IBD Integrated Resources Portal

Who Gets IBD?

The mechanism of IBD's pathogenesis is unknown, but several factors are thought to play a central role: genetics, the environment, gut microbiota, and the dysfunction in the gut immune system. Inflammatory bowel disease often influences relatively young people between the ages of 15 and 30 years.

Symptoms of IBD

The typical symptoms of IBD range from diarrhea, bloody stool, abdominal pain, fever, fatigue, and weight loss. The degree of the above symptoms could be from very mild to very severe. The outer GI tract's damages include joint pain/arthritis, eye/vision problems, certain types of rashes, and liver disease. The pathology of UC is quite different from CD. For UC, the intestinal damage is limited in the colon, continuous superficial ulcers， and toxic megacolon. While for CD, intestinal damage could occur in anywhere the GI tract, jumping fissure ulcer, fistula, or fibrosis.

Diagnosis

IBD is diagnosed by careful consideration of detailed medical history, medical images such as radiography or computed tomography, and endoscopic evaluation with a biopsy pathological diagnosis of the GI tract. Common infections that can cause diarrhea should be ruled out by stool and/or blood tests. No biomarkers are diagnostic of IBD, but some test abnormalities seen in IBD include anemia, elevated ESR and CRP, electrolyte abnormalities due to diarrhea, low albumin due to both inflammation and poor absorption of nutrients, and vitamin deficiencies (in Crohn's disease) due to poor absorption of nutrients.

Endoscopy and biopsy is the important method to diagnose IBD. Endoscopic evaluation can include upper endoscopy, colonoscopy, or both, depending on where the lesions are located. Multiple biopsies of the GI tract are taken, which often confirm the diagnosis.

Treatment

Treatment of IBD depends on the disease type and stage. Mild disease is treated with anti-inflammatory   medications, including 5 aminosalicylic acid, antibiotics, and/or corticosteroids. More severe disease is treated   with immunomodulators, immunosuppress, and biologics.   In particular, biological therapies, which include anti-TNFα antibodies (e.g., infliximab, adalimumab, and certolizumab), anti-integrin antibodies   (e.g.,   vedolizumab and natalizumab), anti-IL-12/23 antibodies (e.g., ustekinumab),   and Janus kinase (JAK) inhibitors, have been   shown to be highly effective in many patients with IBD. Patients with severe gut obstruction, fistula, stenosis,   and toxic megacolon may require surgery. People with IBD that involves the colon are at increased risk of colorectal cancer. Therefore, they need colorectal cancer screening throughout their lives.