Types of Inflammatory Bowel Disease (IBD) Explained

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) refers to a chronic inflammation of the digestive tract that can be painful, debilitating and sometimes leading to life-threatening conditions. Primarily, it includes the Crohn's disease and ulcerative colitis.

Crohn's disease is a type of IBD that causes inflammation along the lining of digestive tract, often spreading deeper into affected tissues. Different areas of the digestive tract may get affected in different patients. It is characterised by severe abdominal pain, diarrhoea and malnutrition.

Ulcerative colitis is a form of IBD that results in a long-lasting inflammation in a part of the digestive tract, most commonly the innermost lining of the large intestine (colon) and rectum. Symptoms of ulcerative colitis develop gradually.

Apart from the above two, collagenous colitis and lymphocytic colitis are also considered forms of IBD, though they differ from classic inflammatory bowel disease.

What are the causes of the disorder?

The exact trigger for IBD is not known but research rules out the involvement of diet and stress. IBD may be linked to the following:

1. Immune system - Some studies point to the role of virus or bacteria in inflaming the immune system in order to fight the invading pathogen. Inflammation may also stem from an autoimmune reaction by the body even in the absence of a pathogen.
2. Heredity - A person is more likely to develop IBD if s/he has a family member with the disease.

What one needs to know about symptoms or signs?

Symptoms of inflammatory bowel disease vary with the location and severity of inflammation.

Symptoms and types of ulcerative colitis:

1. Ulcerative proctitis - Inflammation is confined to the rectum (area closest to the anus). Rectal bleeding is a major symptom, along with rectal pain, frequent and small bowel movements.
2. Proctosigmoiditis - The rectum and lower end of colon are involved, and characterised by abdominal cramps, bloody diarrhoea, and inability to move bowels despite the need.
3. Left-sided colitis - Inflammation extends from the rectum to the sigmoid and descending colon (located in the upper left portion of abdomen). Signs include abdominal cramps, bloody diarrhoea, and pain on left side and unexplained weight loss.
4. Pancolitis - Affects left colon or the entire colon; symptoms include severe bloody diarrhoea, abdominal cramps, and fatigue and weight loss.
5. Fulminant colitis - Rare, life-threatening colitis affecting entire colon; symptoms include severe pain, diarrhoea, along with dehydration and shock. Colon may also rupture and expand (toxic megacolon).

Symptoms of Crohn's disease:

1. Diarrhoea - Diarrhoea develops because the cells of the affected inflamed area secrete large amounts of water and salt. Cramping can cause loose stools.
2. Abdominal pain and cramping - Pain and cramping occurs due to swelling of walls of digestive tract affected by inflammation and ulceration. This affects the movement of contents of digestive tract, causing pain and cramping. More severe pain can lead to vomiting and nausea.
3. Bloody stools - Inflamed tissue can bleed with movement of food through the digestive tract. It may be seen as bright red or dark blood mixed with stool.
4. Ulcers - Small sores may develop on the surface of the intestine that can progress to large ulcers that may penetrate the intestine walls. Ulcers may also occur in the mouth.
5. Loss of appetite and weight loss - Appetite is affected due to abdominal cramping and pain and bowel inflammation, which hinders the ability to digest and absorb food.
6. Other symptoms - Patients may also experience fever, fatigue, eye inflammation, arthritis, skin disorders and inflammation of liver or bile ducts.

Which specialist should be consulted in case of signs and symptoms?

Based on symptoms, a patient is referred to the Best Gastroenterologist in Delhi, a doctor who specializes in treatment of digestive disorders. Source:"Inflammatory bowel disease," MayoClinic.com, Mayo Clinic Staff, https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/definition/con-20034908"Inflammatory bowel disease," MedScape, William A Rowe, MD, https://emedicine.medscape.com/article/179037-overview"Inflammatory Bowel Disease (IBD)," CDC.gov, Centers for Disease Control and Prevention, https://www.cdc.gov/ibd/"Inflammatory bowel disease," NHS.uk, https://www.nhs.uk/conditions/inflammatory-bowel-disease/Pages/Introduction.aspx