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Inflammatory Bowel Diseases-IBD – Ulcerative Colitis & Crohn`s Disease.
A word of caution
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educated decisions. The providing of links no way implies that these institutions recommend or endorse our
products. All the materials on this site are for your reference only. You will find detailed images for various Colitis
conditions at image galary of Gastrolab.net .

Ulcerative Colitis & Crohn`s Disease.
Ulcerative Colitis and Crohn's Colitis are two common diseases from a group of digestive diseases called
Inflammatory Bowel Diseases or IBD. They essentially manifest as inflammation of the Colon (large intestine) or
adjacent areas with in the Intestinal system. The inflammation makes the colon empty frequently (having lost the
ability to reduce the water content and volume of discharge- See How stomach works), causing diarrhea. Ulcers form
in places where the inflammation has killed the cells lining the colon; the ulcers bleed and produce pus. Very often
accompanied by abdominal pain and often rectal bleeding. In either disease, inflammation, fever and bleeding may be
serious and persistent, leading to weight loss and anemia. Children may also suffer stunted growth and delayed
development if untreated.
The most popular theory about the cause is that the body's immune system reacts to a virus or a bacterium by causing
ongoing inflammation in the intestinal wall. People with ulcerative colitis have abnormalities of the immune system
(Blood tests may also uncover a high white blood cell count, which is a sign of inflammation somewhere in the body),
but doctors do not know whether these abnormalities are a cause or a result of the disease. Ulcerative colitis is not
caused by emotional distress or sensitivity to certain foods or food products, but these factors may trigger symptoms
in some people.
Due to abnormalities of the immune system associated with Colitis, some people may experience problems such as
arthritis, inflammation of the eye, liver disease (hepatitis, cirrhosis, and primary sclerosing cholangitis), osteoporosis,
skin rashes, and anemia. Some of these problems go away when the colitis is treated.
But these two diseases are very different in many ways.

How are Ulcerative Colitis & Crohn`s Disease treated.
The medicines used for these two to control (not cure) by forcing disease in to remission and to hold it in remission
are same or similar.

Aminosalicylates, drugs that contain 5-aminosalicyclic acid (5-ASA), help control inflammation. Sulfasalazine is a
combination of sulfapyridine and 5-ASA and is used to induce and maintain remission. The sulfapyridine component
carries the anti-inflammatory 5-ASA to the intestine. However, sulfapyridine may lead to side effects such as include
nausea, vomiting, heartburn, diarrhea, and headache. Other 5-ASA agents such as olsalazine, mesalamine, and
balsalazide, have a different carrier, offer fewer side effects, and may be used by people who cannot take
sulfasalazine. 5-ASAs are given orally, through an enema, or in a suppository, depending on the location of the
inflammation in the colon. Most people with mild or moderate ulcerative colitis are treated with this group of drugs
first.

Corticosteroids such as prednisone and hydrocortisone also reduce inflammation. They may be used by people who
have moderate to severe ulcerative colitis or who do not respond to 5-ASA drugs. Corticosteroids, also known as
steroids, can be given orally, intravenously, through an enema, or in a suppository, depending on the location of the
inflammation. These drugs can cause side effects such as weight gain, acne, facial hair, hypertension, mood swings,
and an increased risk of infection. For this reason, they are not recommended for long-term use.

Immunomodulators such as azathioprine and 6-mercapto-purine (6-MP) reduce inflammation by affecting the immune
system. They are used for patients who have not responded to 5-ASAs or corticosteroids or who are dependent on
corticosteroids. However, immunomodulators are slow-acting and may take up to 6 months before the full benefit is
seen. Patients taking these drugs are monitored for complications including pancreatitis and hepatitis, a reduced
white blood cell count, and an increased risk of infection. Cyclosporine A may be used with 6-MP or azathioprine to
treat active, severe ulcerative colitis in people who do not respond to intravenous corticosteroids.
Other drugs may be given to relax the patient or to relieve pain, diarrhea, or infection.

Hospitalization
Occasionally, symptoms are severe enough that the person must be hospitalized. For example, a person may have
severe bleeding or severe diarrhea that causes dehydration. In such cases the doctor will try to stop diarrhea and
loss of blood, fluids, and mineral salts. The patient may need a special diet, feeding through a vein, medications, or
sometimes surgery.
About 25 percent to 40 percent of ulcerative colitis patients must eventually have their colons removed because of
massive bleeding, severe illness, rupture of the colon, or risk of cancer. Sometimes the doctor will recommend
removing the colon if medical treatment fails or if the side effects of corticosteroids or other drugs threaten the
patient's health.

Ulcerative Colitis	Crohn`s Disease
Affects only the Colon from Anus to end of small intestine. Does not affect Small intestine or stomach.	Can affect almost any part the digestive system. Can cause strictures, scar tissue growth or blockage of small intestine
Affects only the Mucosal layer (inner most layer that comes in contact with the food) of the Colon	Affects all layers (entire thickness) of the Colon wall.
Generally starts in the rectum and spreads from the rectum toward the first part of the colon in a steady progression in continuous pattern.	Can be discontinuous with affected areas interlaced with healthy areas.
Can be viewed easily by the doctor using proctoscope or sigmoidoscope inserted at the rectum.	More easily viewed by X-rays as the affected portion may not easily be viewed by a scope.
About 1/3 patients will eventually require surgery to get relief. Usually cured by removing the entire colon!!!.	About 2/3 patients will eventually under go surgery, though this will not cure the problem. Usually recurs in areas adjacent to removed portions.
98% have active bleeding.	Only 20% have active bleeding.
Sores (Fistulae) are rare	Sores (Fistulae) are common
Abdominal pain uncommon	Abdominal pain uncommon