Illnesses that are characterized by pain, diarrhoea and bleeding from the lining of the intestines.

Causes

The two recognized forms of inflammatory bowel disease are Crohn’s disease and ulcerative colitis. Crohn’s disease can affect any part of the digestive tract from the mouth to the anus; ulcerative colitis affects only the large intestine. Some specialists believe that these are related diseases differing in severity. It is possible that both are caused by an auto-immune condition. Many sufferers lead mainly normal lives in between flare-ups, although severe flare-ups are potentially dangerous. Life expectancy is little affected by ulcerative colitis, whereas people with Crohn’s disease are twice as likely as the general population to die prematurely.

Crohn’s disease

Crohn’s disease became more common during the 20th century, leading to a search for a causative factor such as a virus. Currently the measles virus is suspected but there is no definite proof. There is a strong family tendency in white racial groups, less so in black groups. It is four to six times more common in smokers, whereas smoking appears to have a protective effect against ulcerative colitis. The peak incidence is between 20 and 40 years of age.

Ulcerative colitis

Ulcerative colitis is also more common in families and certain racial groups, for example Jews. Smokers are half as likely to get the condition. (See Lung cancer, however, for the great dangers of smoking.)

Symptoms

Abdominal pains and diarrhoea are prominent features of both conditions, although these tend to be worse in ulcerative colitis. Bleeding and the passage of mucus with diarrhoea are particular symptoms of ulcerative colitis. In both diseases there are periods of ill health, weight loss and anaemia interspersed with remissions when you feel quite normal. People may also have inflammation of their joints and eyes.

The diagnosis is confirmed by blood tests, which show inflammation, and by colonoscopy whereby the bowel can be inspected and biopsies taken. As Crohn’s disease can extend outside the large intestine, barium studies are useful to show the extent of the condition.

Treatment

In acute attacks antidiarrhoea compounds such as loperamide or codeine are needed, plus steroids to reduce inflammation and drugs like mesalazine or salazopyrin to reduce overall bowel inflammation. Disease confined to the rectum can be treated with enemas containing steroids. People can become very ill very quickly through dehydration, bleeding and the bowel rupturing, so hospital treatment is often needed. Many people find that taking mesalazine or similar daily reduces the frequency and severity of the condition. Such drugs are more effective for ulcerative colitis than for Crohn’s disease.

Surgery is avoided if possible because the bowel does not heal well, but it may be a last resort for severe persistent ulcerative colitis. The whole large bowel and rectum are removed, leaving an ileostomy – a bag worn on the abdomen into which the small intestine empties. For Crohn’s disease it may suffice to cut out areas of localized disease.

Ulcerative colitis has a greatly increased risk of bowel cancer after 15-20 years, so that regular screening is advisable.

Complementary Treatment

Useful acupuncture points are Stomach 25, on the abdomen, and Stomach 36, below the knee. In Chinese herbalism helpful herbs include Dang Shen and Bai Zhu, both part of the formula called Si fun Zi Tang (four noble formulae.) Chakra balancing can help reduce inflammation of the gut and aid healing of the gut wall surface. Diet – consult a naturopath or nutritional therapist. Other therapies you could try: homoeopathy; healing; shiatsu-do; chiropractic.

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