VIDA LAB by Rowan Albritton
Sign in
Back to Library
gastrointestinal

Inflammatory Bowel Disease (Crohn's & Ulcerative Colitis)

Chronic autoimmune conditions causing inflammation of the digestive tract, leading to pain, diarrhea, and malnutrition.

Save to favorites
In this report
  1. Overview
  2. Symptoms
  3. Diagnosis
  4. Treatments
  5. Medical Resources
  6. Your Care Plan

Overview

Inflammatory Bowel Disease (IBD) encompasses two main conditions: Crohn's disease, which can affect any part of the digestive tract from mouth to anus in patches, and ulcerative colitis, which affects only the colon and rectum in a continuous pattern. Both are chronic autoimmune conditions where the immune system attacks the digestive tract lining, causing inflammation, ulceration, and scarring.

IBD affects about 3 million Americans and often begins in the teens to thirties, though it can develop at any age. The exact cause is unknown but involves a combination of genetics, immune dysfunction, and environmental triggers, possibly involving the gut microbiome.

IBD is a lifelong condition marked by flares and remission. Untreated, it can lead to serious complications: strictures, fistulas, abscesses (Crohn's), or a significantly increased colon cancer risk (ulcerative colitis). Modern biologic therapies have dramatically improved the ability to achieve and maintain remission.

Symptoms

  • Persistent diarrhea, sometimes with blood or mucus
  • Abdominal pain and cramping
  • Urgency to have a bowel movement
  • Unintended weight loss
  • Fatigue
  • Reduced appetite
  • Fever during flares
  • Anemia
  • Perianal symptoms — fistulas, abscesses (more common in Crohn's)
  • Joint pain, eye inflammation, or skin rashes (extra-intestinal manifestations)
  • Growth delay in children

Diagnosis

  1. Blood tests — inflammatory markers (CRP, ESR), CBC for anemia, and nutritional markers
  2. Stool tests — fecal calprotectin (a key marker of intestinal inflammation) and stool cultures to rule out infection
  3. Colonoscopy with biopsy — the primary diagnostic tool, allowing direct visualization and tissue sampling to distinguish Crohn's from ulcerative colitis
  4. Imaging — CT or MRI enterography to assess the small intestine (especially for Crohn's, which colonoscopy alone can't fully evaluate)
  5. Upper endoscopy — if upper GI symptoms are present

A gastroenterologist makes and manages the diagnosis.

Treatments

  • Biologics — the major advance in IBD treatment: anti-TNF drugs (infliximab, adalimumab), anti-integrins (vedolizumab), IL-12/23 inhibitors (ustekinumab), and JAK inhibitors (upadacitinib) target the immune pathways driving inflammation
  • Immunomodulators — azathioprine, 6-mercaptopurine, methotrexate, often combined with biologics
  • Aminosalicylates (5-ASAs) — mesalamine, effective mainly for mild-to-moderate ulcerative colitis
  • Corticosteroids — for flares, but not for long-term maintenance due to side effects
  • Nutrition support — addressing deficiencies (iron, B12, vitamin D) and, in severe cases, exclusive enteral nutrition or specialized diets
  • Surgery — for Crohn's, resection of severely damaged bowel segments; for ulcerative colitis, colectomy can be curative in severe or refractory cases
  • Treat-to-target approach — using fecal calprotectin and endoscopic healing (not just symptoms) to guide treatment adjustments

Your Care Plan

A step-by-step guide to navigating your condition, from finding the right doctors to advocating for the care you deserve.

Step 1: Doctors to See

Start with: Your primary care doctor for initial blood and stool testing.

Then seek: A gastroenterologist, ideally one with an IBD-focused practice, for colonoscopy and long-term management.

Build your team:

  • Colorectal surgeon — for complications requiring surgery
  • Registered dietitian — for nutrition optimization, especially during flares
  • Rheumatologist — if joint symptoms (extra-intestinal manifestation) develop
  • Mental health professional — chronic GI illness carries a high burden; therapy support matters

Step 2: Advocate for Yourself

Push for a treat-to-target approach — remission should mean healed intestinal tissue (confirmed by colonoscopy or fecal calprotectin), not just fewer symptoms, since silent inflammation still causes long-term damage. If steroids are your main treatment for more than a few months, ask about starting a biologic or immunomodulator — long-term steroid use has serious risks. Track flares, stool patterns, and triggers carefully. If new symptoms appear (joint pain, eye redness, skin lesions), mention them — these extra-intestinal manifestations affect treatment choice.

Step 3: Your Action Plan

  1. Get stool (fecal calprotectin) and blood testing through your primary care doctor.
  2. See a gastroenterologist for colonoscopy with biopsy to confirm and classify (Crohn's vs. ulcerative colitis).
  3. Discuss treatment goals — aim for endoscopic remission, not just symptom control.
  4. Start appropriate medication — biologics are often used earlier now than in the past for better long-term outcomes.
  5. Address nutritional deficiencies with bloodwork and a dietitian's guidance.
  6. Monitor with regular fecal calprotectin and periodic colonoscopy.
  7. Watch for extra-intestinal symptoms and report them promptly.
  8. Discuss a long-term surveillance colonoscopy schedule given increased colon cancer risk (ulcerative colitis).

Important: This report is educational information, not medical advice. Always consult a qualified healthcare professional for diagnosis and treatment decisions.

Have questions about your condition?

Talk to Vida.

She can explain research, symptoms, and terminology in plain language — and point you toward VIDA LAB explainers.

Ask Vida →