Under normal circumstances, our immune system does its job of protecting the body from infection. However in people who suffer from a condition called inflammatory bowel disease (IBD), the immune system mistakes food, bacteria, and other materials in the intestine for foreign substances by attacking the cells of the intestines.
During the time the immune system is attacking the cells, the body sends white blood cells into the lining of the intestines where they produce chronic inflammation leading to a cascade of various symptoms.
IBDs are complex, multifactorial disorders in which the body loses its tolerance to its own gut microorganisms. It’s estimated 1.4 million people in the United States have IBD. The peak age of onset is 15 to 30 years, although IBD can occur at any age.
The two most common IBDs are Crohn’s disease (CD) and ulcerative colitis (UC). Both are conditions characterized by chronic inflammation of the digestive tract. They do share many similarities yet they also have key differences between them.
Similarities between Crohn disease and Ulcerative Colitis
· Both involve a loss of tolerance to intestinal bacteria.
· They often develop in teenagers and young adults.
· They symptoms of both are very similar.
· The causes of each are not known but both have similar types of contributing factors such as environmental, genetic and an inappropriate response by the body’s immune system.
· They are diagnosed more frequently in urban areas compared to rural areas.
· There is a reduced incidence of IBDs in people living in southern latitudes presumably related to vitamin D status.
· Both have signs and symptoms of diarrhea, abdominal pain, weight loss, and decreased bone mineral density. Other symptoms they share are rectal bleeding, urgent need to move bowels, sensation of incomplete evacuation and constipation.
· Both are associated other conditions of arthritis, joint pain, eye irritation, kidney stones, and liver disease.
Differences between Crohn disease and Ulcerative Colitis
· CD can occur anywhere in the gastrointestinal tract from the mouth to the anus; UC only occurs in the colon.
· In CD, there are healthy parts of the intestine mixed in between inflamed areas. UC is a continuous inflammation of the colon.
· UC only affects the inner most lining of the colon while Crohn’s disease can occur in all the layers of the bowel walls.
· CD can have additional problems with the skin and gallstones while UC is associated with osteoporosis and possibly colon cancer if the entire colon has been affected over 8 to 10 years.
· Over 50 percent of individuals with CD will have nutritional deficiencies of folate and vitamin D while over 50 percent of those with UC will have deficiencies of iron.
Dietary considerations for both Crohn’s disease and Ulcerative Colitis
Diet is not a cause of either CD or UC and it won’t cure a person but paying special attention to diet can help reduce and control IBD symptoms. Keeping a food journal by writing down food eaten helping to identify foods causing distress is a good method for determining foods to eliminate from the diet. Here are a few suggestions to help control symptoms during flare ups:
· Eat frequent, small meals
· Reduce the amount of greasy or fried foods
· Limit consumption of milk or milk products
· Restrict intake of certain high-fiber foods such as nuts, seeds, corn, or popcorn
Both CD and UC have their own challenges and complications yet a person can still lead a full, happy and productive life. Finding a healthcare professional who is experienced treating IBDs will help maintain health and they can connect the individual with others having the same condition to lend support.