hi I'm dr. Mike Evans and this is a
brief overview of a disease that attacks
our guts called inflammatory bowel
disease or IBD it is actually not a
single disease but rather refers
primarily to two related but distinct
diseases one is called Crohn's disease
and the other is called ulcerative
colitis or you see the key differences
are firstly the location of the
inflammation and secondly the extent of
the information all sort of colitis only
affects the colon or large intestine
while Crohn's disease can affect the
entire digestive system from the mouth
to the anus or as we say from gum dabomb
and ulcerative colitis inflammation only
involves the inner lining or what we
call the mucosa while in Crohn's disease
inflammation can extend right through
the entire thickness of the bowel wall
to the outermost layer of the digestive
tract these differences lead to
different outcomes and different
treatments which I'll get to later the
major symptoms of you seeing Crohn's do
however overlap these include stomach
pain and a change in bowel habits almost
always this means more urgent movements
other symptoms include weight loss
decreased appetite fever night sweats
and extreme tiredness now these are
trademarks symptoms but it's very
important to remember that IBD can play
out quite differently in different
people the symptoms of IBD can come and
go over long periods of time now people
may experience periods of severe
symptoms or what we call flare-ups they
also go through periods when they have
few or no symptoms at all what we call
remission IBD can occasionally effect or
inflame other parts of your body such as
your eyes your skin your liver your
joints other symptoms can be more
specific for example because you see
only affects the inner lining of the
bowel we tend to see mucus and blood in
the stool whereas Crohn's can inflame
the whole bowel wall so there may be
blood but also significant abdominal
pain nausea and vomiting both diseases
can lead to growth delay in children to
investigate the cause of your symptoms
or or gauge the extent of your disease
your care team will listen to your story
ask if there is any family history and
then investigate with things like blood
tests stool samples and then likely
examination of your bow
for x-rays scans and their scopes to
look at the inside of your bowel IBD is
usually diagnosed in young people say 15
to 25 but it can appear at any time
they're slightly increased risk for
those who have a family member with the
condition an IBD is more common in white
people and more prevalent among Jewish
people of European origin IBD affects
about one in 350 people in most nations
but its more common in northern regions
here in Canada we actually have the
highest rate in the world with IBD
occurring in as many as 1 and 150
persons which translates to about
230,000 Canadians we're not exactly sure
why Crohn's and you see happens it
appears that some sort of environmental
factor in susceptible individuals causes
the immune system the body's defense
against infection to malfunction the
immune system then starts attacking
healthy tissue inside the digestive
system leading to the information
currently there is no cure for IBD but
many of the treatments that are
effective target the immune system so
medications such as corticosteroids or
5a SAS which help reduce inflammation or
immunosuppressants are often used
medicines called biologics have become a
key treatment option for those with
moderate to severe inflammatory bowel
disease they work by using specially
developed antibodies to selectively
block the effects of the molecules that
are involved in the inflammation of the
gut wall the idea here is that we can
move from beyond just symptom management
and heal the mucosal lining which can
lead to remission and prevent relapses
in Crohn's disease mild attacks result
in patches of information the lining of
the intestine with groups of small
ulcers similar to mouth ulcers that can
occur anywhere in the digestive tract
however and moderate or severe Crohn's
disease these ulcers become much larger
and deeper with a lot of surrounding
redness the inflammation can make the
intestine become thickened blocking the
passage of digested food in some cases
deep ulcers break through the wall of
the intestine causing infection outside
the bowel what we call an abscess and
this can actually spread to the skin or
a nearby part of the body what we call a
fistula about 3 out of 4 patients with
Crohn's will require surgery at one
point
move an inflamed section of the
digestive system especially if the
inflammation has caused a blockage
fortunately now our surgical techniques
have become much less invasive than in
the past
surgery is sometimes necessary and you
see but with early treatment it can
often be avoided things to think about
with the diet are pretty common-sense
and individualized there is considerable
variation from person to person so
self-awareness about what foods set you
off or work for you can be very helpful
as is staying hydrated self-awareness is
also important when it comes to managing
stress the unpredictability of IBD or
dealing with symptoms at the same time
you're dealing with life's other
stressors can be incredibly tricky to
navigate inflammatory bowel disease can
have a profound effect on an
individual's life physically emotionally
and socially both at home and at school
or in the workplace having to go to the
washroom more than 10 times a day or
even talking about your bowels is you
know I think it's challenging at any age
but perhaps especially as a young person
when this disease commonly strikes it's
a disease that often impacts families
not just individuals and it is a journey
that requires no small amount of bravery
problem-solving and optimism although
there is no cure yet there are many
treatment options available as one of my
patients with IBD said to me with my ups
and downs it was important for me to
remember that things will return to
normal it may be a new normal but normal
just the same there are some fantastic
IBD resources out there to educate learn
and share with others that are where you
are or have already been there thanks
for listening and take care
you