The most common forms of inflammatory bowel disease are Crohn’s disease and ulcerative colitis, an expression that includes all inflammatory conditions that damage the gut. There is no effective treatment for Crohn’s disease, which takes its name from Beryl Crohn, a physician who discovered the disease with his colleagues in 1932. The only treatment for ulcerative colitis is to surgically remove the colon and rectum.

However, although these two diseases cannot be cured in most cases, they can be cured, and in fact, there are many treatments that can radically reduce symptoms, and may even succeed in providing long-term improvement.

The effects of Crohn’s disease and ulcerative colitis can be so similar that one can sometimes mistake the two. The two cases have many common symptoms. In fact, both lead to inflammation of the inner lining of the alimentary canal. The two cases may take in their symptoms for an indefinite period, such as long periods of irritation followed by periods of improvement. In addition, both diseases may require a complex program of drug therapy. In fact, the drugs used in their treatment are often almost the same.

However, despite this similarity, there are basic differences between the two cases. Crohn’s disease can affect any part of the digestive system, from the mouth to the anus. Inflammation can occur at the same time in different places, and it generally extends to all tissue layers in the affected area.

Ulcerative colitis is usually confined to the colon and rectum. The inflammation often begins in the rectum and extends to the colon. This condition also differs from Crohn’s disease in that the inflammation depends on the inner mucosal lining and does not generally involve the deeper tissues.

Although Crohn’s disease and ulcerative colitis may occur at any age, they usually appear between the ages of fifteen and thirty-five. Both sexes have the same risk, while whites are more susceptible to IBD, despite the fact that the disease affects many ethnic groups.

As for the reasons, the researchers found only theories:

The immune system: There is a theory that the two diseases are caused by an unknown virus or bacteria, and the inflammation is caused by the immune system trying to confront the intruder. In fact, drugs that suppress the immune system have proven effective in controlling symptoms in many infected people, and it is also possible that the inflammation is caused by the virus or bacteria themselves.

genetics. Statistics show that 15 to 20 percent of people with Crohn’s disease or ulcerative colitis have an immediate relative with IBD, ie a parent, sibling, or child. There are many genetic factors that predispose a person to inflammatory bowel disease, and the details of these factors are still the subject of careful research.

The environment. The two diseases prevail in developed countries and cities. This has led some researchers to believe that environmental factors, such as food, may have a role in this. People who live in cities tend to eat more fatty foods than do people in rural areas, and there are other theories that people in countries with cleaner environments may be “victims” of hygiene and sanitation. As a result, they become more susceptible to infections later in life, which causes their immune systems to overreact.

Symptoms

Each of the two diseases has multiple symptoms, which may develop gradually or appear suddenly.

Crohn’s disease:

One or more of the following signs and symptoms appear and be mild to severe:

Diarrhea. The small and large intestine respond to inflammation as they do to bacterial infections. Intestinal cells secrete extra salt and water. This process overcomes the weakness of the small intestine and colon’s ability to absorb liquid. The intestines may contract more than usual, leading to diarrhoea.

Cramping and vomiting: Persistent inflammation can cause the intestinal walls to swell and thicken due to the formation of scar tissue. Intestinal ducts may narrow and block the passage of food. This results in cramping and vomiting.

hemorrhage. As the rest of the food passes through the digestive system, it rubs against the inflamed tissue and causes it to bleed. Sometimes the tissue bleeds on its own without coming into contact with food. The blood is expelled with the stool.

Weight loss and fatigue. If inflammation affects the small intestine, where nutrients are absorbed, the body may not absorb enough nutrients to maintain weight and energy levels. The weight begins to drop and the patient gets tired easily, and excessive blood loss can also cause fatigue.

Poor absorption of nutrients may be what hinders the growth of children with Crohn’s disease. According to statistics, 30 percent of people with IBD are between the ages of ten and nineteen, and two percent of cases involve children under ten.

Sores: Sores may arise as a result of chronic inflammation anywhere in the digestive system, even in the mouth, esophagus or anus. Some have an unconnected series of sores scattered throughout the digestive system. Ulcers caused by Crohn’s disease usually form in the lower small intestine (final ileum), colon, rectum, or both.

Fistulas: deep sores may penetrate completely into the intestinal wall to form a fistula. A fistula is an abnormal tubular ligament that connects internal organs or an organ to the surface of the skin. In most cases, fistulas attach to the rings of the small intestine. It is noticeable that when fistulas form between the small intestine and the colon, food particles shorten the path and head to the opening to enter the colon before nutrients are absorbed into the small intestine.

Sometimes fistulas form in pockets of bacterial infection (abscesses), which can threaten the patient’s life if left untreated. Treatment is with medication or surgery, according to the severity and location of the fistula.

Other complications. Crohn’s disease may cause the following symptoms or diseases:

@ Inflammation swelling, stiffness and pain in the joints.

@ Skin rash or sores.

@ Anal skin growths similar to hemorrhoids.

@ Inflammation of the eyes.

@ Kidney stones.

@ Gallstones.

It’s not clear what causes these problems, but some researchers believe they’re related to an immune system response that creates inflammation in parts of the body beyond the gut. When the disease is treated, some of these symptoms disappear.

Degrees of Crohn’s disease:

minor case:

Diarrhea that causes 4 or less bowel movements per day.

Slight abdominal pain, if any.

@ A healthy weight.

@ Few complications, if any.

@ Normal results in checking temperature, pulse and red blood cell count.

moderate condition:

Diarrhea that causes defecation four to six times a day.

@ Moderate abdominal pain.

@ Other complications.

acute condition:

@ Diarrhea more than six times a day.

@ Severe abdominal pain.

@ Weight loss.

@ Additional complications.

An elevated temperature, a rapid pulse, or a decrease in the number of red blood cells.

Ulcerative colitis:

Similar to Crohn’s disease, ulcerative colitis causes diarrhea and bleeding, as well as cramping, abdominal pain, and other similar complications. But ulcerative colitis is often associated with liver disease rather than kidney stones, gallbladder stones, or skin tags. More often than not, the stool is mixed with blood as well as mucus from the lining of the colon or pus from ulcers.

Toxic megacolon is a serious complication of ulcerative colitis, and it occurs in 2 to 6 percent of cases. The inflamed colon, which is unable to expel feces and gases, paralyzes and swells. Symptoms of this condition include abdominal pain and swelling accompanied by high fever and general weakness. The patient may also feel confused or unable to concentrate. If treatment is delayed, the colon may rupture, causing bacteria to move from the colon into the abdominal cavity. This situation requires emergency surgery.

Degrees of disease:

Minor ulcerative inflammation:

Diarrhea that causes 4 or less bowel movements per day.

Accidental appearance of blood in stool.

Normal results for temperature, pulse and red blood cell count.

@ Few other complications, if any.

Mild ulcerative inflammation:

Diarrhea that causes defecation four to six times a day.

The appearance of blood in the stool regularly.

@ Other complications.

Acute ulcerative inflammation:

@ Cases of diarrhea six times or more per day.

Repeated appearance of blood in the stool.

@ Abdominal pain.

@ Other complications.

High temperature, fast or slow pulse.