1. Inflammatory Bowel Disease Slideshow Pictures
2. Take the Tummy Trouble Quiz
3. Ulcerative Colitis Slideshow Pictures

Medical Author:

Lori Kam, MD

Medical Editor:

Leslie J. Schoenfield, MD, PhD

Leslie J. Schoenfield, MD, PhD

Dr. Schoenfield served as associate professor of medicine and consultant in gastroenterology on the faculty of the Mayo Clinic for seven years. He became a professor of medicine in residence at UCLA from 1972 to 1999 (now emeritus). He was the director of gastroenterology at Cedars-Sinai Medical Center in Los Angeles for 25 years, where he received the chief resident's teaching award, the president's award, and the pioneer of medicine award.

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In this Article

• What is inflammatory bowel disease?
• What are the intestinal complications of IBD?
• Are the intestinal complications of ulcerative colitis and Crohn's disease different?
• Do intestinal ulcers occur in IBD?
• Does gastrointestinal bleeding occur in IBD?
• How do intestinal strictures form in IBD?
• What are the symptoms of intestinal strictures, and how are they diagnosed and treated?
• What are intestinal fistulas?
• What symptoms do fistulas cause and how are they diagnosed and treated?
• What are fissures and how are they treated?
• What is small intestinal bacterial overgrowth (SIBO)?
• Does colon cancer occur in IBD?
• What should be done about polyps in IBD?
• What is toxic megacolon and what are its causes?
• What kind of malabsorption occurs in IBD?
• Intestinal Problems in IBD At A Glance
• Patient Comments: Inflammatory Bowel Disease (IBD) - Treatments
• Patient Comments: Inflammatory Bowel Disease - Experience
• Find a local Gastroenterologist in your town
• Inflammatory Bowel Disease: Intestinal Problems Index

Intestinal Problems in IBD At A Glance

• The inflammatory bowel diseases (IBD) are Crohn's disease (CD) and ulcerative colitis (UC). The intestinal complications of Crohn's disease and ulcerative colitis differ because of the characteristically dissimilar behaviors of the intestinal inflammation in these two diseases.
• The intestinal complications of IBD are caused by intestinal inflammation that is severe, widespread, chronic, and/or extends beyond the inner lining (mucosa) of the intestines.
• While ulcerative colitis involves only the large intestine (colon), Crohn's disease occurs throughout the gastrointestinal tract, although most commonly in the lower part of the small bowel (ileum).
• Intestinal ulceration and bleeding are complications of severe mucosal inflammation in both ulcerative colitis and Crohn's disease.
• Intestinal inflammation in Crohn's disease involves the entire thickness of the bowel wall, whereas the inflammation in ulcerative colitis is confined to the inner lining. Accordingly, complications such as intestinal strictures, fistulas, and fissures are far more common in Crohn's disease than in ulcerative colitis.
• Intestinal strictures and fistulas do not always cause symptoms. Strictures, therefore, may not require treatment unless they cause significant intestinal blockage. Likewise, fistulas may not require treatment unless they cause significant abdominal pain, infection, external drainage, or bypass of intestinal segments.
• Small intestinal bacterial overgrowth (SIBO) in Crohn's disease can result from an intestinal stricture, is diagnosed by a hydrogen breath test, and is treated with antibiotics.
• Because of an increased risk of colon cancer in ulcerative colitis, yearly monitoring with colonoscopies and biopsies of the colon for premalignant cells (dysplasia) and cancer is recommended for patients after 8 to10 years of chronic inflammation of the colon (colitis).
• Narcotics, codeine, and anti-diarrheal medications such as Lomotil and Imodium should be avoided during severe episodes of colitis because they might induce a toxic megacolon.
• In Crohn's disease of the duodenum and jejunum, malabsorption of nutrients can cause malnutrition, weight loss, and diarrhea, whereas in Crohn's disease of the ileum, malabsorption of bile salts can cause diarrhea and malabsorption of vitamin B12 can lead to anemia.