Word Count: 46809-21-1999
This article was published by the Pensacola News Journal on Sept. 21, 1999.
Crohn’s disease and ulcerative colitis, collectively known as inflammatory bowel disease, are chronic diseases of the intestinal tract that afflict up to one million Americans, with 30,000 new cases diagnosed each year.
Fortunately, recent research and new medications offer the promise that these patients can live a full and normal life.
These two diseases most commonly strike younger people in the prime of their life. The majority of patients are diagnosed between ages of 15 and 30 years old, although there is another peak between 60 and 80 years of age.
The estimated yearly cost of inflammatory bowel disease is $2.6 billion, but the personal cost to patients in terms of painful symptoms, lost time from school or work, or disruption of normal lifestyle cannot be easily calculated.
Symptoms of disease
Crohn’s disease is a systemic disease characterized by patchy, full thickness inflammation of the bowel wall that can affect the entire digestive tract.
Symptoms frequently include abdominal pain, cramps, diarrhea, rectal bleeding and weight loss. Complications of the disease include arthritis, skin rash, bowel obstruction, anemia and fistula formation (the development of abnormal connections between the bowel and other loops of the intestine, the bladder, vagina or skin.)
Ulcerative colitis is a systemic disease limited to the colon and the rectum. It is characterized by acute and chronic inflammation of the inner lining of the bowel. Fistula do not occur, obstruction is uncommon, but cramping, abdominal pain, diarrhea and rectal bleeding are typical symptoms.
Crohn’s disease and ulcerative colitis are both associated with an increased risk of colorectal cancer.
Although the exact cause of inflammatory bowel disease is not yet known, great progress has been made in understanding the unique interplay between genetic and environmental factors. Proteins from bacteria in the intestine may interact with the immune system, leading to chronic intestinal irritation.
Great progress has been made in the treatment of patients with inflammatory bowel disease. The number of medications used to treat patients has expanded significantly in the last several years.
The new generation amino-salicylates, mesalamine and olsalazine are effective in the treatment of mild to moderate cases of ulcerative colitis and Crohn’s disease, and in maintaining remission in both diseases.
Other agents which suppress the immune system can heal severe cases that do not respond to steroid treatment.
Most noteworthy is the recent FDA approval of Infliximab (Remicade) in the treatment of severe Crohn’s disease not responsive to steroids and other immuno-suppressive agents. This medication is a genetically engineered substance that blocks a key inflammatory agent present at high levels in patients with Crohn’s disease. Results have been dramatic in many patients.
The future is filled with hope and promise for the patient who is diagnosed with inflammatory bowel disease. With the proper treatment, patients can expect to live a full and normal life.