Inflammatory Bowel Disease: Causes, Symptoms and Treatment

inflammatory bowel disease icd 10

Inflammatory Bowel Disease is a set of chronic pathologies, such as Crohn’s disease and ulcerative colitis.

Inflammatory Bowel Disease (IBD) is the name people give to several and quite similar bowel diseases: the two most common are ulcerative colitis and Crohn’s disease.

These diseases should not be confused with the milder “irritable bowel syndrome.”


These diseases are disorders of the immune system, in which the body’s defense “misfires” and causes inflammation of the gut. Sometimes these diseases first occur following an infection.

It may be the case that the body’s immune system continues to act in the gut after the infection has passed.

Alternatively, it may be that the immune system attacks the “helpful” gut bacteria. There is no clear-cut consensus on exactly why the immune system becomes over-active.

Some researchers had suggested that the bacterium MAP (Mycobacterium Avium, subspecies paratuberculosis), which experts found in cattle, might be a possible cause of Crohn’s disease. It tends to be more prevalent in the guts of people with Crohn’s disease.

You’re more likely to suffer from them if a blood relation already has one of these diseases. The prevalence of the disease differs between different ethnic groups.

Other medical experts had suggested a large number of environmental factors as underlying causes of inflammatory bowel diseases.

These diseases tend to be more common in affluent western countries and to have become more prevalent in recent decades.

Researchers had suggested that the lack of exposure of infants to germs in modern households causes the disease (the same theory is used to explain the rise in asthma numbers).

Experts sometimes considered refrigerated food as a possible environmental cause.

To date, there has not been any decisive evidence to prove for sure if any of these environmental causes are important.

Smokers are at a higher risk of getting Crohn’s disease, but a lower risk of getting ulcerative colitis.

Description and Symptoms

Ulcerative colitis causes inflammation in the large intestine (colon and rectum).

In Crohn’s disease, inflammation can occur anywhere in the digestive tract but is most common in the colon or the last part of the small intestine (ileum).

Both diseases feature persistent diarrhea (which may contain blood or mucus), abdominal pain (particularly after eating), tiredness, and unintentional weight loss.

There may be a fever in severe cases. Crohn’s disease sometimes gives rise to mouth ulcers.

These diseases sometimes produce symptoms on parts of the body away from the digestive tract, such as skin rashes or arthritic symptoms.

Both diseases can go into periods of remission but tend to come back later.

Naturally, patients tend to give the credit for any positive response to whatever treatment they were taking at the time, although it may be that the remission would have occurred anyway.

Many dubious “cures” can be found on the internet, backed by a handful of anecdotes.

At what age is this disease usually present?

Inflammatory Bowel Disease affects men and women equally. It may occur at any stage of life. However, doctors tend to perform the diagnosis on patients between 20 and 40 years.

Also, according to the latest data presented by the European Organization of Crohn and Colitis and the European Federation of Crohn’s and Ulcerative Colitis, in Spain, the incidence of this disease has increased 200% in children under 18 years.

Is it a hereditary pathology?

There are no conclusive studies that claim that Inflammatory Bowel Disease has an inherited component.

However, between 15-20% of patients with this pathology has a direct family member who suffers from it. The most frequent combination is mother-child, followed by brother-brother.

Is it a serious illness?

Inflammatory Bowel Disease occurs in outbreaks, which can be more or less severe. During these outbreaks, it is sometimes necessary for patients to be hospitalized to treat symptoms.

Since it is a chronic disease, it is necessary to strictly and rigorously follow the medication prescribed by specialists in the digestive system.

Nonadherence to treatment (medication, diet, lifestyle) can lead to severe complications that can result in surgical operations (obstructions, perforations, etc.).

IBD Treatments

Lifestyle changes can help sufferers. People with Crohn’s disease should give up smoking. On the other hand, non-smokers with ulcerative colitis may benefit from using a nicotine patch.

They should not be advised to start smoking, due to the many other health risks involved. Some sufferers find changes in diet, such as adopting a low-fiber diet or avoiding dairy products, help ease symptoms.

Aminosalicylate drugs, such as sulfasalazine and mesalazine, are commonly used to treat inflammatory bowel diseases.

These are anti-inflammatory drugs, particularly useful in treating mild to moderate ulcerative colitis. These drugs can be taken orally, or used in the form of a suppository or enema.

Steroids, such as prednisolone and prednisone, are often used to treat inflammatory bowel diseases.

These drugs are often useful, but they have many side-effects, so are not suitable for long-term treatment.

Immunosuppressive medications, such as azathioprine, reduce the symptoms of inflammatory bowel diseases.

They do have side-effects, such as making the patient more vulnerable to infection.

In severe cases, powerful immunosuppressive “biological” drugs, such as infliximab, can be given intravenously.

Doctors use surgery only as a last resort. It is usually an effective treatment for ulcerative colitis.

Removal of the colon typically cures the disease. Surgery is a more doubtful option in the case of Crohn’s disease. Even if all the infected areas get removed, the condition can still re-occur.

It features chronic inflammation of any part of the digestive tract, from the mouth to the anus.

The most affected areas are the end of the small intestine (ileum) and the beginning of the large intestine (blind), although the large intestine (colitis) and the small intestine (enteritis) may also be affected.

It is this inflammation that produces symptoms of Crohn’s disease, which usually occur in the form of outbreaks that alternate with phases of remission (no symptoms arise although the condition is still present).

During outbreaks, the most frequent symptoms are diarrhea (sometimes with bleeding), abdominal pain, weight loss, tiredness, and fever. The duration of the shoots is usually between 2-4 weeks.

Occasionally, the anal area can be affected by the appearance of abscesses (bags filled with fluid, which cause pain) and fistulas (when pus gets expelled through holes around the anus).

When the disease does not get controlled, there may be cases of intestinal perforation and abscesses in the abdomen, where surgery is strictly necessary.