Over the past ten to fifteen years, our lifestyles and dietary choices have changed significantly and overall, we are living longer but are sicker.
In a recent report the rate for IBS (Irritable Bowel Syndrome) was estimated at 10 to 15% of the US population (Source: International Association for Functional Gastro Intestinal Disorders, January 2013).
Although most people don’t go to the doctor, there are still approximately 2.4 to 3.5 million visits per year related to IBS.
IBS is a disorder related to healthy functioning of the gut that may be associated with stress and anxiety, lactose intolerance, sugar metabolism issues and gluten intolerance in addition to other disorders.
IBD (Inflammatory Bowel Disease) is diagnosed as either ulcerative colitis or Crohn’s disease depending upon its location in the digestive tract.
Both diseases cause the tissue to be altered and surgical options are often considered to repair or remove the damaged tissue. Non-surgical options include medications to help manage the symptoms and flare ups. Medications can include laxatives, corticosteroids and pain management.
The exact cause of IBD has not been isolated.
However, it is known to be hereditary and to be an autoimmune disease where the body mistakenly attacks and damages the digestive tract
The basis of both IBD and IBS is an inflammation and often damage in the digestive tract. There are many similarities but also several differences in order to determine diagnosis and subsequent treatment.
In the case of Crohns, the following are common:
- Strictures (obstruction or narrowing of intestinal wall)
- Abscesses or skin tags outside anus
- Fistulae (abnormal channels connecting different intestinal loops)
- Fissures (tears or cracks in lining of anal canal)
- Patchy inflammation of digestive tract (Diagram B)
- Colon involvement (Diagram C below)
- Anus involvement
- Ileum (final section of small intestine) involvement (Diagram A below)
Source: Wikipedia https://en.wikipedia.org/wiki/Crohn%27s_disease
Diagnosis with Ulcerative Colitis is based on the following symptoms:
- Can affect entire digestive tract resulting in colostomy procedure
- Large open sores or ulcers
- Shallow and mucosal inflammation
- Continuous not patchy inflammation
In addition to symptoms, a Colitis diagnosis is based on the origin or etiology of the disease. The following are common:
- Autoimmune Colitis – Characterized by T Cells (a type of immune boosting white blood cell) infiltrating colon.
- Idiopathic (Microscopic) Colitis – Characterized by prolonged watery diarrhea, Microscopic Colitis primary affects middle-aged women with autoimmune diseases. It is common to need more than one colonoscopy to verify the diagnosis, as the tissue often appears normal . This thickening of the tissue may be up to 50 microns thick, where the normal thickness is 5 to 7 microns 
- Idiopathic (Lymphocytic) Colitis – Although less common, lymphocytic colitis also causes chronic watery diarrhea. Diagnosis is based on a colonoscopy where excessive accumulation of lymphocytes with any thickening of the tissue – different to collagenous colitis.
- Idiopathic (Collagenous) Colitis is indicated by watery and intermittent diarrhea more than ten times per day. It affects more women than men and usually occurs from 50 years of age. There have been reported connections between celiac disease and collagenous colitis but not proven.
- Iatrogenic (Chemical) Colitis is an inflammation of the colon and/or large intestine caused by the introduction of harsh chemicals into the colon by enemas or colon related medical procedures.
- Iatrogenic (Diversion) Colitis is often the result of complications from a colostomy or ileostomy.
- Vascular Colitis – most common in the elderly, vascular colitis is caused by an inadequate blood supply to the large intestine resulting in inflammation and damage
- Infectious Colitis – most commonly Clostridium difficile colitis where the gut flora becomes out of balance allowing unhealthy bacteria to produce toxins resulting in a variety of GI issues. Parasitic infections can also cause colitis.
It is common for one set of treatments to work for one person and not another. In addition to being a painful, mentally draining and socially isolated disease, IBD also requires a trial and error approach.
 Fernández-Bañares F, Salas A, Esteve M, Espinós J, Forné M, Viver J (2003). “Collagenous and lymphocytic colitis. evaluation of clinical and histological features, response to treatment, and long-term follow-up.”. Am J Gastroenterol 98 (2): 340–7
Crohns and Colitis Foundation of USA http://www.ccfa.org
Research Network https://crohnology.com
Crohns and Colitis Foundation of UK
Stanford School of Medicine