If you have recently been told you have ulcerative colitis or Crohn’s disease, your first reaction may have been shock that you have an illness which could affect you for the rest of your life. You may also have felt some relief that at last you have an explanation for the way you are feeling. There are probably many questions running through your mind.

Inflammatory bowel disease (IBD) is a term used to describe two diseases, ulcerative colitis and Crohn’s disease, which cause inflammation of the bowel.
Ulcerative colitis causes inflammation of the inner lining of the large bowel (colon and rectum). When only the rectum is involved it is sometimes called ulcerative proctitis or just proctitis. When the entire colon is involved it is sometimes called pan-colitis.

Crohn’s disease causes inflammation of the full thickness of the bowel wall and may involve any part of the digestive tract from the mouth to the anus (back passage). Most frequently the ileum, which is the lower part of the small bowel (ileitis), the large bowel (colitis) or both (ileo-colitis) are involved.
Sometimes people get confused between inflammatory bowel disease (IBD) and the irritable bowel syndrome (IBS). The two conditions are quite different and so are their treatments.

Despite a great deal of research, the cause of ulcerative colitis and Crohn’s disease is unknown. Some scientists believe IBD may be due to a defect in the body’s immune system (its natural protection against diseases), while others believe that bacteria or even viruses might play some role. However, there is no evidence that ulcerative colitis or Crohn’s disease is contagious. Relatives of people with IBD have a slightly greater risk of developing either disease. Stress or diet are not thought to cause IBD. Both diseases are more common in the Western world.

The drugs used to treat Crohn’s disease are the same as those used for ulcerative colitis. However, drugs that suppress the immune system (especially azathioprine, 6-mercaptopurine or methotrexate) are more commonly used to help control the inflammation and as maintenance therapy. Active Crohn’s disease is generally treated with steroid tablets (usually prednisolone).
Sometimes, antibiotics are also used.

Where drug therapy is ineffective, an infusion into the vein of infliximab (Remicade), (an antibody that mops up an important protein made by the body during inflammation), may be used.

In contrast to ulcerative colitis, it is not possible to remove the all of the bowel that may be affected by Crohn’s disease, so the disease cannot be cured by surgery. However, some people do require surgery if drug treatment is ineffective, or if Crohn’s disease causes a blockage or leak in the bowel. Surgery may also be necessary for people with Crohn’s disease of the anus that which is not responding to tablets.

You can obtain more detailed information about the drugs used in the treatment of ulcerative colitis and Crohn’s disease from the ACCA/DHF publication “Drugs and Inflammatory Bowel Disease”, and more information on surgery from the ACCA/DHF publication “Surgery and Inflammatory Bowel Disease”. You can also get more information about the drugs used on the GESA website, www.gesa.org.au