The term inflammatory bowel diseases (IBD) refers to a group of diseases, namely Crohn’s disease and ulcerative colitis, which are associated with chronic inflammation of the gut. There is no known cure for IBD. Disease symptoms include abdominal pain, intestinal bleeding, anemia, and weight loss all of which have a profound impact on an individual’s quality of life. Patients may also experience extraintestinal symptoms such as arthritis, liver disease, or skin problems. Patients with IBD experience intermittent periods of symptom relief (remission) followed by intense flares of symptoms. According to Crohn’s and Colitis of Canada (CCC), a typical patient has a 30% chance every year to experience an intense disease flare.
History of IBD
Crohn’s disease (CD) was first described in 1932 by Dr. Burrill Crohn. CD is characterized by inflammation that can affect any part of the gastrointestinal tract, right from the mouth to the anus (“gums to bums”). The inflammation also impacts all intestinal layers, from the inner layer or lining all the way to the outer layer. Because of the variety in locations of the inflammation, CD symptoms can vary significantly between patients. Many will require surgery to remove part of their intestine over time.
In 1875, Sir William Wilks first introduced the term “ulcerative colitis”. Ulcerative colitis (UC) only affects the inner lining of the colon also known as the large intestine. Symptoms can begin at the rectum and extend upwards to the colon. Symptoms of UC are similar to those of CD. One symptom unique to UC is frequent “false urges” to have a bowel movement when there is little or no feces to expel.
Patients diagnosed with CD or UC are commonly on lifelong medications to extend the duration of remission and prevent the severity of disease flares when they inevitably occur. Medications are used to suppress the overly aggressive immune system unique to IBD patients or to reduce inflammation (e.g., steroids or biologics). IBD patients may also require operations to remove portions of diseased bowel (called a “resection”). Though the surgery may remove symptoms, especially in the case of ulcerative colitis, this has not cured the underlying cause of the IBD. There currently is no cure for IBD because the cause of IBD is unknown, though researchers now believe that it occurs due to an interaction between a patient’s genes, the environment and microbes.
Over the past two decades the prevalence of IBD has climbed steadily, and Canada has one of the world’s highest incidences of IBD. The CCC conservatively estimates that approximately 170,000 Canadian men, women and children have IBD. Of these people, 20% of them have required hospitalization within the last year. IBD afflicts people in the prime of their lives (between the ages of 15–25 or from 45–55), often preventing them from gainful employment and leading to long-term disability. The impact of IBD on patients’ quality of life is immeasurable, and the associated health care costs are staggering.