Inflammatory bowel disease
Ulcerative colitis & Crohn's disease
The term inflammatory bowel disease covers the diseases ulcerative colitis and Crohn's disease.
The cause of these diseases is unknown. They are both characterized by an inflammatory reaction in the intestinal mucosa without detectable pathogenic bacteria, viruses or parasites.
It is an autoimmune disease, i.e. a condition in which the body’s own immune system reacts against its own tissues, in this case the intestinal mucosa.
In 10% of patients there are several cases in the family, but most often you can not detect anything hereditary.
The diseases usually begin at 20-30 years of age, but can easily start later in life. They are chronic, i.e. lifelong, and can vary in activity. They are not contagious.
For Crohn’s disease we know that smoking increases the activity and the risk of recurrence.
Ulcerative colitis is an inflammatory condition, which is usually localized to the rectum, but can spread to the entire colon. Mostly it appears at age 20-35. Symptoms are bloody diarrhea. There may also be abdominal pain, weight loss and fever, if the disease is not treated.
Diagnosis is made by an endoscopy of the colon (colonoscopy), during which tissue samples are collected for microscopy. Read more about colonoscopy.
Treatment aims to dampen disease activity and prevent recurrence. The most effective means contains steroid (cortisone), but due to the risk of side effects, you aim for a short treatment. If the disease is localized to the rectum suppositories are used, otherwise tablets. In the silent phases with no symptoms present recurrence must be prevented with tablets containing 5-aminosalicylic acid (a substance almost similar to Aspirin), for example Asacol or Pentasa.
Long term and widespread ulcerative colitis increases the risk of bowel cancer, which is why endoscopy at suitable intervals should be planned. If you attend to your treatments and controls, the risk is the same as for the rest of the population.
Prospects for ulcerative colitis:
In the vast majority of cases you can keep the disease at rest with medical treatment. It is rarely necessary to operate. Patients with ulcerative colitis have the same life expectancy as the rest of the population; they can take care of their work, have children and live a normal life.
Information booklet – Ulcerative Ulcerosa. (Danish only. Opens in new window)
Crohn’s disease is an inflammation, that can occur from the oral cavity to the anus, but is usually localized in the latter part of the small intestine. The inflammation may go deeply into the tissue and may form strictures in the small intestine and form channels (fistulas) between the intestines or between the intestine and the skin. It can already begin in the teenage years. Most patients are below 30 years of age and most are women.
Symptoms include pain and diarrhea, sometimes fever and weight loss. Quite often abscesses and fistulas in the rectum are present.
The diagnosis can be made with endoscopy of the colon and lower part of the small intestine, where tissue samples are collected for microscopy. It may be supplemented by CT- and MRI scans of the small intestine.
The treatment is to dampen disease activity and to prevent relapse. Crohn’s disease must be treated by a specialist and will depend on how widespread the disease is. The treatment is primarily medical. In acute cases steroid agents are used. If long term treatment is necessary immunosuppressive agents such as Azathioprine and Methotrexate are used. New biological agents in the form of antibody injection are also being introduced in the treatment, but are very expensive.
Prospects for Crohn’s disease:
Compared to the rest of the population the life expectancy for patients with Crohn's disease is just as long and most patients can go to work and lead a normal life. There may be periods with sick-leave depending on the activity of the disease. Crohn’s disease can cause strictures of the intestine due to scar tissue. One third of patients must therefore undergo surgery during the first year of the disease. Hereafter 5% of patients per year require surgery.
Information booklet – Crohn’s disease. (Danish only. Opens in new window)