Got guts? A spotlight on Inflammatory Bowel Disease
Tamar Campbell
Issue date: 11/10/08 Section: Pulse
For UIC student Yasmin Ali, June 9, 2005 is a day she will never forget; that was the day she was diagnosed with Ulcerative Colitis (UC), one of the two main forms of Inflammatory Bowel Disease (IBD).
Doctors are not sure what specifically causes the two most common forms of IBD; Crohn's Disease and UC, but approximately 1 million Americans suffer from the disorder. Ten percent of those diagnosed are under the age of 18. Current theories support the hypothesis that Crohn's and UC are the result of a genetically overactive immune system that is triggered to turn 'on' as a result of a virus or bacteria. Once the immune response is turned on, the body is unable to turn the response 'off,' and so medications to regulate the immune system are the most common forms of IBD treatment. Crohn's and UC are chronic diseases that can never be outgrown.
The classic presentation of Crohn's disease includes persistent diarrhea, stomach cramps, abdominal pain, fever, loss of appetite, extreme weight loss and rectal bleeding. In addition, inflammation can cause fistulas to develop. Fistulas are tunnels that connect a loop of intestine to another section of intestine, to the bladder, vagina, or the skin. However, symptoms can vary largely from person to person. Typical symptoms of UC include (bloody) diarrhea, cramps, and abdominal pain. Patients with UC have ulceration of the colon, or tiny open sores that bleed and produce pus and mucus. IBD sufferers can also have extra-intestinal symptoms, like joint pain, fatigue, eye pain, and skin rashes.
Symptoms of Crohn's and UC sometimes overlap; however, UC is found exclusively in the colon and rectum, while Crohn's can appear anywhere in the digestive tract, although it often manifests in the small intestine. Additionally, Crohn's disease affects the entire bowel wall, while UC only affects the inner epithelial lining of the colon.
Diagnosis of Crohn's or UC is usually made with an endoscopy, colonoscopy, and a subsequent biopsy. During an endoscopy of the gastrointestinal tract, a doctor uses a tube with a camera attached to see inside the small intestine, stomach, and esophagus. Depending on the doctor, anything from a mild anesthesia to general anesthesia can be used for an endoscopy or a colonoscopy.
A colonoscopy follows similar procedure, except that the camera is inserted through the anus in order to view the large intestine. Prior to the colonoscopy, a patient must clear out his/her large intestine using some form of laxative, which one UIC sophomore described as "a horribly vile process. I threw up the MagCitrate [type of laxative] within five minutes. It was so nasty."
Treatment for IBD concentrates on controlling the immune system. There are five basic types of medications used to control IBD. Corticosteroids, such as prednisone and entocort reduce inflammation, but also come with side effects such as weight gain, water retention, and possible adrenal dysfunctions. Aminosalicylates, are sometimes prescribed for moderate cases of IBD and are primarily used as a drug that maintains remission. Immunomodulators help to control the immune system and biologics help to selectively turn off the immune response. Lastly, antibiotics are commonly given to Crohn's patients to help clear up symptoms of a fistula.
To put the medications into perspective, Ali was taking 15 pills a day, not including a calcium and multi-vitamin supplement.
An advocate from the Crohn's and Colitis Foundation of America (CCFA) explains that for students dealing with IBD, the symptoms can interfere with campus life in a manner that is far more real than a quick overview in a newspaper. Alcohol, greasy foods, and stress can all trigger a flare-up of IBD. What college student doesn't face stress?
Airik, a first-year student at UIC, confessed to being late for school often because of the required trips to the bathroom. "Although, I'm fortunate not to be so bad."
Ali was not so lucky. Her UC caused her to stake out "every bathroom on campus… which ones had the longer lines and which ones were more private." After her morning commute to UIC, Ali would often find herself late for class when an unexpected bathroom trip would take longer than anticipated. Her UC eventually required her to take an absence from school for two and a half years while she tried to overcome a particularly bad flare. During that time, she needed to take Incompletes from three of her professors, and then discovered upon her return that the Incompletes had been changed to Failures. UIC policy requires a student to make up work within six months of receiving the initial incomplete.
Ali was given three failing grades, and her subsequent appeal was denied.
And even though Airik has mild IBD, he, too, has had his share of college-related difficulties. He ran out of meds during his switch to UIC's insurance, and for two weeks lacked the medications he needed to keep his symptoms in control.
Airik and Ali were willing to talk openly about their IBD, but not all students feel that level of comfort. One UIC student explained that she tries to keep her UC hidden, after all, "Could you tell everyone about your very personal bathroom habits? That's what this disease deals with."
And yet, Ali summed up the problem with hiding IBD from friends and professors. "Because people don't talk about it, everyone else stays ignorant."
A UIC professional could not be reached for an interview.
Information for this article was taken from CCFA.org. For more information, please contact Jackie Spencer at (646) 943-7424 or e-mail her at Jspencer@ccfa.org.
Doctors are not sure what specifically causes the two most common forms of IBD; Crohn's Disease and UC, but approximately 1 million Americans suffer from the disorder. Ten percent of those diagnosed are under the age of 18. Current theories support the hypothesis that Crohn's and UC are the result of a genetically overactive immune system that is triggered to turn 'on' as a result of a virus or bacteria. Once the immune response is turned on, the body is unable to turn the response 'off,' and so medications to regulate the immune system are the most common forms of IBD treatment. Crohn's and UC are chronic diseases that can never be outgrown.
The classic presentation of Crohn's disease includes persistent diarrhea, stomach cramps, abdominal pain, fever, loss of appetite, extreme weight loss and rectal bleeding. In addition, inflammation can cause fistulas to develop. Fistulas are tunnels that connect a loop of intestine to another section of intestine, to the bladder, vagina, or the skin. However, symptoms can vary largely from person to person. Typical symptoms of UC include (bloody) diarrhea, cramps, and abdominal pain. Patients with UC have ulceration of the colon, or tiny open sores that bleed and produce pus and mucus. IBD sufferers can also have extra-intestinal symptoms, like joint pain, fatigue, eye pain, and skin rashes.
Symptoms of Crohn's and UC sometimes overlap; however, UC is found exclusively in the colon and rectum, while Crohn's can appear anywhere in the digestive tract, although it often manifests in the small intestine. Additionally, Crohn's disease affects the entire bowel wall, while UC only affects the inner epithelial lining of the colon.
Diagnosis of Crohn's or UC is usually made with an endoscopy, colonoscopy, and a subsequent biopsy. During an endoscopy of the gastrointestinal tract, a doctor uses a tube with a camera attached to see inside the small intestine, stomach, and esophagus. Depending on the doctor, anything from a mild anesthesia to general anesthesia can be used for an endoscopy or a colonoscopy.
A colonoscopy follows similar procedure, except that the camera is inserted through the anus in order to view the large intestine. Prior to the colonoscopy, a patient must clear out his/her large intestine using some form of laxative, which one UIC sophomore described as "a horribly vile process. I threw up the MagCitrate [type of laxative] within five minutes. It was so nasty."
Treatment for IBD concentrates on controlling the immune system. There are five basic types of medications used to control IBD. Corticosteroids, such as prednisone and entocort reduce inflammation, but also come with side effects such as weight gain, water retention, and possible adrenal dysfunctions. Aminosalicylates, are sometimes prescribed for moderate cases of IBD and are primarily used as a drug that maintains remission. Immunomodulators help to control the immune system and biologics help to selectively turn off the immune response. Lastly, antibiotics are commonly given to Crohn's patients to help clear up symptoms of a fistula.
To put the medications into perspective, Ali was taking 15 pills a day, not including a calcium and multi-vitamin supplement.
An advocate from the Crohn's and Colitis Foundation of America (CCFA) explains that for students dealing with IBD, the symptoms can interfere with campus life in a manner that is far more real than a quick overview in a newspaper. Alcohol, greasy foods, and stress can all trigger a flare-up of IBD. What college student doesn't face stress?
Airik, a first-year student at UIC, confessed to being late for school often because of the required trips to the bathroom. "Although, I'm fortunate not to be so bad."
Ali was not so lucky. Her UC caused her to stake out "every bathroom on campus… which ones had the longer lines and which ones were more private." After her morning commute to UIC, Ali would often find herself late for class when an unexpected bathroom trip would take longer than anticipated. Her UC eventually required her to take an absence from school for two and a half years while she tried to overcome a particularly bad flare. During that time, she needed to take Incompletes from three of her professors, and then discovered upon her return that the Incompletes had been changed to Failures. UIC policy requires a student to make up work within six months of receiving the initial incomplete.
Ali was given three failing grades, and her subsequent appeal was denied.
And even though Airik has mild IBD, he, too, has had his share of college-related difficulties. He ran out of meds during his switch to UIC's insurance, and for two weeks lacked the medications he needed to keep his symptoms in control.
Airik and Ali were willing to talk openly about their IBD, but not all students feel that level of comfort. One UIC student explained that she tries to keep her UC hidden, after all, "Could you tell everyone about your very personal bathroom habits? That's what this disease deals with."
And yet, Ali summed up the problem with hiding IBD from friends and professors. "Because people don't talk about it, everyone else stays ignorant."
A UIC professional could not be reached for an interview.
Information for this article was taken from CCFA.org. For more information, please contact Jackie Spencer at (646) 943-7424 or e-mail her at Jspencer@ccfa.org.
Viewing Comments 1 - 3 of 5
redwriter1
Kay-lynn
posted 11/10/08 @ 1:13 PM CST
Your students might find great relief with the SCD diet. My 18 year old son is a college student with UC. He started the diet in July and has no problems at all. (Continued…)
onchocerciasis
Kate
posted 11/11/08 @ 4:34 AM CST
Kay-lynn,
I'm the Pulse editor--what's your email address? I can forward it to Tamar and have her contact you to do some sort of a follow-up piece on her IBD article. (Continued…)
redwriter1
Kay-lynn
posted 11/11/08 @ 9:37 AM CST
Here is the official website.
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