Ulcerative colitis and Crohn disease are different types of inflammatory bowel disease (IBD) (Huether & McCance, 2014). IBD is differentiated from other types of bowel disorders by the exclusion of infectious process, episodes of mucopurulent bloody diarrhea, failure to respond to antibiotic treatment, and exacerbations followed by times of remission (Hammer & McPhee, 2014).
Ulcerative Colitis
Ulcerative colitis (UC) causes lesions to appear in the colon, most commonly in the sigmoid colon and rectum (Huether & McCance, 2014). The affected mucosa of the colon has increased blood flow, appears dark red, and is continuous in nature (Huether & McCance, 2014). Abscess formation occurs followed by edema and thickening of the muscularis mucosae; as the destruction of the colon occurs bleeding, cramping pain and diarrhea (Huether & McCance, 2014). Dehydration, weight loss, and anemia can be seen from loss of the absorptive surface of the intestinal mucosa and rapid colonic transit time which causes large numbers of watery stools (Hammer & McPhee, 2014). In people with UC, lymphocytes may have cytotoxic effects on epithelial cells in the colon which causes the associated lesions and symptoms (Huether & McCance, 2014). UC may be seen more often in patients with other autoimmune disorders (Huether & McCance, 2014).
Treatment. Treatment of UC depends on the severity of the disease (Huether & McCance, 2014). Treatments to suppress the inflammatory response are often helpful such as steroids and aminosalicylates (Huether & McCance, 2014). More aggressive treatment may include immunosuppressants may assist in inducing remission, however, due to the nature of the disease, it is often difficult to discern whether treatment or the natural progression of the disease has caused an episode of remission (Hammer & McPhee, 2014).
Crohn Disease
Chrohn Disease (CD) also causes inflammation of the colon but can affect both the large and small intestine (Huether & McCance, 2014). The inflammatory process is thought to be caused by increased levels of interferon-gamma and tumor necrosis factor (Huether & McCance, 2014). The inflammatory lesions in CD often affect the intestines in segments causing “skip lesions” to be seen (Huether & McCance, 2104). These lesions may cause fissures that can extend between loops of intestine, into the bladder, rectum or vagina (Huether & McCance, 2014). Symptoms of CD may be different based on the area of intestine involved; diarrhea, weight loss, rectal bleeding, and anemia caused by malabsorption of vitamin B12 (Huether & McCance, 2014).
Treatment. Treatment of CD is similar to that of UC. Smoking cessation is an important component to control CD and surgery may be needed to treat fistulas associated with the disease (Huether & McCance, 2014).
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain accompanied by either constipation, diarrhea or both (Huether & McCance, 2014). IBS is a complex disorder that is diagnosed with no other detectable pathological processes or structural abnormalities are found to cause symptoms (Hammer & McPhee, 2014). Several proposed pathophysiological mechanisms have been thought to be the cause of IBS including, abnormal gastrointestinal motility, overgrowth of intestinal flora, food allergy or food intolerance, or emotional stress (Huether & McCance, 2014).
Treatment. Treatment of IBS includes the use of laxatives or fiber, antidiarrheals, antidepressants, and analgesics (Huether & McCance, 2014). Alternative therapies that have shown to provide relief include probiotics, hypnosis, and acupuncture (Huether & McCance, 2014).
The Role of Genetics
Genetics have been shown to play a role in the development of both IBD and IBS. Recent studies have found that patients with IBD have abnormalities in several categories of genes, including genes that affect immune function, autophagy and epithelial function (Hammer & McPhee, 2014). However, only about 20-30% of persons with these genetic changes actually develop the disease (Hammer & McPhee, 2014). With regards to IBS, a specific gene has not been found to be associated with the condition, although recent studies suggest that genetics may play a role (Henstrom & D’Amanto, 2016). A Swedish survey with more than 50,000 participants was able to show an increased risk of IBS among first, second, and third-degree relatives; showing a genetic connection exists (Henstrom & D’Amanto, 2016).