How to tell if you have IBD and the difference between Crohn's disease and ulcerative colitis
- You may have inflammatory bowel disease if you have abdominal pain, diarrhea, bloody stool, a low-grade fever, or a number of other digestive symptoms.
- There are two types of IBD: Crohn's disease and ulcerative colitis.
- If you have Crohn's disease, you are more likely to experience symptoms like nausea, vomiting, and mouth sores — whereas ulcerative colitis is more likely to cause bloody stool.
- This article was medically reviewed by Rudolph Bedford, MD, a gastroenterologist at Providence Saint John's Health Center in Santa Monica, California.
Inflammatory bowel disease (IBD) is a serious condition that affects the digestive system making it hard to digest food, which can cause abdominal pain infections and an increased risk of colon cancer. There are multiple types of IBD and each one can present its own risk to your health.
With the right treatment, many with IBD can live a normal life. But if it goes untreated, the condition can cause permanent damage to the digestive system. Here's what you need to know about inflammatory bowel disease and how to manage the condition.
The two types of inflammatory bowel disease
There are two types of IBD: Crohn's disease and Ulcerative colitis.
Crohn's disease
An estimated 46% of people with IBD have Crohn's disease, and it affects roughly 780,000 Americans.
Crohn's disease can cause inflammation and damage throughout your entire digestive tract, but it most often affects your small intestine and colon. This can lead to stomach pain, severe diarrhea, and weight loss.
When your digestive organs become inflamed, you can develop complications including ulcers, bacterial infections in your digestive tract, and narrowing of your intestines, which makes it harder for food to pass through.
There is no cure for Crohn's disease, but medical treatments like medication or surgery can help reduce your symptoms.
Ulcerative colitis
Ulcerative colitis is another type of IBD that causes painful ulcers to develop on your large intestine and rectum. This can cause diarrhea, weight loss, and rectal pain.
Although ulcerative colitis is not a deadly condition, it can cause severe rectal bleeding and in some cases require surgery to treat.
There is no way to cure ulcerative colitis, but with treatment, you can find symptom relief and even prevent symptoms entirely for years at a time.
Symptoms of inflammatory bowel disease
Although Crohn's disease and ulcerative colitis target different parts of the digestive tract, they do share some common symptoms, including:
- Stomach pain or cramping
- Low appetite and weight loss
- Diarrhea or bloody stool
- Low-grade fever
In addition to these general symptoms of IBD, Crohn's disease and ulcerative colitis each have their own negative effects.
If you have Crohn's disease, you are more likely to experience nausea and vomiting because the condition can affect your stomach. Whereas ulcerative colitis is confined to your bowels. In some cases of Crohn's, you may also develop mouth sores or have swelling around your eyes.
If you have ulcerative colitis, you are more likely to see blood and pus in your stool and feel pain in your rectum. You may also feel a strong urge to defecate, even if you aren't able to actually go.
In about 1 in 10 cases of IBD, people experience symptoms of both Crohn's disease and ulcerative colitis. Doctors label this overlapping condition "indeterminate colitis."
Here is a chart showing the different and overlapping symptoms of Crohn's disease and ulcerative colitis:
Diagnosing IBD
"Patients first come to medical attention due to symptoms. However, symptoms alone are insufficient to make the diagnosis," says Raymond Cross, MD, a gastroenterologist and professor at the University of Maryland School of Medicine.
To confirm a diagnosis, doctors will usually perform tests including blood tests and a colonoscopy, in which a camera is inserted into your colon to look for any signs of damage.
Some patients with Crohn's disease only have damage to their small intestine, which can't be reached with a colonoscopy, Cross says. In these cases, doctors will need to perform body scans like an MRI or CT scan to make their diagnosis.
Causes of inflammatory bowel disease
Though experts don't know exactly what causes IBD, there may be multiple reasons people develop the condition. Two possible explanations for IBD are:
- Genetics: You are 4 to 8 times more likely to develop an inflammatory bowel disorder if one of your close relatives has the disease. However, genetics only play a small role, as most people with IBD don't have a family history of the condition.
- Immune system dysfunction: Normally, your immune system works to fight off harmful microbes that enter your body. But if you have IBD, your immune system may overreact and begin attacking the bacteria native to your digestive tract. This means that your immune system will be constantly activated because it reacts to your normal state as if you have an infection, Which can cause inflammation and damages the organs in your digestive system.
Treatments for inflammatory bowel disease
"Fortunately, there are many treatment options," Cross says. Some of the most common treatment options include:
- Anti-inflammatory medication: These prescription medications are one of the first treatments doctors will try when treating IBD. Options can be steroids or non-steroidal, and the medication your doctor chooses will depend on how your digestive system is affected by the disease.
- Changing your diet: For some patients, altering your diet can help control symptoms. This may involve cutting out hard to digest foods like dairy, spicy foods, and alcohol. Your doctor may also recommend a low residue diet, which involves cutting down on high-fiber foods like raw vegetables to reduce the number of bowel movements you have. This can help food move more easily through narrow intestines.
- Immunosuppressants: Because your immune system may be causing the inflammation that damages your organs, doctors may prescribe a medication to suppress your immune system's response.
- Surgery: There are many different types of surgery for IBD, including removing an area of infection or blockage, inserting a feeding tube, or removing large sections of your colon, depending on how severe the disease is.
"Surgery is more often needed to treat complications of Crohn's disease," Cross says, particularly because Crohn's patients often develop abscesses of infection around the anus. Surgery is less common for ulcerative colitis patients, Cross says, but in severe cases where your entire colon is removed, the disease will be fully cured, as colitis doesn't affect any other parts of your digestive system.
Inflammatory bowel disease is a serious condition that can be life-threatening if it isn't treated. If you think you may have IBD symptoms, it's best to visit a doctor as soon as possible. "Patients with new onset diarrhea with or without bleeding and/or abdominal pain should seek medical attention," Cross says.
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