The percentage of patients seeking health care related to IBS approaches 12% in primary care practices and is by far the largest subgroup seen in gastroenterology clinics (World J. Gastroenterol, 2014). Inflammatory bowel disease is seen in the form of ulcerative colitis and Crohn disease. Ulcerative colitis is a chronic inflammatory disease that causes ulceration of the colonic mucosa (sigmoid colon and rectum). This disease is less common in people who smoke. Age of incidence ranges from 20 to 40 years of age are susceptible to these lesions appearing (Huether & McCance, 2017). The pathophysiology of UC begins with the base of the crypt of Lieberkuhn in the large intestine becoming inflamed. The mucosa becomes hyperemic appearing dark red and velvety. Small erosions develop and form coalesce ulcers (Huether & McCance, 2017). Diagnoses are based on lab results, medical history, clinical s/s, and endoscopic/biopsy findings. Mild to moderate disease is treated with 5 aminosalicylate therapy followed by steroids. Thiopurine and immunomodulatory agents (cyclosporine and TNF blocking agents) are used for more serious cases.
Crohn’s disease is a chronic disease that causes inflammation and irritation in your digestive tract. Crohn’s affects your small intestine and the beginning of your large intestine. The pathophysiology of this disease begins with inflammation of the intestinal mucosa and spreads with transmural involvement. Smoking increases the risk and equates for the majority of severe cases of this disease (National Digestive Diseases Information Clearing House, 2016). Diagnoses are made by imaging and an endoscopy examination. According to Huether & McCance (2017), treatment includes, immunodialators. Also, regular colonoscopies are done to screen for cancer due to the risk of developing from long term colon disease.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is described as a functional disorder with reoccurring abdominal pain and bloating (Huether & McCance, 2017). Signs and symptoms include constipation or diarrhea. It can alter between both. The pathophysiology of this syndrome is not well defined, but alterations of the brain-gut axis, microflora, and neuroendocrine cell function along with many other factors that alter the motility and secreting factors of the GI system plays a role in this disease process. Diagnosing occurs from endoscopic evaluation, blood test, CT scans, and a test for lactose intolerance. This disease has no cure (Huether & McCance, 2017). Treatment is geared toward symptom management. Antidiarrheals are given to treat diarrhea, laxatives are given for constipation.
Similarities and Differences
Both interferes with motility and secretory responses of the GI tract. Both IBS and IBD cause abdominal pain, diarrhea, and constipation. They both have an inflammatory response that always initiates the disease process. The differences are IBS pathophysiology is unknown and it occurs more in North America, more so in women. IBD is more prevalent amongst white populations and involves 2 different diseases such as Crohn disease and ulcerative colitis. IBD patients must have regular colonoscopies and other screenings to assess for cancer due to the risk of long-term colon disease and alterations of the colon cells.
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