Inflammatory bowel disease - Ulcerative colitis and Crohn's disease - Clinical Features Part 1
Inflammatory bowel disease (IBD) refers to a group of chronic inflammatory disorders that affect the gastrointestinal tract. The two main types of IBD are Crohn's disease and ulcerative colitis. While these conditions share some similarities, they also have distinct clinical features. Here are the key clinical features of inflammatory bowel disease:
General Features:
Abdominal Pain: Persistent and often crampy abdominal pain is a common symptom in both Crohn's disease and ulcerative colitis.
Diarrhea: Chronic or recurrent diarrhea is a hallmark symptom of IBD. The stool may be watery, contain blood, and occur with urgency.
Weight Loss: Unintentional weight loss is often observed in individuals with IBD, particularly in cases of severe disease.
Fatigue: Chronic inflammation, malabsorption, and other factors can contribute to fatigue in individuals with IBD.
Crohn's Disease Specific Features:
Location of Inflammation: Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus. It often involves the end of the small intestine (ileum) and the beginning of the colon.
Skip Lesions: Crohn's disease is characterized by "skip lesions," where inflamed areas are separated by normal tissue. This can make the disease patchy.
Fistulas and Abscesses: Crohn's disease can lead to the formation of abnormal connections (fistulas) between different parts of the intestine or between the intestine and other organs. Abscesses may also occur.
Strictures: Inflammation can lead to the formation of scar tissue, causing narrowing of the intestine (strictures) and potential obstruction.
Ulcerative Colitis Specific Features:
Location of Inflammation: Ulcerative colitis is limited to the colon and rectum. The inflammation typically starts at the rectum and may extend continuously to involve varying lengths of the colon.
Continuous Inflammation: Unlike Crohn's disease, ulcerative colitis usually involves continuous inflammation without skip lesions.
Bloody Diarrhea: Bloody diarrhea is a characteristic symptom of ulcerative colitis. The blood may be visible in the stool.
Rectal Involvement: Inflammation often starts at the rectum, leading to symptoms such as tenesmus (the feeling of incomplete bowel movements) and urgency.
Extraintestinal Manifestations (Common to Both):
Joint Pain: Arthritis and joint pain are common extraintestinal manifestations of IBD.
Skin Disorders: Conditions like erythema nodosum and pyoderma gangrenosum can occur in IBD patients.
Eye Involvement: Inflammation of the eyes (uveitis) is another possible extraintestinal manifestation.
Liver Involvement: Conditions like primary sclerosing cholangitis (PSC) can affect the liver in individuals with IBD.