Crohn's and Ulcerative Colitis

Could my stomach pain be caused by Crohn's or ulcerative colitis? 

We all experience unpleasant, uncomfortable stomach pain and GI issues from time to time. But if those symptoms occur frequently, they can signal a chronic condition that requires medical attention. 

Inflammatory bowel disease (IBD) is the umbrella name given to two chronic diseases of the intestinal tract: Crohn's disease and ulcerative colitis. Once diagnosed, dietary changes and medication can provide relief, and flare-ups become less frequent. 

What is IBD?

Both Crohn's disease and ulcerative colitis cause inflammation but at different locations along the GI tract. About 1 in 100 Americans are diagnosed with IBD, according to the Crohn's and Colitis Foundation. 

• Crohn's disease – Causes inflammation of the lining of the digestive tract from the mouth to the rectum, although it most commonly affects the small intestine. Crohn's disease is most often diagnosed in adolescents and adults between the ages of 20 and 30. 

• Ulcerative colitis – Causes inflammation and sores (ulcers) along the lining of the large intestine (colon) and rectum. Symptoms usually appear before 30 but can occur at any age. Ulcerative colitis can occur in any race but is more prevalent in Caucasians. 

Studies show between 1.5 percent and 28 percent have a first-degree relative (parent, child or sibling) with Crohn's or ulcerative colitis. 

"Many people mix up IBD with irritable bowel syndrome – or IBS – but they are not the same conditions," explains Victor J. Mihal, DO, a Sentara family practice physician and director of medical operations for a Sentara medical group.  "They have similar symptoms but are treated differently. IBS doesn't inflame or harm the digestive tract." 

How is IBD diagnosed? 

The most common symptoms of Chron's and ulcerative colitis are:

• Abdominal pain and cramping
• Constipation 
• Diarrhea and an urgency to have a bowel movement
• Fatigue
• Stool with blood or mucus
• Weight loss
• Vomiting 

"If you notice frequent or long-lasting abdominal distress and GI problems, it's best to see a family physician, nurse practitioner or gastroenterologist to determine the cause of your symptoms," Dr. Mihal advises. "We can order imaging, blood and stool tests to help us determine a diagnosis. But the gold standard to diagnose is endoscopy with a biopsy."

Are there treatments for IBD? 

Your doctor can prescribe Crohn's or ulcerative colitis medication that suppresses inflammation along the GI tract and gives tissues time to heal. When inflammation is under control, people also feel relief from symptoms like diarrhea and abdominal pain. 

Biologics – medications created from biological substances rather than chemicals – may also be prescribed to treat IBD. They target specific proteins in the body that cause inflammation. Some are administered through an IV, and others through self-administered shots. 

Another class of medication called an immunomodulator may be prescribed for IBD. These modify the activity of the immune system to decrease inflammation. 

"People with IBDs experience flare-ups and then periods of remission where they feel well," Dr. Mihal says. "Even during remission, patients take maintenance medications. During a flare-up, we may add more treatments to get it under control."

Diet is also crucial to managing IBD. Some types of food, such as spicy and processed foods, may trigger an IBD flare-up. Typically, bland, non-dairy foods are helpful during a flare-up. An appointment with a dietitian will help develop a diet that works best for you. Healthier lifestyles help avoid flare-ups – exercising, reducing alcohol consumption and quitting smoking will help.