Inflammatory bowel disease: what you need to know

Abdominal cramps, pain, bleeding, and diarrhea may mean you have inflammatory bowel disease (IBD)—a catchall name for disorders that inflame the intestines. Crohn's disease and ulcerative colitis are the most common forms of IBD.

• Crohn's disease causes ulcers throughout the small and large intestines, and sometimes around the rectum.
• Its inflammation may spread to other neighbouring organs, such as the bladder or vagina, through an abnormal connection called a fistula.
• Other symptoms of Crohn's are reduced appetite and weight loss.
• Although no cure yet exists for Crohn's, medications can help relieve the pain and sometimes even cause a remission.

• Ulcerative colitis affects only the lining of the large intestine and the rectum.
• There are several types: Ulcerative proctitis, signalled by rectal bleeding and a feeling of urgency even when you don't have to go, is confined to the rectum.
• Left-sided colitis (only from the rectum up the left side of the sigmoid and descending colon) and pancolitis, which affects the whole colon, have symptoms of bloody diarrhea, cramps, and weight loss.

• No one knows what causes IBD, but doctors are coming closer to an answer.
• A recent study found that mice without a certain signalling molecule that helps gut cells deal with stress developed IBD. When that molecule is missing, the intestine can grow inflamed, allowing bacteria to invade the intestinal wall. This, in turn, activates the immune system. The result: chronic inflammation. Heredity plays a part as well.

• Your doctor will do a series of tests, including some of the following: blood tests to check for low red blood cell count and infection; a stool sample to test for blood and infection; X-rays with a barium enema, which uses a white liquid that displays the ulcers on imaging.
• A sigmoidoscopy and/or a colonoscopy might also be performed. Both these tests allow the doctor to look with a lighted instrument at part or all of your colon. Computerized tomography (CT), a kind of X-ray, provides more detail than a standard X-ray.

• There is hope. Although IBD can be serious, even life-threatening, if not controlled with medications and lifestyle changes, both the disease and the pain can be treated.
• According to a recent Canadian study, 86 percent of patients with ulcerative colitis improved or went into remission after six weeks of taking probiotics, supplements of beneficial bacteria that live in our guts.