What symptoms might someone experience with Crohn’s disease and UC?
Crohn’s disease symptoms vary, but the most common are abdominal pain, diarrhea, and weight loss. Other frequent symptoms include abdominal bloating, constipation, blood in the stool, fevers, or perianal irritation from fistula formation, which occurs when an abnormal connection forms between part of the GI tract and the skin or another organ. Children may fail to meet growth expectations if Crohn’s disease is diagnosed during childhood or adolescence. In severe Crohn’s disease, fatigue and nutritional deficiencies may be seen.
UC tends to present with diarrhea, with or without bleeding. Other common symptoms are abdominal pain, weight loss, fatigue, mucus in the stool, and urgency for bowel movements. Often, patients will experience tenesmus, the sensation of needing to have a bowel movement without the ability to do so due to rectal inflammation.
Symptoms occurring outside of the intestines with both Crohn’s and UC include joint pain in the spine, lower back, and peripheral joints; inflammation in the eyes with blurry vision, redness, and/or eye pain; cold sores in the mouth (aphthous ulcers); skin rash or ulcer; kidney stones; and blood clots.
How can you test for Crohn’s or UC?
When IBD is suspected, routine laboratory tests, imaging studies, and endoscopic evaluation can be helpful in establishing a diagnosis. Complete blood counts may assess for anemia. Certain blood tests can measure the degree of inflammation present in the body, while a stool analysis can distinguish inflammatory causes of diarrhea from functional causes, such as irritable bowel syndrome (IBS).
If there is significant abdominal pain, weight loss, or fevers, cross-sectional imaging with a CT scan or MRI enterography are useful in detecting inflammatory changes in the small and/or large intestine. Ileocolonoscopy with biopsy is the gold standard for assessing for IBD. This can detect visible inflammation and also allows for tissue biopsies to look for the presence, type, and severity of inflammation while excluding other sources of inflammation.
While there are several commercially available blood tests aimed at helping diagnose IBD, they are not reliable or well-validated to establish a definitive diagnosis.
Are Crohn’s and UC life-threatening?
The vast majority of IBD cases are not life-threatening. Fortunately, medical and surgical therapies have advanced in recent years, making complications much less common.
What are the treatment options for Crohn’s disease and UC?
While Crohn’s disease and UC are chronic diseases with no known cures, there are several effective treatment options. Initial treatment should follow a complete laboratory, imaging, and endoscopic evaluation to determine whether a patient is experiencing mild-to-moderate versus moderate-to-severe disease.
Once the severity is assessed, there are four basic categories of medications that may be used to help induce remission, prevent flare-ups, and ultimately improve one’s quality of life. Those include aminosalicylates (a class of drugs used to reduce inflammation in the lining of the intestine), corticosteroids (often known as steroids), immune modulators (a class of drugs that helps activate normal immune function), and biologic therapies.
Ultimately, the goal is to avoid long-term steroid use and to maintain remission with effective anti-inflammatory therapies.