Crohn's and Colitis Q&A

For Crohn’s and Colitis Awareness Week on 1st-7th Dec, our Consultant Gastroenterologist Simon Scott Campbell from BMI The Alexandra Hospital, is answering some of the most commonly asked questions about the disease.

Dr Campbell is the scientific advisor to NACC North West (National Association for Crohn's and Colitis).

Simon Scott Campbell
Crohn’s disease is a form of inflammatory bowel disease that causes inflammation in the gut. It can affect the gastrointestinal tract anywhere from the mouth to the anus, although the most common area affected is the end of the small bowel (ileum). There are 4 types: Crohn’s disease, ulcerative colitis, indeterminate colitis and microscopic colitis.

Colitis is a generic term for inflammation of the large bowel (colon). The term colitis does not imply the specific cause, so you can have Crohn’s colitis, ulcerative colitis, indeterminate colitis, microscopic colitis as well as infective colitis amongst many others!

Simon Scott Campbell
Inflammatory conditions affecting the gut almost always give symptoms of diarrhoea. In Crohn’s disease abdominal pain can often predominate as well as weight loss and watery diarrhoea, while in ulcerative colitis bloody diarrhoea predominates.

Simon Scott Campbell
In the early forms of inflammatory bowel disease (IBD) symptoms can be impossible to differentiate from IBS. Weight loss, bloody diarrhoea, and significant diarrhoea symptoms (4 bowel movements/day) are not typical of IBS.

Investigations are often needed to help differentiate these conditions including stool analysis, colonoscopy or even capsule endoscopy.

Simon Scott Campbell
The cause of inflammatory bowel disease remains unknown. Genetic or hereditary risk is increased in offspring from parents with Crohn’s disease and ulcerative colitis.

There is more genetic risk involved in Crohn’s disease (around 15% of patients with Crohn’s disease will have a family member with inflammatory bowel disease), but it is far from a certainty that you will pass on inflammatory bowel disease to your children. There have been more than 50 genes involved in inflammatory bowel disease.

Simon Scott Campbell
No, unfortunately inflammatory bowel disease cannot be prevented. It can present at any age, but there is an increase incidence in early adulthood.

Simon Scott Campbell
Diagnosis can be made by using a combination of stool sampling, blood tests, colonoscopy, capsule endoscopy as well as scans such as CT or MR.

Simon Scott Campbell
If left undiagnosed, patients can become dehydrated, malnourished and may need admission to hospital for special drug treatments. Occasionally surgery is necessary to remove the bowel. In the long-term there is a small increased risk of cancer of the bowel, but this risk is significantly lowered with effective management of the condition.

Simon Scott Campbell
The majority of treatments for inflammatory bowel disease revolve around drug therapy - either in tablet form or injection of drug treatments (these can be intravenous or subcutaneous). Over the last ten years there has been an explosion of new novel drug treatments which have dramatically changed the outlook of the condition in the long-term. All the drug treatments help to reduce inflammation which in-turn reduces the damage to the bowel wall. They help the bowel wall to heal.

Simon Scott Campbell
Surgery is always used as a last resort and its necessity is decreasing because of effective drug treatment. In the severest forms, the colon may be removed and this can lead to a stoma on the abdominal wall.

Simon Scott Campbell

Effective management of inflammatory bowel disease requires close follow-up with an expert in the field. The goal of treatment is to keep patients in remission and to have a normal quality of life with minimal effects on day-to-day activity.

Joining patient support groups like Crohn’s and Colitis UK are also incredibly helpful, and following the drug treatment prescribed by your specialist is paramount.

The condition follows a relapsing and remitting pattern and during a relapse other drug treatments may be necessary.

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