In inflammatory bowel disease, parts of the bowel become inflamed. There are two main types of IBD:

• ulcerative colitis- ulcerative colitis usually develops slowly over time and involves continuous segments of the rectum and colon (large intestine). Usually the innermost lining is affected.
• Crohn’s disease- in Crohn’s disease, inflammation may occur anywhere in the small and large intestines. Inflammation may involve deep layers of the bowel

• ulcerative colitis- symptoms of ulcerative colitis may vary according to the areas of the large bowel affected. Symptoms are mildest when only the rectum is involved, causing rectal pain, bleeding and a sense of urgency surrounding bowel movements (ulcerative proctitis). Sometimes rectal bleeding is the only symptom experienced. When greater segments of the colon is involved, symptoms may include bloody diarrhea, abdominal pain and cramping, tiredness and unintended weight loss. Bouts of illness may alternate with periods of wellness (remission).
• Crohn’s disease- in addition to abdominal pain and cramping, diarrhea, blood in the stool, decreased appetite and malnutrition due to the inability of diseased bowel to absorb nutrients (remember, the small bowel can be involved in Crohn’s, which is where nutrients are absorbed), Crohn’s is a systemic disease that can affect other body systems. Individuals with Crohn’s may also have fever, rashes, fatigue, arthritis and inflammation affecting the eyes. As with ulcerative colitis, people with Crohn’s disease may experience periods of remission when their symptoms disappear.

Risk factors for IBD include:

• age- most people with IBD are under the age of 30, but IBD develops later in some individuals (50s and 60s)
• cigarette smoking- smoking can make your symptoms worse and increases the risk of complications
• NSAID use- using non-steroidal antiinflammatory agents, such as ibuprofen or Naproxen, can cause ulceration in the GI tract and may worsen IBD. Tylenol is safe to use.
• ethnicity- Caucasians and people of Jewish descent have a higher prevalence of IBD
• family history- as mentioned, having someone in your family diagnosed with the condition raises your risk

Next, I’ll ask you about your symptoms. I may ask you about:

• pain- where is it located? does it come and go? is the pain related to bowel movements? on how many days of the past month did you experience abdominal pain?
• bowel habits- are you experiencing diarrhea? constipation? how often do your bowels move and what is the consistency of your bowel movements?
• blood in the stool- is there fresh blood only when you wipe, is the blood mixed in the stool, or is there blood in the toilet water?
• weight loss- have you lost weight unintentionally? how much weight do you estimate you have lost?
• fever- have you been experiencing any fever?
• other symptoms- have you experienced other symptoms, such as rash, joint pain or eye inflammation?