Crohn’s disease, one of the most common forms of IBD, causes painful swelling of the small intestine, usually in the lower part. It is sometimes called ileitis or enteritis. The inflammation can spread deep into the intestinal lining, causing constant, severe diarrhea.

People with Crohn’s often have problems with their immune systems, but it is not known whether that is a cause or a result of the disease. Crohn’s disease is not caused by emotional stress.

It affects men and women in equal numbers and appears to run in some families, suggesting a genetic link. About 20 percent of patients have a close blood relative with some form of IBD.

The most common symptoms are pain in the stomach area (usually on the right side) and diarrhea. Some patients experience rectal bleeding, weight loss and fever. Extensive bleeding may result in anemia. Children with Crohn's disease may experience delayed or stunted growth.

Ulcerative colitis – sometimes called colitis, or proctitis – causes ulcers and painful swelling in the lining of the colon, or large intestine. Because the symptoms are so similar to Crohn’s disease and irritable bowel syndrome (IBS), it is hard to diagnose.

Men and women are affected by the disease in equal numbers and it most often appears between the ages of 15 to 40. Like Crohn’s disease, ulcerative colitis may have a hereditary component. A small percentage of patients go on to develop colon cancer. The risk for cancer appears to increase with the duration of the disease and how much of the colon is affected.

Patients also can experience such seemingly unrelated medical problems as arthritis, eye inflammation, liver disease, osteoporosis (loss of bone mass), skin rashes and kidney stones. These conditions are usually mild and disappear away when the colitis is treated. Although symptoms of ulcerative colitis may disappear for months or even years, they eventually return.

• Pouchitis
• Colorectal cancer related to IBD
• Extraintestinal manifestations of IBD

• Pouchitis, the inflammation of a pouch created from a part of the small intestine that allows patients to eliminate fecal matter.
• Colorectal cancer related to IBD. Recent studies suggest that IBD patients have an increased risk of developing colorectal cancer.
• Extraintestinal manifestations of IBD. Some IBD patients also suffer from certain types of arthritis, skin conditions, inflammations of the eye, bone loss and disorders of the liver and kidney.

Ulcerative colitis and Crohn’s disease, the most common forms of inflammatory bowel disease (IBD), are extremely difficult to diagnose and are often mistaken for one another.

Both inflame the lining of the digestive tract and both can produce abdominal pain and severe bouts of watery diarrhea. Ulcerative colitis usually affects the surface lining of the colon and rectum. In Crohn's disease, the inflammation can occur anywhere along the digestive tract, often affecting the lower part of the small intestine called the ileum. They are best diagnosed through an array of endoscopic, radiologic, blood and tissue tests.

• A complete blood-count test can reveal signs of infection and anemia, as well as detect whether a patient is having a reaction to medications used to treat IBD.
• Liver function tests check for abnormalities of the liver or bile duct problems. A test of stool samples can reveal the presence of bacterial infections, which can spark or aggravate IBD.
• Antibody tests can help in difficult cases to determine whether a patient has indeterminate colitis.

• In a colonoscopy, the physician examines the lining of the colon and sometimes can also view the lower end of the small intestine, or ileum.

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• With an esophagogastroduodenoscopy (EGD), the physician examines the esophageal lining, the stomach and the first part of the small intestine, known as the duodenum.

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• In a sigmoidoscopy, the physician inspects the lining of the lower third of the colon.

• In an endoscopic retrograde cholangiopancreatography (ERCP), the physician views the ducts in the liver and pancreas.

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• In a capsule endoscopy, the patient swallows a pill-sized camera that can transmit more than 50,000 images as it moves through the small intestine over an eight-hour period. This allows doctors to view parts of the small intestine unreachable by other methods.

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• With an endoscopic ultrasound, the physician can examine fistulas and other deep tissue problems in the gastrointestinal tract, especially in the rectal area.

Radiology tests provide vital information about the small intestine that cannot be gathered by endoscopic techniques. They include:

• Plain X-rays, which can detect blockage in the small or large intestine.
• X-rays with contrast, which usually involves swallowing a liquid such as barium to give contrasting images of the intestinal tract.
• MRI, or magnetic resonance imaging, which can reveal areas of active and inactive inflammation in the digestive tract.
• Computed tomographic (CT) enterograpy, which involves swallowing a contrast medium, can detect inflammation and thickening of the small bowel walls as well as the engorged blood supply and peri-intestinal inflammatory changes that are associated with Crohn’s disease. As a result, CT enterography is becoming the first-line method to investigate suspected inflammatory bowel disease.

UC Irvine’s experienced, multidisciplinary IBD team offers patients aggressive, leading-edge treatments aimed at suppressing the inflammatory response and improving quality of life. Patient care is highly individualized and may consist of medical therapy, surgery or both.

Medications are effective for treating symptoms as well as for inducing and maintaining remission. Commonly prescribed medications for IBD include aminosalicyclates, steroids, antibiotics and immunosuppressive therapy. We also are experienced in the targeted use of anti-tumor necrosis factor agents.

Surgery sometimes is necessary for the treatment of Crohn’s disease and ulcerative colitis. The IBD team’s colorectal surgeons are skilled in minimally invasive techniques as well as in bowel and continence preservation.

UC Irvine Healthcare’s colorectal surgeons are skilled in the latest minimally invasive surgical techniques to treat Crohn’s disease, ulcerative colitis, fistulas and IBD-related colorectal cancer. Laparoscopic surgery requires smaller incisions, resulting in less pain and fewer complications as well as shorter hospitalization and recuperation time.

Surgeons also perform ileo pouch anal anastomosis (IPAA), also known as J-pouch surgery, and stricturoplasty, a bowel-sparing procedure. Preservation of the small bowel is critical for patients with Crohn’s disease.

UC Irvine Healthcare’s IBD team provides expert care for patients with ostomy bags.

The IBD team uses a holistic approach with each patient, considering their physical, psychological and social needs in developing a treatment plan. Support programs are available to help you and your family members cope with your disease. They include:

• The “Buddy” program, which matches newly diagnosed individuals and those who are experiencing stress related to their diagnosis with other IBD patients of similar age, gender, and diagnosis. Each “buddy” is trained to provide support for patients with this complex disease.

• The “hospital visitation” program, which trains patients who aren’t experiencing active systems to provide emotional support for hospitalized individuals struggling with the disease.

• Counseling, advocacy and education. Social workers assist IBD patients, addressing their psychosocial needs through crisis intervention, counseling, community resources, referrals for long-term therapy, advocacy and education.

• The IBD support group, which meets the first Wednesday of each month from 6:30 to 8:30 p.m. on the fourth floor of the Chao Family Comprehensive Cancer Center in Orange. Each month a presenter discusses a topic chosen by the group members. For more information, call Kristin McMaster, 714.456.7057.

UC Irvine’s IBD team members are regularly involved in many clinical research trials. Patients with Crohn’s disease and ulcerative colitis may be eligible to participate in these trials. An individual’s participation in a trial depends on the requirements of the particular research study.

For more information, view available clinical trials or call 714.456.7090

One of our missions is to offer up-to-the-minute educational programs and conferences to patients and family members, as well as to local healthcare providers. Our goal is to provide support to those affected by IBD, to encourage the most effective management of the disease and to convey information about rapidly occurring advances in the research and treatment of the disease.

For more information on upcoming programs, please call 714.456.7347.