People with Crohn's disease or ulcerative colitis, the two most common inflammatory bowel diseases, complain of
abdominal pain and diarrhea and sometimes experience anemia, rectal bleeding, weight loss, or other symptoms. No definitive test exists for either disease, and patients endure two initial misdiagnoses on average, says R. Balfour Sartor, chief medical adviser to the Crohn's & Colitis Foundation of America. With Crohn's, he says, appendicitis, irritable bowel syndrome, an ulcer, or an infection is often wrongly suspected.
Both disorders may arise from a wayward immune system that leads the body to attack the gastrointestinal tract. Crohn's involves ulcers that may burrow deep into the tissue lining at any portion of the GI tract, leading to infection and thickening of the intestinal wall and blockages that need surgery. Ulcerative colitis, by contrast, afflicts only the colon and rectum, where it also causes ulcers; colitis is characterized by bleeding and pus.
Treating either disease requires beating back—and then continuously holding in check—the inappropriate inflammatory response. Both steps are achieved through some combination of prescription anti-inflammatories, steroids, and immunosuppressants. Crohn's patients may also be given antibiotics or other specialized drugs. Of current hot debate is whether Crohn's sufferers benefit if given highly potent drugs early in the course of treatment as opposed to escalating potency over time from milder initial treatments, as is traditionally done, explains Themos Dassopoulos, director of inflammatory bowel diseases at Washington University in St. Louis.
Surgery "cures" ulcerative colitis by removing the colon but means patients must wear a pouch—internally or externally—for waste. IBD patients should take special care when popping NSAIDs like aspirin, as these painkillers can trigger further gut inflammation in 10 to 20 percent of patients, says Dassopoulos.