With December 1 to 7 designated National Crohn’s and Colitis Awareness Week, Dr Zak urges readers to beware the signs.

AS a nation famously renowned for keeping their personal issues private, the thought of openly discussing one’s bowel habits may be an uncomfortable subject. Indeed awareness and understanding of Crohn’s Disease (CD) and Ulcerative Colitis, (UC), collectively labelled Inflammatory Bowel Disease (IBD), has only really increased in the last few years, thanks to high profile sufferers including sportspeople and politicians, brave enough to come forward, share their individual experiences, and highlight the presence of what can be an extremely debilitating condition.

Inflammatory bowel disease, as the name implies, is inflammation of the gastrointestinal tract (GI tract). In Crohn’s disease it can affect anywhere from the mouth to anus, and patches of inflammation are said to “skip” through the GI tract, whereas in Ulcerative Colitis, this inflammation starts in the rectum (the area just above the anus) and processes backwards, although it is usually only confined to the large bowel. According to the support website Crohnsandcolitis.org.uk, there are 300,000 individuals living with IBD in the UK, with a new case of either CD or UC found every 30 minutes. Most people are diagnosed between the ages of ten and 40.

Loading article content

There are many suggestions as to the cause of IBD. There is a slightly increased risk if you have a first degree relative who is also a sufferer. Another theory is that an abnormal response by the body’s immune system to a virus or bacteria in the bowel triggers the start of the disease. Symptoms include chronic diarrhoea, sometimes with mucus and blood, abdominal pain, weight loss and persistent tiredness. Unlike in gastroenteritis, where you are largely back to normal after a few weeks, a flare up of IBD may last much longer, and individuals can become seriously ill.

The most important task for anyone who feels they may have IBD is to see their routine doctor as soon as possible. After taking a history of your complaint and performing a physical examination, if your symptoms are suggestive, he or she will refer you to a gastroenterologist. Diagnosis is made with a colonoscopy (camera test of the large bowel). In addition, tissue biopsies will be taken to find out if the bowel has the typical features of IBD, when seen under a microscope.

Although we have no cure at the present time, the goal of treatment is to reduce symptoms to a point where the individual can lead as normal a life as possible. When dealing with an acute attack, drugs including anti-inflammatory medications and steroids are used. Although steroids are excellent medications, their numerous side effects make them less suitable for long term treatment. In this case, disease modifying drugs similar to those used in other inflammatory conditions such as Rheumatoid Arthritis will be started under the guidance of a specialist. Bowel surgery is reserved for cases where the condition cannot be brought under control, or the damage is such that a portion of the intestines requires removal. However, with specialist centres UK wide, we are now in the best position ever for managing this disease.

Useful websites; www.crohnsandcolitis.org.uk; www.nhs.uk/conditions/crohns-disease