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Bowel disease symptoms

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Bowel disease symptoms

Autoimmunity is the main culprit behind the chronic inflammation of the digestive tract leading to a medical condition termed as inflammatory bowel disease. The two major types of IBD are ulcerative colitis and Crohn’s disease. Although classified as a single entity, the two forms of disease vary in many aspects.

Based on the etiology and origin, inflammatory bowel disease is classified as;

  • Familial “ it is a familial disease in 5-10% of the individuals. In such cases the disease has early onset usually presenting in the first decade of life. In Crohn’s disease, there is concordance of clinical findings and anatomical sites.
  • Sporadic “ remaining cases of inflammatory bowel disease has no previous family history of the disease. The lifetime risk of first degree relative of an individual suffering from inflammatory bowel disease is almost 10%.

For detailed etiopathogensis of ulcerative colitis and Crohn’s disease please visit;



Although the inflammatory bowel disease, whether Crohn’s disease or ulcerative colitis, involves the gastrointestinal tract primarily, however extra intestinal systems may also be affected due to the ongoing disease process. Extra intestinal manifestations are present in almost 1/3rd of the individuals suffering from inflammatory bowel disease. Common manifestations are;

  • Dermatologic
    • Erythema nodosum “ it occurs in almost 10 % of ulcerative colitis and 15 % of Crohn’s disease patients. The lesions of erythema nodosum are present on the shins, calves, ankles, thighs and arms. It is characterized by red, hot and tender nodules that measure almost 1-5 cm in diameter. Skin lesions usually develop after the onset of bowel symptoms.
    • Pyoderma gangrenosum “ it is less common in Crohn’s colitis and in almost 1-2 % of patients suffering from ulcerative colitis. It commonly presents as pustules on the dorsal aspects of the legs and feet. Other sites involved are chest, stoma, face and arms. Pustules may be single or multiple and they usually ulcerate complicating the disease.
    • Other less common dermatologic manifestations are pyoderma vegetans, pyostomatitis vegetans, Sweet’s dyndrome (cutaneous granuloma formation), psoriasis ( 5-10%), perianal skin tags, aphthous stomatitis and “cobblestone” lesions of the buccal mucosa.
  • Rheumatologic
    • Peripheral arthritis “ it affects almost 15 to 20 % of patients suffering from inflammatory bowel disease. It commonly occurs in the patients of Crohn’s disease worsening with the exacerbations of bowel activity. It involves multiple large joints of the upper and lower extremities, is asymmetric and migratory.
    • Ankylosing spondylitis “ it occurs in almost 10 % of IBD patients and is more common in Crohn’s disease as compared to ulcerative colitis. It commonly affects the pelvis and spine and presents are morning stiffness, pain in buttocks and low backache. Infliximab is effective in relieving the stiffness and alleviates the symptoms associated with it.
    • Sacroiliitis “ it occurs equally in ulcerative colitis and Crohn’s colitis, and is symmetric.
    • Other rheumatic disorders include relapsing polychondritis, hypertrophic osteoarthropathy and pelvic/femoral osteomyelitis.
  • Ocular
    • Incidence is 1-10%.
    • Common ocular manifestations are conjunctivitis, anterior uveitis and episcleritis.
    • Anterior uveitis is associated with both Crohn’s colitis and ulcerative colitis. Common symptoms are blurring of vision, ocular pain, photohobia and headache.
    • Episcleritis occurs in 3-4% of IBD patients with ocular burning being the most common symptom. It occurs frequently in the patients of Crohn’s disease.
  • Hepatobiliary
    • Hepatic steatosis “ patients usually present with enlarged liver.
    • Cholelithiasis “ it occurs in almost 10-30% of the patients having Crohn’s disease.
    • Primary sclerosing cholangitis
  • Urologic
    • Nephrolithiasis
    • Ureteral obstruction
    • Ileal bladder fistulas
  • Metabolic bone disorders
    • Low bone mass
    • Increased risk of spine, wrist and rib fractures
    • Osteonecrosis
  • Thromboembolic disorders
    • Increased risk of venous and arterial thrombosis
    • Vasculitides involving small, medium and large vessels

Bowel disease symptomsInflammatory bowel disease is strongly associated with the development of carcinoma due to chronic underlying inflammation of the digestive tract. Longstanding underlying ulcerative colitis and Crohn’s disease increase the risk of epithelial dysplasia and carcinoma of colon. Here are few risk factors associated with the developmental of carcinoma in cases of inflammatory bowel disease;

  • Extensive and long duration IBD
  • Positive family history of the disease
  • Development of strictures
  • Associated primary sclerosing cholangitis (PSC)

Inflammatory bowel disease can affect any age group. When children are affected with IBS, the management becomes complex. In children IBD usually presents with fatigue and irritability of a normal child. The treatment must be started as soon as possible. The most important step is the dietary management that is difficult to be done strictly in the children. Balanced diet with sufficient calories in it must be provided to the children because they may have malnutrition due to diarrhea of IBD. Moreover, children must be encouraged to take healthy small meals and avoid fatty junk food that can worsen the IBD symptoms.

Bowel disease

Bowel disease

Although home remedies, alternative medicine, prescription drugs and nutritional therapies have shown promising results in the management of inflammatory bowel disease,

Table of Biological Therapies

Table of Biological Therapies

however in some cases surgery become inevitable. Here are the common indications for which surgery becomes mandatory in order to save the digestive tract and alleviate the symptoms of inflammatory bowel disease;

  • Ulcerative colitis
    • Intractable disease
    • Toxic megacolon
    • Colonic perforation
    • Massive colonic hemorrhage
    • Extracolonic disease
  • Crohn’s disease
    • Stricture and obstruction
    • Abscess
    • Perianal disease unresponsive to medical treatment
    • Cancer prophylaxis