Symptoms for IBD can be different from one form to the other because they are dependent on what part of the intestinal tract is involved [7]. Common symptoms are abdominal pain and diarrhea. Since these symptoms and some of the other presentations of IBD are rather nonspecific, a diagnosis for either form of the condition can be delayed for months or even years.

Affected individuals can experience abnormal bowel habits, tenesmus, and passages of mucus without pus or blood. Extraintestinal manifestations include arthralgia, rash, malaise, fever, and weight loss.

• Weight Loss

  Relationship between IBD and obesity remains unclear, but weight loss could be useful in the pharmacological control of IBD. [ncbi.nlm.nih.gov]

  The primary symptoms of Crohn’s disease are abdominal cramps, diarrhea, delayed growth (in children), weight loss, fever and anemia. [hopkinsmedicine.org]

  Other symptoms of IBD can include weight loss. [webmd.com]

• Malnutrition

  Depending upon the nature of the association, skin conditions associated with IBD can be listed under 4 categories: specific, reactive, secondary to malnutrition or malabsorption, and secondary to drug therapy. [ncbi.nlm.nih.gov]

  What side effects of IBD can cause malnutrition? There are several reasons why people with IBD may be at risk for malnutrition. The following list includes some side effects that contribute to malnutrition. [ucsfhealth.org]

  Crohn disease of the duodenum and jejunum can cause malabsorption of nutrients can cause malnutrition, weight loss, and diarrhea. [rxlist.com]

• Diarrhea

  A 2-month-old girl with a dysmorphic face presented with recurrent respiratory tract infections, vomiting, diarrhea and hepatosplenomegaly. [ncbi.nlm.nih.gov]

  Fluid requirements increase during or after episodes of diarrhea and with exercise. Make sure you replenish losses of electrolytes from diarrhea. [ucsfhealth.org]

  The most common symptoms of ulcerative colitis, which occurs in the lining of the colon (large intestine) and/or rectum only, are diarrhea, rectal bleeding—often with mucous—and abdominal pain. [oregonclinic.com]

• Abdominal Pain

  We report two cases of CSVV associated with ulcerative colitis, review the literature, and discuss the diagnostic evaluation of children who present with CSVV and abdominal pain. [ncbi.nlm.nih.gov]

  Variable Abdominal Pain With jejunoileitis, abdominal pain varies greatly and can be characterized as either mild or severe. [verywellhealth.com]

  They include urgent and frequent bowel movements, persistent diarrhea, incontinence, rectal bleeding and pain, bloody stool, abdominal pain, and cramping. [nyulangone.org]

• Nausea

  One main problem is that eating is often associated with symptoms such as nausea, pain, bloating, and diarrhea. Another reason is that symptoms of nausea and diarrhea tend to make people feel less like eating. [verywell.com]

  Some Crohn’s patients present with obstructive symptoms, specifically sudden onset of uncontrollable nausea, vomiting, and abdominal pain. [oregonclinic.com]

  Adverse effects include nausea, vomiting, and asymptomatic liver test abnormalities. Folate 1 mg orally once a day may diminish some of the adverse effects. [msdmanuals.com]

  Any pain that is new to you, is severe, or is happening at the same time as symptoms such as lack of stool, abdominal bloating, nausea, constipation, or vomiting is cause for a call to your doctor or a trip to the ER. [verywellhealth.com]

• Abdominal Cramps

  IBD Overview Inflammatory bowel disease can cause symptoms such as abdominal cramps, bloody diarrhea, and fever. Other symptoms of IBD can include weight loss. [webmd.com]

  The primary symptoms of Crohn’s disease are abdominal cramps, diarrhea, delayed growth (in children), weight loss, fever and anemia. [hopkinsmedicine.org]

  IBD Symptoms When the digestive tract is chronically inflamed, it produces symptoms such as diarrhea, abdominal cramps and pain, bloody stools and the formation of ulcers. [uclahealth.org]

  If your child begins to lose weight quickly, has repeated bouts of diarrhea, or complains of abdominal cramping, IBD may be the cause. [brennerchildrens.org]

  Symptoms of IBD may range from mild to severe but tend to include the following: abdominal cramps and pain frequent, watery diarrhoea (may be bloody) severe urgency to have a bowel movement fever during active stages of disease loss of appetite and weight [crohnsandcolitis.com.au]

• Chronic Diarrhea

  Characterized by chronic diarrhea with normal radiologic and endoscopic findings and typical findings on histologic examination of colonic tissue and as such a medical differential diagnosis, they will not be covered here. [radiopaedia.org]

  Both are immune disorders of the intestine that can cause: Chronic diarrhea Abdominal pain Bleeding Anemia Weight loss An accurate diagnosis is essential for optimal management and is one of the strengths of the group of specialists in the IBD center [virginiamason.org]

  Crohn’s disease has more varied symptoms, with the most common symptoms listed first: abdominal pain and cramps chronic diarrhea blood in feces bloating and gas fatigue fevers lack or loss of appetite weight loss mouth ulcers arthritis slowing of growth [canada.ca]

  Patients with IBS experience chronic diarrhea, constipation, and in some cases both. For years, IBS patients have complained to doctors about being gassy, bloated, and constipated. [cedars-sinai.org]

• Night Sweats

  sweats weight loss IBD may also be associated with symptoms that do not appear to be related to the digestive system, such as: joint pain canker sores in the mouth inflammation of the eyes skin disorders irregular periods in females Children with IBD [medicalnewstoday.com]

In order to diagnose IBD, other conditions like various infections, ischemic colitis, colon cancer, and diverticulitis must be first ruled out [8]. Once these other conditions are excluded, a workup for IBD can include:

• Blood tests including complete blood count and inflammatory markers 
• Stool analysis for enteric pathogens 
• Imaging of the upper gastrointestinal tract including barium enema, ultrasonography and magnetic resonance enterography 
• Colonoscopy
• Flexible sigmoidoscopy
• Capsule endoscopy

Usually, IBD can be treated with medication, surgery, or a combination of both when necessary [9]. Any specific treatment is based on whether the patient is suffering from ulcerative colitis or Crohn disease.

The major goals of any of the treatment methods are achieve remission and to prevent flares. These therapies can include symptomatic care that will help alleviate the cramps and other systemic symptoms related to the condition, as well as mucosal healing. These treatment methods are usually followed by individualized escalated steps in order to get a positive response.

In terms of mortality, the rate related to IBD falls between 1.4 to 5 times within the general international population according to research [6]. Between the two forms of IBD, Crohn disease is more commonly linked to mortality as people with ulcerative colitis vary only slightly from the general population.

There are a number of factors that lead to IBD including a genetic predisposition to the condition. Other factors include altered responses to microorganisms found in the gut and a dysregulation of the immune system [2]. As of yet, there is no determinable primary cause for IBD, but researchers continue to propose theories as studies continue. According to research, the cause for the altered immune response that leads to IBD is considered to be unidentifiable [3]. Several risk factors including diet, smoking, physical activity, other disorders and medications have been proposed to contribute to the development of an inflammatory bowel disease.

The instances of IBD seem to be dependent on location as the highest rates of IBD seem to be found in developed countries while developing regions show the lowest rates of recorded cases of the disorder. Similarly, the rates of IBD also seem to correlate to the climate of an area with warmer climates reporting a lower rate of IBD when compared with colder climates. Urban areas report a higher rate of IBD when paralleled with rural areas, too.

Statistically speaking, the incidence of ulcerative colitis falls between 0.5 and 24.5 cases out of 100,000 per year internationally. Crohn disease occurs between 0.1 to 16 in 100,000 cases. Annually, there are around 396 cases of general IBD reported on average.

Crohn disease can involve any part of the gastrointestinal tract from the mouth to the perianal area. Affected segments usually are separated by normal bowel, leading to the occurrence of skip lesions. The inflammation is transmural, often extending through to the serosa, resulting in fibrosis and strictures, sinus tracts and fistula formation.

Ulcerative colitis is considered to be the inflammation of the mucosal layer of the colon with continuous involvement. The rectum is affected in the majority of cases. The inflammation leads to edema, fluid and electrolyte loss, bleeding, formation of crypt abscesses and ulceration [5].

There are dietary changes that a patient may implement in order to reduce symptoms and stave off inflammation and recurring flare ups of IBD, however ways to prevent the disorder from ever occurring in the first place are unknown [10]. 

Inflammatory bowel disease, abbreviated IBD, is a group of inflammatory conditions with two major types, ulcerative colitis and Crohn disease [1]. After a proper workup it is usually possible to determine which form of IBD is present in a patient, if not, the condition is referred to as indeterminate colitis. Other types of colitis include microscopic colitis, lymphocytic colitis, and collagenous colitis but they are usually not considered to fall under the umbrella of IBD.

Both Crohn disease and ulcerative colitis affect the gastrointestinal tract. Ulcerative colitis affects the colon while Crohn disease is a condition that may develop in the whole digestive system, characterized by skip lesions.

Inflammatory bowel disease (IBD) is a chronic inflammation disorder that affects different parts of the digestive tract. Under the general diagnosis of IBD are two disorders, ulcerative colitis and Crohn disease. The former condition affects the large intestine and rectum while the latter affects the entire digestive system.

Both disorders can create pain and discomfort along with abnormal bowel habits. They can also lead to other health complications that, if left untreated, can be life threatening. 

The symptoms associated with IBD can be medically treated but there are times where surgery might be necessary to address larger problems in more severe cases. In most cases, lifestyle changes related to a person’s daily diet will be recommended to prevent flare ups of IBD. There are no known ways to prevent IBD from occurring in the first place.

1. Agrawal D, Rukkannagari S, Kethu S. Pathogenesis and clinical approach to extraintestinal manifestations of inflammatory bowel disease. Minerva Gastroenterol Dietol. Sep 2007;53(3):233-48.
2. World Gastroenterology Organisation (WGO). World Gastroenterology Organisation Global Guideline. Inflammatory bowel disease: a global perspective. Munich, Germany: World Gastroenterology Organisation (WGO); 2009.
3. American Gastroenterological Association medical position statement: perianal Crohn's disease. Gastroenterology. Nov 2003;125(5):1503-7. 
4. Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. Mar 2010;105(3):501-23; quiz 524. 
5. Kiran RP, Nisar PJ, Church JM, Fazio VW. The role of primary surgical procedure in maintaining intestinal continuity for patients with Crohn's colitis. Ann Surg. Jun 2011;253(6):1130-5. 
6. Farmer RG, Hawk WA, Turnbull RB Jr. Clinical patterns in Crohn's disease: a statistical study of 615 cases. Gastroenterology 1975; 68:627.
7. Pimentel M, Chang M, Chow EJ, et al. Identification of a prodromal period in Crohn's disease but not ulcerative colitis. Am J Gastroenterol 2000; 95:3458.
8. Burgmann T, Clara I, Graff L, et al. The Manitoba Inflammatory Bowel Disease Cohort Study: prolonged symptoms before diagnosis--how much is irritable bowel syndrome? Clin Gastroenterol Hepatol 2006; 4:614.
9. Mekhjian HS, Switz DM, Melnyk CS, et al. Clinical features and natural history of Crohn's disease. Gastroenterology 1979; 77:898.
10. Schwartz DA, Loftus EV Jr, Tremaine WJ, et al. The natural history of fistulizing Crohn's disease in Olmsted County, Minnesota. Gastroenterology 2002; 122:875.