Sotirios Vasilopoulos, M.D., a board-certified gastroenterologist who specializes in IBD management and advanced endoscopy, describes the differences between IBD and other diseases.
What is IBD? Inflammatory bowel disease includes a spectrum of chronic inflammatory diseases of the intestines of unknown cause. IBD involves two main conditions: ulcerative colitis, which affects the inner lining of the large intestine or colon alone, and Crohn’s disease which is a more complex syndrome that may affect any part of the gut causing full, thick inflammation of the intestinal wall.
What are the symptoms? The classic symptom of ulcerative colitis is bloody diarrhea. On the other hand, Crohn’s can have a variety of presentations, so the doctor has to be careful to make sure not to confuse it with other less severe conditions, such as irritable bowel syndrome (IBS). The most common symptoms of Crohn’s include abdominal cramping and diarrhea. Other IBD symptoms may be related to skin sores, anal fistula, liver disease, high inflammation, arthritis, etc.
How does IBD differ from IBS? The diagnosis of Crohn’s is sometimes significantly delayed for years due to its similarity to IBS, which is a non-inflammatory condition of the colon. The presence of alarming symptoms such as chronic fatigue, chronic fevers, night sweats, joint pain, anemia and weight loss should heighten the suspicion of Crohn’s disease and trigger a gastrointestinal (GI) investigation.
How many people are affected by IBD? IBD is very common. One in 200 people, or 1.6 million Americans are currently living with IBD. It may affect people of any age, but usually starts between ages 15 and 30.
Is it inherited? If not, what causes it? There is a genetic predisposition with up to 25 percent of people having a close relative with IBD. However, environmental factors seem to play a role, such as smoking, the use of non-steroid, anti-inflammatory drugs, antibiotics and also infections. Both genetic and environmental factors seem to affect the body’s ability to distinguish foreign antigens from the body’s own intestinal tissues. This leads to an inappropriate and excessive immune reaction against the intestine. We have found that people with Crohn’s disease who smoke have worse symptoms.
Is IBD the same as colitis? There may be a partial overlap between IBD and colitis. Colitis means inflammation of the colon. It can be acute or chronic. On the other hand, IBD is always chronic and sometimes may not involve the colon at all, but only the small intestine.
What are some tests that are performed to diagnose IBD? Besides a good history taking and physical examination, most patients would require blood work and a colonoscopy. In addition, many patients may also require a CT or barium X-ray, study of the small intestine and perhaps an upper endoscopy.
How is it treated? Treatment generally varies according to the type of IBD – Crohn’s vs. ulcerative colitis – the severity of IBD, and the presence (or not) of complications. In many cases, surgical therapy is required, especially when there are severe complications such as narrowing of the intestines from scar tissue or the development of fistulas, abscesses or intestinal perforation.
Newer, more effective treatments for IBD have been developed and are now available at Northwest Community Healthcare (NCH). There are many different medications available. In the last two decades there has been a major breakthrough with the development of biologic drugs that have had a major impact.
What does the Center for Advanced Therapeutic Endoscopy (CATE) at NCH offer patients with IBD? At CATE, we offer patients a comprehensive GI and endoscopic evaluation in order to diagnose IBD and guide medical endoscopic and surgical treatment. We provide guidance to our patients to maintain their disease in remission and prevent complications.
CATE is on the fourth floor of the Busse Center, 880 W. Central Road, Suite 4500, in Arlington Heights. Call 847-618-3060 to schedule an appointment. For most patients, a referral is not required.
Dr. Vasilopoulos has a special interest in IBD and worked with colleague and mentor David Binion, M.D., an IBD specialist, at the Medical College of Wisconsin in Milwaukee during his training. He completed advanced endoscopy training at Northwestern University under the direction of Willis Parsons, M.D.