About Crohn’s Disease & Ulcerative Colitis
- Crohn’s disease and ulcerative colitis are chronic digestive disorders of the intestines. These illnesses are collectively known as inflammatory bowel diseases, or IBD, because many of their symptoms and complications are similar. However, recent evidence suggests that they are separate disorders.
- It is estimated that some 1.4 million Americans suffer from IBD, with approximately 30,000 new cases diagnosed each year.
- Anyone can get IBD, but adolescents and young adults between the ages of 15 and 35 are most susceptible. (Ten to 20 percent of those afflicted develop symptoms before the age of 18.)
- The cause of IBD is unknown. There is no medical cure for these conditions, which can flare up without warning. Colectomy (surgical removal of the colon) cures ulcerative colitis. Crohn’s disease is incurable; its relapse rate is 75-80 percent.
- Approximately 20 percent of patients have another family member with IBD, and families frequently share a similar pattern of disease.
- According to a 1990 study, the medical costs of IBD in the U.S. totaled $1.4-$1.8 billion annually. Surgery and inpatient care were estimated to account for roughly one-half of this amount. The disability costs of illness (lost labor productivity) were estimated to be $0.4-$0.8 billion, making the total estimated annual cost of IBD $1.8-$2.6 billion.
Symptoms & Complications
- Ulcerative colitis involves the inner lining of the colon, while Crohn’s disease involves all layers of the intestine and can occur in both the small intestine and colon.
- Symptoms range from mild to severe and life-threatening, and include any or all of the following:
- persistent diarrhea
- abdominal pain or cramps
- blood passing through the rectum
- fever and weight loss
- joint, skin, or eye irritations
- delayed growth and retarded sexual maturation in children
- Crohn’s disease and ulcerative colitis are unpredictable illnesses. Some patients recover after a single attack or are in remission for years. Others require frequent hospitalizations and surgery. Symptoms may vary in nature, frequency, and intensity.
- Without proper treatment, symptoms may worsen considerably and complications, such as abscesses, obstruction, malnutrition, and anemia, are frequent.
- Colon cancer may be a serious complication of long-term ulcerative colitis or Crohn’s disease involving the whole colon, even in a patient who is in remission.
- Medications currently available alleviate inflammation and reduce symptoms, but do not provide a cure or prevent long-term complications. The principal drugs used to treat both Crohn’s disease and ulcerative colitis are 5-ASA preparations, corticosteroids (e.g., prednisone, budesonide), and immunosuppressants. Antibiotics are useful in Crohn’s disease of the colon.
- 5-ASA is the active ingredient of sulfasalazine, which was widely prescribed to treat IBD for many years. Today, other 5-ASA preparations, which have fewer side effects than sulfasalazine, are FDA-approved for treatment of ulcerative colitis: Asacol®, Rowasa®, Dipentum®, and Pentasa®. Though they have not been approved for this indication, Asacol and Pentasa are useful in Crohn’s disease because they are delivered to the small intestine.
- Immunosuppressive agents, such as azathioprine (Imuran®) and 6-mercaptopurine (6-MP, Purinethol®), are helpful in persons who do not respond to 5-ASA and corticosteroids, or who have recurrent flare-ups of disease when steroids are tapered.
- New treatments are being developed, based on research of the immune system’s role in the symptoms of IBD. The first of these, Remicade®, has been approved by the FDA for treatment of patients with moderate to severe Crohn’s disease who have not responded to conventional therapy. Remicade targets TNF-alpha. This chemical, which is secreted by cells in the immune system, plays a key role in causing inflammation in people with IBD.
- Surgery is sometimes recommended when medications can no longer control symptoms, when there are intestinal obstructions, or when other complications arise.
- An estimated two-thirds to three-quarters of persons with Crohn’s disease will have one or more operations in the course of their lifetime. The surgery for Crohn’s disease, however, is not considered a permanent cure, because the disease usually recurs. For ulcerative colitis, surgical removal of the entire colon and rectum (colectomy) is a permanent cure. Approximately 20 percent of ulcerative colitis patients have to undergo colectomy eventually. The risk for surgery for ulcerative colitis may be higher if the disease begins in childhood.
- IBD is not a psychosomatic illness–there is no evidence to suggest that emotions play a causative role. Flare-ups of disease may occur, however, during times of emotional or physical stress.
- There is no link between eating certain kinds of foods and IBD, but dietary modifications, especially during severe flare-ups, can help reduce disease symptoms and replace lost nutrients. People with IBD may suffer uncomfortable symptoms when they drink milk or eat dairy products, as approximately 20 percent of the Caucasian population, and the majority of non-Caucasians, have lactose intolerance.
Effects on the Person With IBD
- The economic and social burden on patients and their families can be enormous. Children and adults may have to interrupt school and work for repeated hospital stays, and medical and disability insurance often are unavailable.
hi everybody,i have been dealing with Crohns Disease for over 5years. The pain and discomfort caused by this hideous disease destroyed my life. I have gone through two bowel resections and numerous emergency room and hospital visits over the years. During the first twenty years of this disease, Prednisone and Sulfasalazine were the main treatment. Later Antibiotics (Ciprofloxacin or Metronidazole), Corticosteroids, 6-Mercaptopurine (6-MP), Methotrexate, and Cyclosporine when I ended up in emergency rooms. Which happened more than I can remember. None of these worked as the Prednisone did. I eventually started receiving Remicade treatments that helped with the fistulas for a while. This was temporary and I had to go back every 6 weeks. In 2007 , the disease flared-up and consumed me. I was found in bed un-responsive and rush to the hospital in an ambulance. I spent three days on life support and stayed in the hospital for approximately 35 days. During this time, they were not able to get control of the disease and I experienced my second bowel resection. I never recovered. After the surgery, I got worse. The pain returned and got worse, and I developed a new symptom of rashes all over my skin. The pain stayed at a level 10 and was now 24 hours. I slept in 30 minute increments because my bowel frequency was unparalleled to anything I had experience in all the years of harboring this disease. I literally was preparing for my death. I sent all my possessions to my children and arranged for my body to be taken care of. I at this time lost all hope and wanted nothing more than to die. In September of 2010 , my roommate approached me and told me she met someone whose grandchild had Crohns disease. He had come across a spell-caster that he felt could help me. I responded that I did not want help and really, as if I need another miracle in my life as I rolled my proverbial eyes. Through the years, I had tried everything. I made my own food. I ate different diets. I tried everything from Probiotic products to vitamins to miracle cures. At every corner through the years was the ultimate miracle that resulted in yet another disappointment. With her insistence, I contacted this individual and when we talked I felt there was no way I wanted anything to do with this. To my disappointment, there was a voice deep down pushing me forward. I accepted everything he said i should do and everything he told me. My attitude was that I had nothing to lose. Therefore,I followed his instructions,he sent me some materials and information on how to prepare and use them which i did. Two weeks after, the pain disappeared and I was able to sleep through most of the night. The frequency went down and I was able to sleep through the night within a week of starting the formula of what he gave me. Today I am not totally symptom free and there are some resemblances of the disease present at times. However, I lost my ileum in the first bowel resection and bile can be an issue if I do not watch my diet. For the most part, I live a productive, happy symptom free life. In my heart, I know the disease is gone. I feel that after 6 years of pain and everything else that comes with Crohns disease there is a body and cellular memory.this is his contact details: odonmark11(at)gmail(dot)com.As each day goes by, I laugh more than the day before. There is hope for people out there.I guess he saved me and magic does still exist with right people…