Inflammatory Bowel Disease (IBD): Start Here

Inflammatory bowel disease (IBD) is a group of lifelong conditions where the immune system mistakenly attacks the intestines, causing ongoing inflammation and damage. The two main types are Crohn’s disease and ulcerative colitis. Symptoms often come in “flares” with quiet periods in between. With modern treatment and organized care, many people achieve long stretches of remission and active lives. (cdc.gov)

Key Takeaways

• IBD is a chronic immune disease of the gut, not an infection and not caused by one food or a single life event. (cdc.gov)

• The two main types, Crohn’s disease and ulcerative colitis, affect different parts and layers of the intestine. (webmd.com)

• Common symptoms include diarrhea, belly pain, urgency, blood in the stool, fatigue, and weight loss, often in flares and remissions. (cdc.gov)

• Diagnosis usually combines blood tests, stool tests, colonoscopy with biopsies, and imaging to rule out other conditions. (mayoclinic.org)

• Care is long term and team based, often using a “treat to target” plan that aims for both symptom control and healing seen on tests. (pubmed.ncbi.nlm.nih.gov)

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is a group of conditions where the body’s defense system attacks healthy cells in the bowel. This causes long-lasting inflammation, swelling, and ulcers in the intestines. (cdc.gov)

The main types are Crohn’s disease and ulcerative colitis. Both are lifelong conditions that usually start in adolescence or early adulthood, but they can appear at any age. (cdc.gov)

IBD tends to follow a pattern:

• Flares, when symptoms worsen

• Remission, when symptoms improve or disappear for a time (cdc.gov)

Most people with IBD, with the right treatment, can have long periods of remission and maintain work, school, family life, and activities. (cdc.gov)

IBD is different from short-lived infections such as a “stomach bug.” It is also different from irritable bowel syndrome (IBS), which affects how the gut works but does not cause visible inflammation or damage on tests. (cdc.gov)

Crohn’s disease and ulcerative colitis: key differences

Both Crohn’s disease and ulcerative colitis involve immune-driven inflammation in the digestive tract, and they share many symptoms. The main differences involve where the inflammation occurs and how deep it goes. (webmd.com)

(ncbi.nlm.nih.gov)

Because of these differences, Crohn’s disease may cause problems like strictures or fistulas, and ulcerative colitis more often causes rectal bleeding and urgency from inflamed colon lining. (hopkinsmedicine.org)

Typical symptoms of IBD

Symptoms can vary widely from person to person and can change over time. Common bowel-related symptoms include: (cdc.gov)

• Diarrhea or frequent loose stools

• Blood or mucus in the stool, especially in ulcerative colitis

• Belly pain or cramping

• Urgent need to have a bowel movement, sometimes with difficulty passing stool (tenesmus)

• Feeling of incomplete emptying

• Constipation in some patterns of disease

Whole-body symptoms often reflect inflammation, blood loss, or poor nutrient absorption:

• Fatigue or low energy

• Unintentional weight loss or poor growth in children

• Fever in more active disease

• Nausea, reduced appetite

• Anemia from blood loss or poor iron absorption (cdc.gov)

IBD can also affect areas outside the gut, called extraintestinal manifestations. These can include joint pain, certain skin rashes, eye inflammation, and reduced bone density. (cdc.gov)

Symptoms usually wax and wane. A person may feel well for months or years, then experience a flare with more pain, diarrhea, bleeding, or urgency. Tracking patterns over time is a key part of organized care in IBD. (cdc.gov)

How IBD is diagnosed and monitored

There is no single test that proves IBD. Diagnosis usually combines: (mayoclinic.org)

• Medical history and exam

• Blood tests, looking for anemia, signs of inflammation, or infections

• Stool tests, checking for infections and markers of gut inflammation such as fecal calprotectin

• Endoscopy

• Colonoscopy or flexible sigmoidoscopy to look at the colon and rectum and take biopsies

• Sometimes upper endoscopy or capsule endoscopy for small intestine involvement

• Imaging, such as MRI or CT scans, especially for small bowel Crohn’s disease or complications

Other conditions like IBS, celiac disease, and some infections can mimic IBD, which is why this full workup is important. (cdc.gov)

After diagnosis, monitoring continues. Tests and visits help check:

• Symptoms and daily impact

• Blood and stool markers of inflammation

• Healing or ongoing inflammation on endoscopy or imaging

Many specialists now use a treat to target strategy. In simple terms, care aims not only to calm symptoms but also to reach clear goals such as clinical remission, normal labs, and healing seen on scopes, which are linked with better long-term outcomes. (pubmed.ncbi.nlm.nih.gov)

How IBD care is organized

Because IBD affects many parts of life, care often involves a team:

• A gastroenterologist, often with a focus on IBD, usually leads medical treatment and monitoring. (mayoclinic.org)

• A primary care clinician helps with vaccines, overall health, and routine screening. (mayoclinic.org)

• A colorectal surgeon may become involved for strictures, fistulas, severe colitis, or when the colon needs to be removed, especially in ulcerative colitis. (mayoclinic.org)

• An IBD nurse or care coordinator often helps with education, medication questions, and navigating tests and appointments. (pubmed.ncbi.nlm.nih.gov)

• A registered dietitian supports nutrition, helps adjust eating patterns during flares or strictures, and addresses weight loss or growth concerns. (mayoclinic.org)

• Mental health professionals help with anxiety, depression, and stress, which are more common in IBD and can affect quality of life. (cdc.gov)

Depending on symptoms outside the gut, rheumatologists, dermatologists, eye specialists, or liver specialists may also join the team.

Effective care usually involves:

• A shared, written treatment plan

• Clear targets for remission and monitoring

• Regular review of symptom patterns, labs, and scopes

• Attention to vaccines, bone health, and cancer screening when needed (mayoclinic.org)

This “big picture” organization helps move from only reacting to flares toward a proactive, long-term plan for living with IBD.

FAQs

Is IBD the same as irritable bowel syndrome (IBS)?

No. IBD involves chronic inflammation and damage in the intestines that can be seen on biopsy or imaging. IBS affects how the gut moves and senses pain but does not cause visible inflammation or ulcers. The two conditions can share symptoms, so proper testing is important. (cdc.gov)

Is IBD curable?

IBD is considered lifelong. Medicines and, in some situations, surgery can bring long periods of remission and prevent complications, but they do not usually “cure” the underlying immune tendency. Removal of the colon can eliminate colitis in ulcerative colitis, although some symptoms or extraintestinal issues can persist. (cdc.gov)

Who typically manages medications and follow-up?

A gastroenterologist usually manages IBD medicines and monitoring, often in partnership with an IBD nurse or coordinated clinic. Primary care clinicians support vaccines and general health, while surgeons and other specialists become involved if complications or surgery are being considered. (mayoclinic.org)