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Inflammatory Bowel Diseases (IBD)

Inflammatory Bowel Diseases (IBD)

Inflammatory bowel disease (IBD) is a group of conditions affecting the colon and small intestine. The two major types of IBD are Crohn's disease and ulcerative colitis, although there are other, rarer forms of colitis that fall under the umbrella of IBD.

IBD is very common, affecting 1 out of every 250 persons in America. Crohn's disease has a high incidence rate in the Jewish population, and all types of IBD have a strong genetic component. About 10% of IBD patients are under 18.

The precise cause of IBD remains unknown. These inflammatory conditions are most likely caused by the body's immune system reacting abnormally to bacteria in the intestine. When this happens, white blood cells infiltrate the intestinal lining,producing substances that harm your internal tissues.

Symptoms and Diagnosis

Although the two diseases are very different, Crohn's disease and ulcerative colitis present with such similar symptoms that they often are mistaken for each other. Both conditions can manifest in abdominal pain, diarrhea, rectal bleeding, internal cramps, weight loss, vomiting and changes in the stool.

For effective treatment, it is very important that patients receive an accurate diagnosis of their IBD condition. Physicians can give a precise diagnosis based on a variety of tests, including stool analysis, barium enemas, blood tests, and colonoscopy with biopsy of the patient's lesions.

Colonoscopy remains the most definitive method of diagnosing types of IBD. In this procedure, your physician inserts a thin,lighted camera tube that facilitates a view of the entire colon. During the endoscopy, tissue samples from inside the colon can be biopsied, or removed for analysis. In the laboratory, the biopsied cells are tested for granulomas, or clusters of inflamed cells. Because Crohn's disease results in granulomas and ulcerative colitis does not, colonoscopy continues to present a reliable method of precise IBD diagnosis.

Treatment

There is currently no medical cure for IBD. Thus, the goal of treatment is to increase quality of life for patients and achieve symptom remission, which allows the intestinal tissues to heal. Once the primary symptoms are under control, certain medicines can greatly reduce the frequency of what physicians call "flare-ups."

Commonly prescribed drugs for IBD include corticosteroids, which reduce inflammation in the intestines, and immunosuppressives,which help control the body's immune response and can often maintain and extend a patient's remission. Other drugs include metronidazole, an antibiotic affecting the immune system, and mesalazine, a bowel-specific anti-inflammatory drug.

At Memorial Hermann, Dr. Attila Ertan is working at the forefront of new medical treatments for Crohn's and ulcerative colitis. In his research over the past two decades, he has facilitated the emergence of biologic therapy through agents like infliximab, which block chemicals involved in the inflammatory and immune response. With infliximab infusions, two-thirds of patients with Crohn's disease improved; this biologic therapy also succeeded in closing most fistulas in the Crohn's patient population. Today, Dr. Ertan is a principal investigator in several research protocols involving new, promising biologic agents that are not yet commercially available.

In advanced forms of IBD, your physician may consider surgical treatment, although results vary widely according to the specific type of disease. Crohn's disease can be exacerbated and complicated by surgical intervention, while ulcerative colitis can in certain cases be treated by dramatic procedures such as colectomy, or the surgical removal of the colon.