Day 1 ~ Learning

What is IBD?

Inflammatory bowel disease (IBD) is a catchall phrase that encompasses a variety of conditions that are marked by inflammation and can occur anywhere from the lips to the anus. There are two main diseases that are commonly referred to as IBD, Crohn's disease and ulcerative colitis.

What is Crohn's disease?

Crohn's disease was first written about in the United States by Burrill B. Crohn, Leon Ginzburg and Gordon Oppenheimer, a team of doctors in New York City who noticed that 14 patients shared the same characteristics of a disease pattern affecting the last part of the small intestine known as the terminal ileum.

Their paper on the topic was published in the Journal of the American Medical Association in 1932. Later in the same year, the same doctors reported on 52 others who also shared some symptoms, specifically the formation of small lesions called granulomas that were found in the small intestine.

While Dr. Crohn was the one for whom the disease was named, he was in no way the first to find it. According to Dr. Joseph B. Kirsner, a leader in IBD research and treatment, a physician who performed an autopsy as early as 1612 on a boy who had symptoms like those of CD. Another physician, T. Kennedy Dalziel of Glasgow, Scotland, reported on nine cases of "chronic intestinal enteritis" he had seen as a surgeon in a hospital there in 1913.

What are fairly clear are the characteristic markers of the disease in the gastrointestinal tract. CD can affect any site along the entire gastrointestinal tract-the lips, the oral cavity, the esophagus, the stomach, the duodenum, the jejunem, the ileum, the ileocecal valve, the cecum, the ascending or right colon, the transverse colon, the descending or left colon, the sigmoid colon, the rectum and the anus.

Because of this, the disease may go by other names, which indicate exactly where the diseased portion of the intestines is located. For example, it is commonly located in the ileum where it is referred to as ileitis or Crohn's ileitis or regional enteritis or terminal ileitis; if it involves the ileum and the colon, it is ileocolitis. When it is in the stomach or first few loops of the intestine, it is known as gastroduodenal Crohn's disease. If it is in the next few loops of intestine, it is called jejunoileitis. If it resides in the colon, it is known as Crohn's colitis. Another term for the disease is granulomatous ileitis or enteritis.

Just as Juliet wondered whether a rose by any other name would smell as sweet, a form of Crohn's disease by any other name usually acts the same way. Sores or lesions appear on the surface of the mucosa, the innermost layer or lining of the intestines; the mucosa is assigned the job of absorbing salts, water and other substances while releasing mucous. The different layers of the bowel wall become inflamed, past the muscular layer of the intestines to a protective coating called the serosa. Also inflamed is the mesentery, semi-circular fold of the peritoneum that holds the blood vessels and lymph glands associated with the intestines and adheres to the intestines as a means of support.

Generally, the symptoms of the disease include abdominal pain that can range from cramps to sharp, localized pains; a change in bowel motility such as diarrhea or constipation; blood in the stool, the color of which depends upon where it is released in the intestines and ranges from bright red to black; vomiting; nausea; lack of appetite; fever; fatigue; painful abscesses and resulting fistulas; and weight loss.

The disease can also affect other areas of the body such as the eyes, the kidneys, the liver, the joints, the gall bladder and the skin through related conditions. Because of this, occurrences such as strange bumps on the skin, a reddened or itchy eye, kidney stones, gallstones, swollen and painful joints can at times be related to CD.

There are a number of medical treatments that are effective in reducing or controlling inflammation in CD patients and there are surgical options when the medical efforts fail, when abscesses or fistula occur or scar tissue threatens to block intestinal openings. However, there is presently no cure for CD.

Click here to continue reading First Year: Crohn's Disease & Ulcerative Colitis.

All information is copyrighted by Jill Sklar, 2002. All rights reserved.

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