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Inflammatory Bowel Disease

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) refers to two main diseases of the gastrointestinal tract: Crohn’s disease and ulcerative colitis.
Both of these diseases are characterized by inflammation, the immune system’s attempt to protect itself from something seen as harmful. Ulcerative colitis is restricted to the colon and rectum, and only affects the innermost lining of the digestive tract. Crohn’s disease can affect any part of the gastrointestinal tract. It also can penetrate deeper into affected tissues.
People with IBD can experience many GI symptoms including  abdominal pain, diarrhea and bleeding. In some cases, life-threatening complications can develop.
Inflammatory bowel disease should not be confused with irritable bowel syndrome.

What are the risk factors?

The exact cause of inflammatory bowel disease is not known. Doctors and researchers believe that it is caused by a combination of several factors, such as genetics, the immune system and the patient’s environment.
Several factors can increase a person’s chances of developing IBD:
  • Age. IBD usually develops before age 30.
  • Ethnicity. People who are white have a higher incidence of IBD.
  • Family history. You are more likely to develop IBT if a close family member also has it.
  • Smoking. Cigarette smoking is a risk factor for developing Crohn’s disease.
  • Use of pain relievers. Some pain relievers such as ibuprofen and naproxen have been shown to make IBD worse.
  • Geography. People who live in cities or industrialized countries are more likely to develop IBD.

What are the symptoms?

In most cases, inflammatory bowel disease develops over time. As a result, symptoms also tend to become greater with time, too.
The following are symptoms that may be present with inflammatory bowel disease:
  • Abdominal pain
  • Diarrhea
  • Loss of appetite
  • Unexplained weight loss
  • Bleeding from the rectum
  • Joint pain
  • Skin problems
  • Fever
  • Urgent or frequent small bowel movements
  • Fatigue
  • Delayed growth in children with IBD
Symptoms may not be present all the time. Some people may have periods of months of even years when they have no symptoms.

How is inflammatory bowel disease diagnosed?

An important part of diagnosing inflammatory bowel disease is ruling out other causes of inflammation.
The following diagnostic tools may be used to diagnose inflammatory bowel disease:
Stool sample. Pathologists may examine stool samples for blood, infection, or white blood cells that could indicate an inflammatory situation.
Colonoscopy. A flexible scope is used to provide pictures of the colon and check for inflammation. A biopsy, or tissue sample, may also be removed for further examination.
Sigmoidoscopy. This test allows a doctor to examine the last part of the colon. While not providing a picture of the full colon, it may be helpful if the colon is highly inflamed.
CT Scan. A CT scan provides images of the gastrointestinal tract in “slices”. These highly detailed images allow a doctor to detect IBD and determine its severity.
Capsule endoscopy. A small pill with a miniature camera is swallowed. The pill provides images of parts of the gastrointestinal tract that cannot be reached by colonoscopy of endoscopy. 

How is inflammatory bowel disease treated at URMC?

At the University of Rochester Medical Center, we treat inflammatory bowel disease with a combination of medical and surgical approaches. 
Through close collaboration with our Gastroenterology Department, we provide patients with the very latest drugs for inflammatory bowel disease. Our involvement in national clinical trials gives our patients access to promising new drugs that are not yet widely available.
For some patients, surgery may be required to remove all or part of the colon and rectum. Our surgeons are highly experienced at performing ileoanal pouch surgery, a procedure that creates a reservoir inside your body to collect waste and allows you to have normal bowel movements without needing a permanent stoma. We usually perform this surgery with a minimally invasive approach, helping our patients to recover more quickly. 
Some patients with inflammatory bowel disease may require a ostomy, an external bag for the collection of waste. With the help of sensitive and experienced nurses, we help patients who require a colostomy to live healthy and vigorous lives.