Inflammatory bowel disease is a disease of the intestines that causes symptoms of rectal bleeding, diarrhoea, abdominal pain and frequently weight loss.
The two commonest types of inflammatory bowel disease are Ulcerative Colitis and Crohn’s Disease. The symptoms from both of these diseases are similar to the ones described above. The main differences between the two are that Ulcerative Colitis only affects the large bowel (colon and rectum), but Crohn’s Disease can affect all of the bowel, small intestine as well, sometimes involving the mouth and anus, producing fistulas and fissures. The other main difference is that Ulcerative Colitis only affects the lining (mucosa) of the bowel but Crohn’s disease also affects the muscle layers of the bowel as well.
Despite much research the exact causes of these diseases is not certain. There is frequently a hereditary factor and someone else in the family may also be a sufferer. The only factor that we are sure about is that smoking with Crohn’s disease accelerates the disease terribly and can sometimes prevent any forms of treatment working whilst the the patient still smokes – even one a day!
In normal health the lining of the bowel is a one way membrane. Digested nutrients and water are absorbed back into the bloodstream but nothing goes the other way. When the lining is inflamed the cells forming the lining become swollen and fragile and burst easily. This causes bleeding and the blood is frequently seen in the stool. Also, when the lining is disrupted the waterproof barrier that allows the digestion and water to only flow in one direction stops working, and water and protein can now leak into the bowel from the bloodstream. This causes frequent watery stools and if a lot of protein is lost also causes weight loss. Obviously this whole process is painful and can produce a constant nagging tummy ache.
Most people have the diagnosis of Ulcerative Colitis or Crohn’s Disease made by their gastroenterologist following a prolonged period of diarrhoea and bleeding. Fortunately, most patients can be treated successfully with modern medications that keeps the condition under control or even causes a complete remission.
Occasionally, however, the symptoms of the disease cannot be controlled on medication or the side effects of the medications are such that they cannot be taken regularly enough to control the disease. In these circumstances surgery may be suggested as the next step of treatment. Modern surgery for inflammatory bowel disease does not always mean a colostomy bag, although sometimes it is necessary. However surgery frequently avoids the need for powerful medication and controls the diarrhoea and other symptoms and many patients return to leading a normal and healthy life.
If you have been advised that you need surgery for your Ulcerative Colitis or Crohn’s Disease, or if the side effects of your medications are severe enough to consider surgery and you would like a discussion about what might be involved please contact Dr Gold.
For more information on Crohn’s and Colitis take a look at the Crohns and Colitis Associations of Australia and the UK.