Dr Stephen John Middleton MA MD FRCP FAHE

Consultant Gastroenterologist

Inflammatory Bowel Disease

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Inflammatory Bowel Disease (IBD) is a term referring to several inflammatory conditions of the large and small intestines which are chronic (long lasting) and leave long lasting changes to the lining of the intestines. The cause of these conditions is unknown but there are many theories. It appears that there is not a single cause but many different factors that can lead to the intestine becoming inflamed (irritated). Some of these are determined by genes of which there are many, and slight differences in the structure and function of these genes can increase the chances of developing IBD. There are also  believed to be environmental factors such as bacteria, foods, stress and smoking for instance which can also influence the chance of getting these conditions.
 
IBD can be roughly divided into three main conditions; 1: Ulcerative colitis 2: Crohn's disease 3: Indeterminate colitis.
 
Ulcerative colitis (UC) affects the large intestine, usually just the lining (mucosa) and can involve all or just part of the large intestine (colon) but always starts in the lower reaches (rectum) and works its way up in a continuous stretch if inflammation.
 
Crohn's disease (CD) can affect any part of the gastrointestinal tract from the mouth to the anus and is usually patchy. It can involve deeper layers than UC.
 
Indeterminate colitis is somewhere in between the above two, but is usually reserved for inflammation of the large bowel which is not quite typical of UC and has some features of Crohn's disease but not enough to be sure.
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