Inflammatory Bowel Disease (IBD): Start Here

Inflammatory bowel disease is a group of lifelong conditions that cause ongoing inflammation in the digestive tract. The two main types are Crohn’s disease and ulcerative colitis. Symptoms often come and go, with periods of flare and remission. Most people do well with the right plan. This overview explains what IBD is, how Crohn’s and ulcerative colitis differ, common symptoms, and how care is organized. (cdc.gov)

Key takeaways

• IBD includes Crohn’s disease and ulcerative colitis. Both are immune‑mediated and chronic. (cdc.gov)

• Crohn’s can affect any part of the gut and go through the bowel wall. UC is limited to the colon’s inner lining. (cdc.gov)

• Typical symptoms are diarrhea, belly pain, fatigue, weight loss, and sometimes bleeding or urgency. (cdc.gov)

• Diagnosis relies on endoscopy with biopsies, stool and blood tests, and imaging when needed. (journals.lww.com)

• Care uses a treat‑to‑target plan with symptom control plus objective healing, tracked by labs, stool tests, and scopes. (pubmed.ncbi.nlm.nih.gov)

What is IBD

IBD is a long‑term inflammation of the intestines that can affect daily life and health. In the United States, an estimated 2.4 to 3.1 million adults live with IBD. The conditions flare, then settle into remission for weeks to years. Many people lead active lives with the right treatment and follow‑up. (cdc.gov)

Crohn’s disease and ulcerative colitis at a glance

These features guide testing and treatment choices throughout care. (cdc.gov)

Common symptoms

IBD symptoms vary by type, location, and severity. Frequent symptoms include diarrhea or frequent stools, belly pain, fatigue, nausea, and weight loss. Rectal bleeding and urgent bowel movements are more common in ulcerative colitis. Some people also have symptoms outside the gut, such as joint pain, eye irritation, skin rashes, or anemia. (cdc.gov)

Crohn’s disease may also cause perianal problems like fissures, abscesses, and fistulas. These need prompt evaluation because they can become serious. (cdc.gov)

How IBD is diagnosed

No single test confirms IBD. Diagnosis combines:

• Endoscopy with biopsies. Colonoscopy examines the colon and last part of the small intestine. Biopsies show inflammation patterns that distinguish Crohn’s from ulcerative colitis. Flexible sigmoidoscopy may be used when full colonoscopy is not safe. (journals.lww.com)

• Stool tests. Fecal calprotectin helps tell inflammatory disease from disorders like irritable bowel syndrome and helps track inflammation over time. (journals.lww.com)

• Blood tests. C‑reactive protein and complete blood count look for inflammation and anemia. (gastro.org)

• Imaging. Magnetic resonance enterography or computed tomography can show inflammation in parts of the small bowel that scopes cannot reach and can detect complications like strictures or abscesses. (journals.lww.com)

How care is organized

IBD care is a team effort. A gastroenterologist leads care, often with an IBD nurse, primary care clinician, dietitian, pharmacist, and mental health professional. A colorectal surgeon joins for complications or when surgery is the best option. Shared decision‑making helps match therapy to disease severity and life goals. (journals.lww.com)

Treat‑to‑target: what “remission” means

Modern care sets clear targets, then checks progress at regular intervals. Short‑term targets are symptom control and normal blood and stool markers. Long‑term targets are steroid‑free clinical remission and healing seen on endoscopy. In Crohn’s disease, imaging may also show deeper healing. This approach improves outcomes over time. (pubmed.ncbi.nlm.nih.gov)

Monitoring between visits

• Biomarkers. In stable remission, many teams check fecal calprotectin and C‑reactive protein every 6 to 12 months, or sooner if symptoms return. Abnormal results often prompt endoscopy or imaging. (gastro.org)

• Scopes and imaging. Endoscopy documents healing after a treatment change, then at intervals based on disease course. Imaging helps follow small‑bowel Crohn’s and complications. (journals.lww.com)

• Cancer prevention. Long‑standing colitis raises colon cancer risk. Regular colonoscopic surveillance is recommended, with timing based on extent and duration of disease. (journals.lww.com)

Medications and steroid stewardship

Treatment ranges from rectal therapies and aminosalicylates for limited ulcerative colitis, to corticosteroids for short‑term control, to immunomodulators, biologics, and small‑molecule drugs for moderate to severe disease. Plans aim for steroid‑free remission and early use of effective therapy when risk is high. Updated U.S. guidelines in 2025 reflect these priorities for Crohn’s disease. (journals.lww.com)

Prevention and whole‑person health

• Vaccinations. Before starting immune‑suppressing therapy, vaccines are reviewed and updated based on the current U.S. adult schedule. Live vaccines are avoided while immunosuppressed. (cdc.gov)

• Nutrition. Malnutrition is common, especially in Crohn’s. A dietitian can help maintain weight, correct deficiencies, and tailor eating plans during flares and remission. (cdc.gov)

• Mental health. Anxiety and low mood are common and treatable. Screening and support improve quality of life and adherence to care. (journals.lww.com)

When to seek urgent care

Severe belly pain, high fever, repeated vomiting, heavy rectal bleeding, signs of dehydration, or new severe perianal pain are red flags. People with ulcerative colitis who have more than six bloody stools daily with fever or rapid heart rate may have a severe flare that needs hospital care. (cdc.gov)

FAQs

Is IBD the same as IBS

No. Irritable bowel syndrome affects how the bowel works, not how it looks under the scope. IBD shows visible inflammation and damage on biopsy. (journals.lww.com)

Are there cures for IBD

Medicines and surgery can control inflammation and prevent complications. Surgery can cure ulcerative colitis by removing the colon. Surgery does not cure Crohn’s disease, so ongoing care remains important. (journals.lww.com)

What does “remission” really mean

True remission means feeling well and also having normal objective markers and healed bowel on scope or imaging. This lowers the risk of future flares and complications. (pubmed.ncbi.nlm.nih.gov)