In inflammatory bowel disease (IBD) our digestive system is impaired and the gut becomes inflamed and swollen. The most common forms of inflammatory bowel disease are Crohn’s disease and ulcerative colitis.
The two types of IBD can be hard to tell apart. In both diseases, there is inflammation and damage to the intestine wall in the form of lesions or sores that often bleed easily. In Crohn’s disease, symptoms can be more severe and any part of the intestine can be injured, but problems are most common in the small intestine or ileum near the entrance to the large
The disease lesions are concentrated in patches and penetrate deeper layers of the intestinal wall. The lesions are often called skip lesions, as there can be areas of diseased tissue that are separated by healthy tissue.
Ulcerative colitis
Ulcerative colitis is generally a milder condition and affects one specific area of the digestive tract, which is the colon or small bowel. Disease lesions are more superficial. They are usually restricted to the top layer of the intestinal wall. They are diffuse with uniform inflammation and no areas of healthy tissue in between.
Indeterminate colitis is diagnosed when Crohn’s and ulcerative colitis symptoms overlap and are indistinguishable. It is thought that this can happen in about one in 10 cases.
Crohn’s disease
The symptoms of Crohn’s disease vary considerably and they may be mild or severe. These include persistent diarrhoea (which can sometimes be bloody), or acute pain or cramps in the abdomen. Fever, fatigue and weight loss are also common presenting symptoms. Loss of appetite is common.
Children with Crohn’s disease may first present with symptoms that seem to be unrelated to their digestive system. They may not be growing properly or they may have pains in their joints that are similar to arthritis. They may have experienced significant recent weight loss.
Diarrhoea and Crohn’s disease
Diarrhoea is one of the most distressing symptoms of Crohn’s disease. Some people may also experience extreme bloating and flatulence (farting) after a meal.
They may need to go to the toilet much more often than a non-sufferer, and for many people this can be one of the most incapacitating and distressing symptoms.
The diarrhoea may come and go or may alternate between bouts of constipation in some cases. In chronic diarrhoea, the consistency of stools can be very watery and bloody.
The most common type of pain is similar in location to a troublesome appendix with pain on the right side. Your pain may go away after a visit to the toilet.
As the severity and location of Crohn’s disease varies so much, the associated pain can also vary considerably. Pain may be very severe or mild, depending on the level of inflammation and where it is.
The pain of Crohn’s disease is usually much more than you might feel if you have a simple upset stomach or indigestion Whether your pain is cramp-like, feels like an ache or is acute will also provide clues to your doctor as to the location of the disease.
The symptoms of Crohn’s often come and go and there are times when the pain feels unbearable and other times when you think that the illness has gone away for good but it may be in remission. The pain will be less severe or disappear during periods of less active disease. Sudden onset of pain may indicate that the disease may be flaring up again.
Crohn’s disease symptoms may not necessarily get worse over time. However, when they do, medical advice is required. In cases of severe Crohn’s disease, the pain is more acute and the diarrhoea worsens with more trips to the toilet needed. Bleeding can become heavy. If the intestine becomes partially or fully blocked, nausea and vomiting are common.