UC and Crohn’s are chronic (ongoing) conditions, which are not infectious. The most common age for diagnosis is between 15 and 35 (although diagnosis can occur at any age). In both UC and Crohn’s there is a higher chance of developing either illness if you have a close relative who has the condition. In 10-15% of cases, UC and Crohn’s may be difficult to distinguish. Men and women suffer equally.

Ulcerative Colitis (UC)

Ulcerative Colitis affects approx 95,000 people in the UK – that’s about 1 in 600. Approximately 5,500 new cases are diagnosed each year.

Crohn’s Disease affects approx 55,000 people in the UK – that’s about 1 in 1,000. Approximately 3,000 new cases are diagnosed each year. Research shows that the number of people with Crohn’s Disease has been rising steadily, particularly among young people. More recently, numbers have stabilised.

What is it?

Ulcerative Colitis affects the rectum and sometimes the colon (large intestine). Inflammation and many tiny ulcers develop on the inside lining of the colon resulting in urgent and bloody diarrhoea, pain and continual tiredness. The condition varies as to how much of the colon is affected. In addition, UC can cause inflammation in the eyes, skin and joints. If the inflammation is only in the rectum it is known as proctitis.

Crohn's Disease can affect anywhere from the mouth to the anus but most commonly affects the small intestine and/or colon. It causes inflammation, deep ulcers and scarring to the wall of the intestine and often occurs in patches. The main symptoms are pain in the abdomen, urgent diarrhoea, general tiredness and loss of weight. Crohn’s is sometimes associated with other inflammatory conditions affecting the joints, skin and eyes.

For both illnesses

The severity of the symptoms fluctuates unpredictably over time. Patients are likely to experience flare-ups in between intervals of remission or reduced symptoms. The cause or causes have not yet been identified in either illness. Both genetic factors and environmental triggers are likely to be involved.

Treatments

Ulcerative Colitis Most patients will be treated with drugs, including 5-ASA therapies (eg: mesalazine) and steroids, to control or reduce the inflammation. Suppressants of the immune system (eg: azathioprine) are used to maintain remission. Some people need surgery to remove the whole of the colon if their symptoms do not respond to treatment with drugs. If the colon is removed, the small intestine leads to a stoma (opening on the abdomen or ‘tummy area’) for emptying of liquid stool (faeces). Or a replacement colon (ileo-anal pouch) is created by the surgeon reshaping the end of the small intestine.

Crohn's Disease drug treatment is similar to that for Ulcerative Colitis (above). In addition, various antibiotics can be used; and a new range of drugs are being introduced called monoclonal antibodies (eg: infliximab). Crohn’s Disease can also be helped by special liquid feeds which rest the bowel. Surgery may be required to remove narrowed or damaged parts of the intestine. Smoking has an adverse effect on Crohn’s Disease, so patients are discouraged from smoking.

For both illnesses, UC and Crohn’s are relapsing, remitting conditions. Most patients remain under hospital follow-up. Urgent consultation or hospital admission may be required for ‘flare-ups’. There is no cure for UC or Crohn’s at present (except for UC, if the colon is surgically removed), but treatment can control the disease in most cases. Worldwide research is rapidly increasing understanding of IBD, and so hopes for better treatments are high. Education, work and social functioning UC and Crohn’s can affect young people during their education or as they become established in their career. Most sufferers can be maintained in remission for most of the time and are able to lead a full working life. However, some who have severe disease do not achieve their educational and career potential.

IBD is not to be confused with Irritable Bowel Syndrome (IBS) which is a completely separate condition, but which shares some symptoms with IBD.