‘Inflammatory bowel disease’, or IBD, is a general term that includes both ulcerative colitis and Crohn’s disease. Both diseases cause inflammation (sores, swelling, bleeding and pain) in the digestive system. Ulcerative colitis affects the inner lining of the large intestine (colon and rectum), and Crohn’s disease can affect any part of the digestive tract from the mouth to the anus. Both diseases are manageable, and with treatment most people are able to carry on living normal lives.
IBD affects different people in different ways, and no two people with IBD are alike. Here are some answers to some of the most common questions about IBD, to help you understand how it might affect you and how it is managed.

What are the symptoms?
The most common IBD symptoms are abdominal pain, cramping, tiredness (fatigue), diarrhoea and weight loss. Other symptoms may include bloody diarrhoea, slight fever, anaemia (low levels of red blood cells in the blood which can make you feel tired, faint or breathless) and exhaustion (extreme tiredness).
Both diseases are ongoing (chronic) with times when symptoms get worse (called flares, flare-ups, or attacks) and other times when symptoms get better (remission). Although the symptoms can make you feel unwell and may make your daily activities difficult, they can usually be managed with a combination of care, medication, hospitalisation and (sometimes) surgery. Many people find that in well managed IBD, making some simple changes to their everyday lives enables them to continue their normal activities.
Who gets IDB ?
The most common IBD symptoms are abdominal pain, cramping, tiredness (fatigue), diarrhoea and weight loss. Other symptoms may include bloody diarrhoea, slight fever, anaemia (low levels of red blood cells in the blood which can make you feel tired, faint or breathless) and exhaustion (extreme tiredness).
Both diseases are ongoing (chronic) with times when symptoms get worse (called flares, flare-ups, or attacks) and other times when symptoms get better (remission). Although the symptoms can make you feel unwell and may make your daily activities difficult, they can usually be managed with a combination of care, medication, hospitalisation and (sometimes) surgery. Many people find that in well managed IBD, making some simple changes to their everyday lives enables them to continue their normal activities.
What causes IBD?
Although the exact causes of IBD are unknown, they are believed to be related to changes in the immune system brought about by an environmental trigger in people who are genetically prone to the disease. A combination of factors may play a role, including bacteria, viruses, genetics, smoking and over-the-counter pain medicines. Other factors, such as stress and diet, are not believed to cause IBD, although they may be involved in worsening symptoms for some people.

How is IBD treated
For most people with IBD, especially with mild to moderate symptoms, treatment with medicine is usually the first approach. The type of treatment you will be given depends on several things – such as whether you have ulcerative colitis or Crohn’s disease, the extent of the disease, and the impact of your symptoms on your daily life.
For people with ulcerative colitis, the type of treatment depends on the amount of the large bowel affected and the severity of the inflammation. For example, disease in the lower part of the bowel may be treated with drugs given directly into the rectum with an enema or suppository. A medicine called mesalazine may be given by mouth. Steroid tablets (such as prednisolone) may be given in more severe cases or if more of the bowel is affected. Immunosuppressants may also be used to help reduce the activity of the body’s immune system, which causes a lot of the damage to the bowel. After symptoms are reduced, many people take medicine to keep symptoms from returning; this is called maintenance therapy.
For Crohn’s disease, there are generally the same options as those used for ulcerative colitis. However, with Crohn’s disease, drugs that suppress the immune system (azathioprine, 6-mercaptopurine or methotrexate) are used more often to help control the inflammation and as maintenance therapy to help keep symptoms from coming back. Active Crohn’s disease is usually treated with steroid tablets (eg, prednisolone) and sometimes antibiotics are also used. When other drug therapy does not work well, an anti-TNF drug may be given by infusion (drip) in the hospital or by injection at home.
With both diseases, surgery may be needed if medication does not work well or if there are complications. If you have any questions about the possibility of needing surgery, it is best to discuss your situation with your doctor. In general, surgery is usually only used in severe situations when other options are not possible or do not work.