What is inflammatory bowel disease?

Inflammatory bowel disease is the name of a group of disorders that cause the intestines to become inflamed (red and swollen). The inflammation lasts a long time and usually comes back over and over again. More than 600,000 Americans have some kind of inflammatory bowel disease every year.

If you have inflammatory bowel disease, you may have abdominal cramping and pain, diarrhea, weight loss and bleeding from your intestines. Two kinds of inflammatory bowel disease are Crohn's disease and ulcerative colitis. Crohn's disease usually causes ulcers (open sores) all along the length of the small and large intestines. Crohn's disease either spares the rectum, or causes inflammation or infection with drainage around the rectum. Ulcerative colitis usually causes ulcers in the lower part of the large intestine, often starting at the rectum.

What causes inflammatory bowel disease?

The exact causes are unknown. Some researchers think the disease is caused by a germ or by an immune system problem. You don't have to worry about your family members catching the disease from you, because it isn't contagious. However, inflammatory bowel disease does seem to run in families.

How is inflammatory bowel disease diagnosed?

Based on your symptoms, your doctor may suspect that you have Crohn's disease or ulcerative colitis. Your bowel movements will be tested for germs and the presence of blood. A doctor will look inside your intestines with a sigmoidoscope or a colonoscope. In these procedures, the doctor uses a narrow flexible tube to look directly inside your intestines. Special barium enema X-rays may be helpful in diagnosing your illness.

How is inflammatory bowel disease treated?

The best thing you can do is take good care of yourself. It's important to eat a healthy diet. Depending on your symptoms, your doctor may ask you to cut down on the amount of fiber or dairy products in your diet. In addition to eating well, you need to get enough rest. It's also important that you learn to manage the stress in your life. When you become overly upset by things that happen at home or at work, your intestinal problems can get worse.

You will most likely be treated by a team of doctors. This team may include your family physician, a gastroenterologist (a specialist in stomach and intestinal disorders) and, possibly, a surgeon.

The goal of treatment is to get rid of the inflammation by taking anti-inflammatory medicines. Some of these medicines are sulfasalazine (brand name: Azulfidine), olsalazine (brand name: Dipentum) and mesalamine (brand names: Asacol, Pentasa, Rowasa). An antibiotic such as metronidazole (brand names: Flagyl, Protostat) may be helpful for killing germs in the intestines, especially if you have Crohn's disease. You may also need to take a corticosteroid such as prednisone.

If you have severe symptoms, such as diarrhea, fever or vomiting, you may need to go to the hospital to be treated with special fluids and medicines that must be given intravenously (in your veins). If you have severe inflammatory bowel disease, you may need to take powerful medicines called immuno-suppressants. They are sometimes used to treat cancer.

If your ulcerative colitis becomes so severe that it can't be helped by medicines, it may be necessary to remove your colon surgically. Crohn's disease cannot be helped with surgery.

Because Crohn's disease and ulcerative colitis keep coming back and their symptoms cannot be predicted ahead of time, patients with these illnesses can become depressed. If you feel depressed, talk with your family doctor. An antidepressant medicine could help you feel better.

Where can I get more information about inflammatory bowel disease?

By asking questions, reading informational materials and discussing your treatments with your doctor, you'll be able to understand your illness and manage it better. Patient support groups are helpful, especially if you have severe disease.

The Crohn's and Colitis Foundation of America, Inc., has regional and local chapters. It provides free educational materials, as well as educational activities, through local chapters in most parts of the country. You can contact the foundation to ask for the address of your nearest local group:

• Crohn's and Colitis Foundation of America, Inc.

• 386 Park Avenue South, 17th Floor

• New York, NY 10016-8804

• telephone: 1-800-932-2423 or 1-212-685-3440

• Internet address: http://www.ccfa.org

A comprehensive reference book covering disease complications, medication use, pregnancy and insurance issues can be purchased through the Crohn's and Colitis Foundation of American, Inc. This is the name of the book:

The National Digestive Diseases Information Clearinghouse is a service of the National Institutes of Health. This clearinghouse, which provides educational materials on many gastrointestinal topics (including Crohn's disease and ulcerative colitis), can be contacted at this address:

• National Digestive Diseases Information Clearinghouse

• 2 Information Way

• Bethesda, MD 20892-3570

• telephone: 1-301-654-3810

• Internet: http://www.niddk.nih.gov

On the World Wide Web, information about inflammatory bowel disease can be found at this Internet address: http://qurlyjoe.bu.edu/cduchome.html