Crohn’s and Colitis Awareness Week is observed annually in December. Begun in 2011, Crohn’s and Colitis Awareness Week is a time to shed light on the challenges faced by those with inflammatory bowel diseases (IBD), which affect an estimated 1.6 million Americans, with 70,000 new cases of IBD being diagnosed each year. This year’s theme is to help make #IBDVisible.
What Are Crohn’s Disease and Ulcerative Colitis?
Crohn’s disease, named for the doctor who first identified it in 1932, is a chronic inflammatory condition of the gastrointestinal (GI), or digestive, tract, and ulcerative colitis is a chronic inflammatory condition limited to the large intestine (the colon). They are known collectively as IBD. (Note: IBD is different from IBS, irritable bowel syndrome. IBS is a common disorder affecting the large intestine that is not caused by inflammation and the tissues are not damaged the way they are in IBD.)
IBD can cause the following symptoms:
- severe abdominal pain and cramping
- persistent diarrhea
- debilitating discomfort
- rectal bleeding
- gas or flatulence
- unintentional weight loss
- nausea and vomiting
- sores in the mouth and around anus
IBD can also affect other parts of the body, namely the joints, skin, bones, kidneys, liver, and eyes.
How Do Crohn’s and Colitis Symptoms Differ?
Because Crohn’s disease affects the upper GI tract and ulcerative colitis affects the colon, symptoms differ between the two disease. Examples of how Crohn’s and ulcerative colitis can differ include:
- False urges: Ulcerative colitis causes false urges, that is, the feeling of needing to have a bowel movement but not being able to pass any or just a small amount of feces. The sense of urgency is due to rectal inflammation.
- Pain: Pain in Crohn’s disease patients is felt throughout the entire abdomen, whereas pain in colitis is typically localized to the left area of the abdomen.
- Sores in the mouth and around anus: These sores occur more often in people with Crohn’s disease than colitis.
- Perianal disease: This condition is more common in Crohn’s disease sufferers and can cause the following symptoms to develop:
- swollen skin tags that appear to be hemorrhoids but are not
- abscesses (pockets of pus that occur from infections)
- fistulas (infections that have resulted from abscesses and settled in hollow organs of the body, such as the rectum)
People with Crohn’s disease may also experience the following symptoms:
- inflammation of the skin, eyes, and joints
- inflammation of the liver or bile ducts
- kidney stones
- in children, delayed growth or sexual development
There are different types of ulcerative colitis, depending on where the inflammation occurs. The types of colitis include:
- ulcerative proctitis: inflammation of the area around the anus (rectum); rectal bleeding may be the only symptom
- proctosigmoiditis: inflammation of the rectum and sigmoid colon, the lower end of the colon; bloody diarrhea, abdominal cramps and pain, and an urge but no ability to move bowels are signs
- left-sided colitis: inflammation runs from the rectum through the sigmoid and down into the colon; symptoms include bloody diarrhea, abdominal cramping and pain on the left side, and an urgency to defecate
- pancolitis: the entire colon typically is inflamed; bouts of bloody diarrhea, abdominal cramps, fatigue, and significant weight loss can occur
When to See a Doctor
A persistent change in bowel habits to include the following is a sign to call a doctor and be examined:
- unexplained abdominal pain
- blood in the stool
- ongoing diarrhea that does not let up with over-the-counter medications
- diarrhea that is persistent and awakens you from sleep
- unexplained fever that lasts for more than two days
Causes of Crohn’s and Colitis
The cause of Crohn’s disease and ulcerative colitis is unknown. Diet and stress were once suspected, but doctors now believe these may be aggravating factors but not causes. A malfunctioning, overactive immune system that mistakenly fights off nonthreatening cells instead of invading viruses or bacteria may be one cause. Heredity may be another.
Recent research has pointed to autism spectrum disorder (ASD) in children as a possible link since children with autism are prone to gastrointestinal disorders. A 2014 study in the journal Pediatrics found that children with ASD are four times more likely to experience gastrointestinal distress as their peers and are 67 percent more likely to receive an IBD diagnosis.
Risk Factors of Crohn’s and Colitis
The following risk factors contribute to Crohn’s disease and ulcerative colitis:
- Age: Although IBD can occur at any age, both Crohn’s and colitis typically begin before age 30.
- Race or ethnicity: Although IBD can occur in all ethnic groups and races, whites have the highest risk, especially people of Eastern European Jewish (Ashkenazi) heritage. The incidence of Crohn’s disease also is increasing among Black people of North America and the United Kingdom.
- Family history: People with a parent, sibling, or child have the highest risk, and as many as one in five people with Crohn’s has a family member with it.
- Cigarette smoking: Smoking is the most important avoidable risk factor and can lead to more-severe symptoms.
- Nonsteroidal anti-inflammatory medications (NSAIDs): Ibuprofen, naproxen sodium, and diclofenac sodium, among other NSAIDs, can lead to inflammation of the bowels that makes IBD worse.
Complications of Crohn’s and Colitis
The following complications are possible with Crohn’s and colitis:
- severe bleeding
- perforated colon
- severe dehydration
- inflammation of the skin, joints, and eyes
- increased risk of colon cancer
- rapidly swelling colon
- increase risk of blood clots in veins and arteries
- bowel obstruction
- anal fissure
For more information on IBD, including how to manage social situations, relationships, and work and school life, visit the Crohn’s & Colitis Foundation website. Here, you will find support and listen to firsthand accounts of people living active lives with IBD.
Herrick Library Resources on Crohn’s Disease and Ulcerative Colitis
The following materials can be reserved and checked out via curbside pickup:
- 20 Questions & Answers about Crohn’s Disease, by Francis Farraye: This thorough book covers many topics about Crohn’s, including risk and prevention, treatment options, and forms of diagnosis.
- 100 Questions & Answers about Crohn’s Disease, and Ulcerative Colitis, by Andrew Warner and Amy Barto: Two doctors with the Lahey Hospital and Medical Center in Boston answer 100 top questions about IBD.
- Alive & Kicking: The True Life Story of How an NFL Star Survived Ulcerative Colitis & Ostomy Surgery, by Rolf Benirschke: The former San Diego Chargers placekicker gives his account of living with Crohn’s disease.
- Crohn’s & Colitis: Understanding & Managing IBD, by Hillary Steinhart: Dr. Steinhart provides information about the two forms of IBD and how to manage them.
- Crohn’s Disease: Second Opinion: This DVD focuses on a patient who has had Crohn’s disease since age 12.
- What to Eat with IBD, by Tracie Dalessandro: A dietitian and patient with IBD provides nutrition information for people suffering from Crohn’s and colitis.
- Your Child with Inflammatory Bowel Disease: A Family Guide for Caregiving, Maria Oliva-Hemker, ed.: This informative book is a family guide for caregivers that explains IBD and its challenges.
Sources: Capital Digestive Care, This Is Crohn’s & Colitis Awareness Week, https://www.capitaldigestivecare.com/news-resources/news/this-is-crohns-colitis-awareness-week; Centers for Disease Control and Prevention, Inflammatory Bowel Disease (IBD), https://www.cdc.gov/ibd/what-is-IBD.htm; Crohn’s and Colitis Canada, About Crohn’s & Colitis, https://crohnsandcolitis.ca/About-Crohn-s-Colitis/Signs-Symptoms; Crohn’s & Colitis Foundation, Crohn’s & Colitis Awareness Week, https://www.crohnscolitisfoundation.org/awarenessweek; Crohn’s & Colitis Foundation, Navigating Daily Life with IBD, https://www.crohnscolitisfoundation.org/mental-health/navigating-daily-life-with-ibd; Harvard Medical School, News & Research, The Autism-GI Link, https://hms.harvard.edu/news/autism-gi-link; Mayo Clinic, Crohn’s Disease, https://www.mayoclinic.org/diseases-conditions/crohns-disease/symptoms-causes/syc-20353304; Mayo Clinic, Ulcerative Colitis, https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326; Spectrum News, Analysis Finds High Rates of Gut Problems in Autism, 5/15/14, https://www.spectrumnews.org/news/analysis-finds-high-rates-of-gut-problems-in-autism/; Spectrum, Large Study Ties Gut Issues in Autism to Inflammation, https://www.spectrumnews.org/news/large-study-ties-gut-issues-autism-inflammation/#:~:text=IBD%20includes%20the%20painful%20conditions,have%20a%20diagnosis%20of%20IBD
Graphics: American Gastroenterological Association, https://gastro.org/news/its-crohns-and-colitis-awareness-week-2020/; Redfern Physiotherapy, https://www.redfernphysio.com.au/may-crohns-colitis-awareness-month/;