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TOPIC: The UNC Med Patient info for IBD

The UNC Med Patient info for IBD 03 Oct 2012 12:27 #674

  • Debra
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When it's more than constipation or diarrhea

Do you have a family member with an IBD and wonder about your own predisposition to IBD? You will find some very helpful information about the differences between Ulcerative colitis and Crohn's disease, diagnosis and treatment. I've worked with many women who have done very well with food sensitivity testing and elimination of certain reactive foods. If you have a current IBD diagnosis with continued digestive/absorption problems an elimination/challenge diet may be helpful.

You or a member of your family has been confronted with the diagnosis “inflammatory bowel disease” or IBD. In most cases, this means either ulcerative colitis or Crohn’s disease. At first, these names seem strange and you probably wonder what they can mean. Both refer to chronic inflammation of the mucosal lining of the intestine or bowel, though each has quite specific characteristics. What do the names mean? The use of different names is based on the fact that the disease is often named according to the portion of the bowel it affects and which becomes inflamed.

The chart shows the digestive tract and gives the names of the various segments. The small bowel is normally 3–5 m (10 - 16 feet) in length, while the large bowel or colon is about 1.5 m (5 feet) long. We distinguish between two main forms of IBD. The first is ulcerative colitis, an inflammation (“-itis”) affecting only the colon and associated with the formation of ulcers. In some cases, only the rectum is involved, and we speak of ulcerative proctitis (proctos greek = rectum). The second main type of IBD is Crohn’s disease. Named for its discoverer, the American gastroenterologist Burrill B. Crohn, who described the disease in 1932, it can affect any portion of the digestive tract, from the mouth to the anus. Depending on the exact segments affected, we can speak of Crohn’s ileitis, ileocolitis, colitis or enteritis. The digestive tractWhat you should know about the normal digestive tract

The digestive tract or canal begins in the mouth. Here, the food is chewed and mixed with saliva, lubricating and partially digesting it. Once swallowed, the food passes into the esophagus, a muscular tube, whose walls move in wave-like patterns propelling the food downward into the stomach. In the stomach, the food is mixed with gastric juices, which consist of acid, mucus and various enzymes, which begin the breakdown of proteins.

 In the duodenum, the food is further mixed with secretions from the pancreas, which contain other digestive enzymes, and with bile. Bile is produced in the liver and contains bile acids, which also help in digestion. These functions are rarely compromised in ulcerative colitis, and, when they are, it is usually due to an associated disorder of the biliary tract. They are sometimes be affected in Crohn’s disease.

The upper segment of the small bowel, also known as the jejunum, is where fats, fat-soluble vitamins (A, D, E and K), protein breakdown products, sugars and some trace elements are absorbed. Vitamin B12 and bile acids, however, are absorbed in the ileum, the lower part of the small bowel. This latter function is often compromised in patients with Crohn’s disease, though disturbances of the upper small bowel are less frequent.

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