Inflammatory bowel disease (IBD) affects between 2.4 and 3.1 million people across the United States, according to the Centers for Disease Control and Prevention. Data from a U.S. National Health and Nutrition Examination Survey showed 1 percent of U.S adults may have diagnosed IBD. Also, the National Institutes of Health report an estimated 322,600 Canadians were living with IBD in 2023. Canada has one of the highest rates of IBD in the world.

The Mayo Clinic notes that IBD refers to disorders involving chronic inflammation of tissues in the digestive tract. The two most common types of IBD include ulcerative colitis and Crohn’s disease. Both diseases typically develop in teenagers and young adults, although they can occur at any age. Ulcerative colitis and Crohn’s disease affect men and women equally, and symptoms are very similar. Understanding the differences between colitis and Crohn’s can direct people to the best courses of treatment for their ailments.

Crohn’s disease

Crohn’s disease is characterized by inflammation of the lining of the digestive tract, anywhere from the mouth to the anus. However, the small intestine is most often affected. According to UCLA Health, when a person has Crohn’s disease, there are healthy parts of tissue mixed in between inflamed areas. Because Crohn’s disease affects more of the GI tract, WebMD says doctors may see sores in the mouth, on the lips or tongue, or even anal tears and rectal infections.

Ulcerative colitis

Ulcerative colitis is a form of IBD that is limited to the colon. It affects the inner most lining of the colon, while Crohn’s disease can occur in all of the layers of the bowel walls. With colitis, there are no healthy areas of tissue in the colon between inflamed spots; the inflammation is continuous.

Diagnosis

Doctors use various tests to diagnose IBD. A colonoscopy checks the large intestine. A sigmoidoscopy examines only the lower part of the large intestines, while an esophagogastroduodenoscopy checks the lining of the esophagus, stomach and the duodenum. Additional testing may be used to examine the small intestine or bile and pancreatic ducts, says WebMD. Even after various imaging tests, doctors still may be unsure if Crohn’s disease or ulcerative colitis is responsible for symptoms.

Scientists are working to improve blood tests to help diagnose ulcerative colitis and Crohn’s. These tests check levels of certain antibodies found in blood. Most often people with ulcerative colitis have the pANCA (perinuclear anti-neutrophil) antibody present, while those with Crohn’s disease have the ASCA (anti-Saccharomyces Cerevisiae) antibody present. These tests are not always accurate, so other diagnostic criteria should be used.

Treatment

The goal of IBD treatments is to reduce the inflammation that triggers symptoms. Anti-inflammatory drugs often are the first step in the treatment of IBD as well as immune system suppressors. The Mayo Clinic says biologics are a newer category of therapy for IBD, and are aimed at neutralizing proteins in the body that are causing inflammation.

When dietary changes and medication are not completely effective for IBD, doctors may suggest surgery. The Mayo Clinic says up to two-thirds of people with Crohn’s disease will require at least one surgery in their lifetime. The damaged portion of the digestive tract is removed and then the healthy sections are joined together. Surgery for ulcerative colitis may include removing the entire colon and rectum and using an internal pouch for bowel movements.

Inflammatory bowel diseases can affect people in many ways and require treatment to restore quality of life.