceted and includes the use of medication, alterations in diet and nutrition, and sometimes surgical procedures to repair or remove affected portions of your GI tract.
Medication for ulcerative colitis can suppress the inflammation of the colon and allow for tissues to heal. Symptoms including diarrhea, bleeding, and abdominal pain can also be reduced and controlled with effective medication.
In addition to controlling and suppressing symptoms (inducing remission), medication can also be used to decrease the frequency of symptom flare ups (maintaining remission). With proper treatment over time, periods of remission can be extended and periods of symptom flare ups can be reduced. Several types of medication are being used to treat ulcerative colitis today.
In some circumstances, a health care provider may recommend adding an additional therapy that will work in combination with the initial therapy to increase its effectiveness. For example, combination therapy could include the addition of a biologic to an immunomodulator. As with all therapy, there are risks and benefits of combination therapy. Combining therapies can increase the effectiveness of IBD treatment, but there may also be an increased risk of additional side effects and toxicity. Your health care provider will identify the treatment option that is most effective for your individual health care needs.
Diet & Nutrition
While ulcerative colitis is not caused by the foods you eat, you may find that once you have the disease, particular foods can aggravate the symptoms. It’s important to maintain a healthy and soothing diet that helps reduce your symptoms, replace lost nutrients, and promote healing.
For people diagnosed with ulcerative colitis, it is essential to maintain good nutrition because the disease often reduces your appetite while increases your body’s energy needs. Additionally, common symptoms like diarrhea can reduce your body’s ability to absorb protein, fat, carbohydrates, as well as water, vitamins, and minerals.
Many people with ulcerative colitis find that soft, bland foods cause less discomfort than spicy or high-fiber foods. While your diet can remain flexible and should include a variety of foods from all food groups, your doctor will likely recommend restricting your intake of dairy foods if you are found to be lactose-intolerant.
In one-quarter to one-third of patients with ulcerative colitis, medical therapy is not completely successful or complications arise. Under these circumstances, surgery may be considered. This operation involves the removal of the colon (colectomy).
Depending on a number of factors, including the extent of the disease and the patient’s age and overall health, one of two surgical approaches may be recommended. The first involves the removal of the entire colon and rectum, with the creation of an ileostomy or external stoma (an opening on the abdomen through which wastes are emptied into a pouch, which is attached to the skin with adhesive).
Today, many people are able to take advantage of new surgical techniques, which have been developed to offer another option. This procedure also calls for removal of the colon, but it avoids an ileostomy. By creating an internal pouch from the small bowel and attaching it to the anal sphincter muscle, the surgeon can preserve bowel integrity and eliminate the need for the patient to wear an external ostomy appliance.
Living with ulcerative colitis and Crohn’s disease may not be under your immediate control and will often cause anxiety about when your next flare-up might occur, what your able to eat, and more. Talking to others about your UC, communicating with your doctor, knowing your rights, and understanding your condition are all ways that may help you find success in your daily life with UC and Crohn’s. Being your own best advocate can help make living well a reality.