Both Crohn’s Disease and Ulcerative Colitis are classed as Inflammatory Bowel Diseases (IBD), lifelong gastrointestinal disorders that are prevalent in Australia and progressively becoming more common. Around 80,000 Australians currently live with IBD, and that number is expected to increase to 100,000 by 2022.
What is Crohn’s Disease?
Crohn’s disease is an Inflammatory Bowel Disease that can cause inflammation of the digestive tract, leading to swelling, pain and bleeding, most commonly in the small bowel, the large bowel and the area around the anus. While the inflammation is most common in the bowels and anus, Crohn’s disease can affect any part of the digestive tract.
The disease is most commonly diagnosed in people between the ages of 15 and 40 and although there is no definitive cause of the disease, there are appear to be a number of contributing factors that lead to the development of Crohn’s.
- Autoimmune Reaction - Infections and foreign bodies can cause the body’s own immune system to attack the tissue of the digestive tract. One of the contributing factors to all IBDs seems to be the immune response not “turning off” after an infection, causing prolonged inflammation that eventually causes damage to the walls of the digestive tract and the symptoms of Crohn’s or Colitis.
- Genetic Factors - While not necessarily an inherited condition, there does appear to be genetic predisposition, with people with a relative with Crohn’s disease having an increased chance of developing the disease.
- Lifestyle - Smoking increases both the chance of developing and severity of Crohn’s disease. Given that Crohn’s is far more prevalent in Australia, Wesern Europe and North America, the Western diet and lifestyle could be a contributing factor to developing the disease.
Symptoms of Crohn’s Disease
Symptoms vary when it comes to Crohn’s disease depending on which part of the digestive tract the disease is affecting. Common symptoms include:
- Abdominal pain/cramps
- Bloody stool
- Diarrhea
- Fatigue
- Feeling of needing frequent bowel movements or not feeling “empty” after having a bowel movement
- Fever
- Loss of appetite
- Mouth ulcers
- Nausea and vomiting
- Swelling around the anus
- Weight loss
If the disease is not managed or progresses, people living with Crohn’s can develop more serious symptoms including:
- Anemia
- Bowel obstruction
- Inflammation in the joints and skin
- Jaundice caused by inflammation of the liver or bile ducts
- Perianal fistula - an abscess or tunnel between the anus and external skin leading to pain and leakage. A fistula can also connect the bowel with another organ - commonly the bladder - leading to infection and possible sepsis
- Ulcers - these can appear anywhere in the digestive tract from the mouth to anus
People with Crohn’s disease also have a higher chance of developing bowel cancer as well as psychological conditions including anxiety and depression.
If you’re experiencing abdominal pain and a lack of appetite, or have passed blood, the easiest way to find and book an appointment with a doctor is to do it online with MyHealth1st.
What is Ulcerative Colitis?
Much like Crohn’s disease, ulcerative colitis is an Inflammatory Bowel Disease that is caused by inflammation of the digestive tract., but unlike Crohn’s, colitis can’t form anywhere in the digestive tract, instead being limited to the large intestine (the colon) and the rectum. As the name suggests, the condition causes small lesions or sores known as ulcers to form in the bowel, leading to pain, bleeding and inflammation.
Doctors are yet to pinpoint a definitive cause of ulcerative colitis, but there appear to be a number of contributing factors. People with immune disorders have an elevated chance of developing colitis, but environmental factors and genetics also play a part. Colitis can form in people of all ages but is typically diagnosed in people between the ages of 15 and 35. For some reason, the risk of developing ulcerative colitis seems to drop in men over 50.
Symptoms of Ulcerative Colitis
The symptoms of ulcerative colitis are all but identical to those presented by people with Crohn’s disease. The diagnosis of whether a person has colitis or Crohn’s comes down to where in the digestive tract the inflammation occurs. If it occurs in the colon and rectum only, the condition is colitis. If it occurs anywhere outside of those areas it is Crohn’s.
Treatments for Crohn’s Disease and Ulcerative Colitis
While Crohn’s disease and ulcerative colitis have no cure, there are a number of treatments that can control symptoms, minimise flare ups and reduce the chances of developing some of the more serious symptoms or complications. Treatment options depend on what part/s of the digestive tract are affected by the disease, but can include:
Anti-inflammatories - Anti inflammatory drugs are often the first course of medication someone living with IBD will be prescribed. Non steroidal anti inflammatory drugs can control mild symptoms. Corticosteroids are usually a short term medication.
Antibiotics - Although IBD disease isn’t cured or directly affected by antibiotics, the medications can help with the treatment of fistulas or infections that can be causing or exacerbating inflammation.
Biologics - Biologic medications are capable of blocking certain proteins that can trigger inflammation and flare ups. Biologics are typically prescribed for moderate to severe Crohn’s disease and are typically administered as injections every 6-8 weeks.
Diet - What you eat isn’t responsible for causing IBD, but diet is one of the most effective ways to limit flare ups and control symptoms of the disease. There is no one size fits all Crohn’s or Colitis diet, so a diagnosis will often be accompanied by a referral to a dietician. Dietary measures can include, limiting or increasing fibre intake, limiting fat and dairy, increasing hydration and vitamin and mineral supplements. Most diets revolve around fairly bland, easily digestible and non-spicy food.
Immunosuppressants/Immunomodulators - These drugs affect the immune system and can help control the severity of the disease by lowering the immune response that leads to the inflammation of the digestive tract. As immunosuppressants affect the entire immune system they are not appropriate in all cases.
Surgery - The majority of people with Crohn’s disease or ulcerative colitis will require surgery at some time in their lives. Surgery can take many forms, including removing damaged sections of the digestive tract and reconnecting healthy tissue, removing or minimising scar tissue, treating severe infections or repairing severely damaged tissue.
If you have an Inflammatory Bowel Disease, or have a loved one who has, Crohn’s and Colitis Australia offers support groups for people living with IBD, online support, a helpline 1800 138 129 and resources to help you stay informed about developments in treatment, diet and control of IDB.