Inflammatory bowel diseases (IBD) are a group of complex, chronic conditions, characterised by prolonged inflammation of the gastrointestinal (GI) tract, which can have a long-term impact on a patient’s quality of life.1,2
Two main types of IBD
Ulcerative colitis and Crohn’s disease are the two major types of IBD.3
These two diseases differ in their primary symptoms and location within the GI tract. In ulcerative colitis, the site of inflammation is confined to the inner layer of the colon and rectum, while in Crohn's disease the inflammation can occur anywhere in the GI tract and involves all layers of the gut wall.1,2
Common symptoms include abdominal pain and cramping, frequent bowel movements, diarrhoea, weight loss and feeling fatigued. Rectal bleeding is more common in ulcerative colitis, while abdominal pain is more common in Crohn's disease.4,5
How does IBD affect patients’ lives?
Patients feel weak and worn-out during flare-ups and many find it difficult to manage daily life in school, at home and at work because of their symptoms. IBD can also prevent patients from making or keeping friends and intimate relationships as the highly unpredictable nature of IBD affects patients’ ability to make plans and attend events.
Who is affected by IBD?
The age range in which IBD is most commonly diagnosed.
IBD is a global disease, although the highest reported prevalence is in Europe and North America.7,8 Increasing incidence and prevalence of IBD have been reported in southern and central Europe, Asia, Africa and Latin America.7
The number of people estimated to be living with IBD worldwide. This number is steadily increasing year-on-year.9
What causes IBD?
What causes IBD is not fully understood. Genetic and environmental factors are thought to play a role, but specific triggering events are yet to be identified.
In patients with IBD, the immune system mounts an inappropriate response in the GI tract, resulting in an increased number of white blood cells and prolonged inflammation.10
The cells that are meant to protect the GI tract from pathogens end up causing damage to the gut wall through excessive and continuous inflammation.
What are the current treatment options?
Corticosteroids, immune-suppressing agents and antibiotics are all used to treat IBD and in serious cases, surgery and hospitalisation are required.11,12
What is the future outlook for IBD?
More is being done to understand this complex group of diseases. Every patient is different, and personalised strategies may enable us to better meet individual patients’ needs.
Through pioneering IBD research, we hope to achieve control not only of the symptoms reported by patients, but also the underlying biology of the disease. This will help patients reach rapid and sustained remission, for the control they want to be able to live life confidently.
1) Ungaro R, et al. Ulcerative colitis. Lancet. 2017;389:1756-70.
2) Torres J, et al. Crohn's disease. Lancet. 2017;389:1741-55.
3) Crohn’s and Colitis UK. Tests and Investigations for IBD. [Internet; cited 2019 April 25]. Available at: https://www.crohnsandcolitis.org.uk/about-inflammatory-bowel-disease/publications/tests-and-investigations-for-ibd.
4) Jung SA. Differential diagnosis of inflammatory bowel disease: what is the role of colonoscopy? Clinical Endoscopy. 2012;45:254-62.
5) Medscape. Inflammatory Bowel Disease. [Internet; cited 2019 April 25]. Available at: https://emedicine.medscape.com/article/179037-overview.
6) Nasiri S, et al. Long-term outcomes of pediatric inflammatory bowel disease. Semin Pediatr Surg. 2017;26:398-404.
7) Loftus EV, Jr. Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology 2004;126:1504-17.
8) M'Koma EA. Inflammatory bowel disease: An expanding global health problem. Clinical Medical Insights Gastroenterology. 2013;3:33-47.
9) GBD 2017 Inflammatory Bowel Disease Collaborators. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020; 5(1):17-30.
10) Dave M, et al. Immunology of Inflammatory Bowel Disease and Molecular Targets for Biologics. Gastroenterol Clin North Am. 2014; 43: 405–24.
11) Bernstein CN, Nabalamba A. Hospitalization, surgery, and readmission rates of IBD in Canada: a population-based study. The American Journal of Gastroenterology 2006;101:110-8.
12) Sandborn WJ. The Present and Future of Inflammatory Bowel Disease Treatment. Gastroenterol Hepatol.. 2016; 12: 438–41.
13) Stein RB, Hanauer SB. Comparative tolerability of treatments for inflammatory bowel disease. Drug Safety 2000;23:429-48.