In Germany, 12 out of every 100,000 people develop a new case of inflammatory bowel disease (IBD) each year. It is striking that most of those affected live in Northern Europe and North America. Our Western lifestyle appears to be a risk factor for chronic inflammatory bowel diseases. Unfortunately, the exact cause of IBD is still not fully understood scientifically.
What happens in IBD?
The intestinal immune system must constantly determine whether the intestinal contents contain beneficial nutrients or harmful foreign substances. The intestinal mucosa acts as a barrier against these foreign substances, preventing them from penetrating the intestinal wall. In inflammatory bowel disease (IBD), the intestinal mucosa is altered, and this barrier is weakened. As a result, both harmless and harmful substances can enter the intestinal wall. In both cases, this triggers an immune response, leading to inflammation. This inflammation damages the intestinal tissue.
How does one detect IBD?
Once the intestines become inflamed, symptoms such as persistent diarrhea, abdominal pain, and ongoing fatigue are very likely. IBDs occur periodically. d.h. Periods with symptoms alternate with symptom-free intervals. The severity, duration, and frequency of such relapses vary greatly and are therefore difficult to predict. Typical symptoms include mucus-filled diarrhea and stomach pain. In addition, approximately 35% of those affected suffer from symptoms outside the digestive tract. These include, for example, symptoms affecting the joints, skin, eyes, liver, and bones. In children and adolescents, this disease can lead to severe weight loss and growth disorders.
What are the differences between ulcerative colitis and Crohn's disease?
The two diseases differ primarily in which parts of the digestive tract are affected. You can learn more about both conditions now:
Crohn's disease:
Crohn's disease can affect the entire digestive tract – that is, the whole area from the mouth to the anus. However, the disease most commonly occurs in the final sections of the small intestine. A distinctive feature of Crohn's disease is that the affected parts of the digestive tract are usually not connected. This means that healthy and unhealthy sections of the intestine alternate – essentially a patchwork of healthy and diseased sections.
When a patient has Crohn's disease, all layers of the intestine are affected in the inflamed areas. In some cases, they are even completely destroyed! This can lead to abscesses (collections of pus) or fistulas. When fistulas occur, the inflammation has created channels in the intestinal wall and surrounding tissue. Furthermore, stenoses can develop – this term refers to scarring and narrowing of the intestine.
It has been scientifically proven that Crohn's disease has a strong genetic component.However, other influences on the organism, such as personal hygiene, diet and mental health, also play an important role.
To summarize briefly again:
- Can occur anywhere in the digestive tract (mouth to anus).
- The disease is characterized by a segmental-discontinuous pattern, meaning that inflamed segments of the digestive tract alternate with non-inflammation segments.
- The inflammation of the intestinal wall extends to all layers of the intestinal wall.
Ulcerative colitis
This chronic bowel disease is translated as “colon inflammation with ulcers”.
It differs from Crohn's disease, explained above, in that the resulting inflammation occurs only in the large intestine. Another difference is that the patient's intestine is continuously affected. This means that once the disease has broken out, there are no inflammation-free sections in the intestine. Another interesting fact is that ulcerative colitis begins in the rectum and spreads orally from there. Furthermore, this disease only affects the outermost layer of the intestine and does not penetrate into deeper intestinal layers like Crohn's disease.
To summarize briefly again:
- Affects only the large intestine and rectum.
- The inflammation spreads continuously from “back” to “front” (d.h. (from anal to oral).
- Only the outermost layer of the intestinal wall, the intestinal mucosa, is inflamed.
Both diseases have one thing in common: when they occur, the natural barrier function of the intestine is disrupted. This has several negative consequences, as this barrier is responsible for preventing pathogenic, harmful bacteria or other "invaders" from penetrating the intestinal lining.
If the intestinal barrier is compromised, this results in impaired immune function. This allows bacteria to more easily enter the body and trigger systemic inflammatory responses – just as in the two previously described diseases. Over time, systemic inflammation can unfortunately become chronic. This, in turn, can lead to symptoms that also occur outside the intestines. These include inflammation in the joints, ligaments, muscles, skin, eyes, and liver. Furthermore, a prolonged illness of the colon significantly increases the likelihood of developing colon cancer.
How can IBD be treated?
In general, chronic inflammatory bowel diseases (IBD) are classified and treated according to their severity. In acute cases, doctors usually prescribe medications to suppress symptoms and inflammation, as these can cause severe pain. Therefore, the primary goal of IBD treatment is to enable patients to live as symptom-free a life as possible.
Recent studies show that Probiotics have positive effects These treatments can have a positive impact on the course of the disease, as they can reduce various symptoms. They involve therapeutic procedures that aim to positively influence the composition of the intestinal mucosa through various microbiological corrections.
Crohn's disease is currently incurable, while ulcerative colitis can be cured by surgical removal of the colon and rectum.Treatment is multimodal and can provide good symptom control and a high quality of life for many patients. Probiotics may also be used in treatment.
- https://www.mondosano.de/ratgeber-artikel/ced
- http://www.gastroenterologie.usz.ch/fachwissen/morbus-crohn-colitits-ulcerosa/Seiten/default.aspx
- https://www.deutsche-apotheker-zeitung.de/daz-az/2004/daz-26-2004/uid-12167
