IBD GlossaryBelow is a compilation of terms and definitions pertaining to inflammatory bowel disease that I gathered over the past several months. I hope it helps those who are newly diagnosed and those who have never heard of Crohn’s or UC to understand the diseases better. If you think a term is missing from the list, please email me at firstname.lastname@example.org.
Abdomen: Crohn’s Disease and Ulcerative Colitis is a disease located in your abdomen.
Abscess: A common complication of Crohn’s Disease and UC, abscesses are pus-filled pockets that sometimes form in the anus and in the intestines.
Acupuncture: Some people use accupuncture as a holistic treatment for Crohn’s Disease and UC. Acupuncturists treat people with Crohn’s and UC based on individual assessments of the excesses and deficiencies of qi located in various meridians. It involves sticking tiny needles in various points on the body.
Adalimumab: More commonly known as Humira, adalimumab is a TNF inhibitor that is used to treat moderate to severe cases of Crohn’s and UC (as well as rheumatoid arthritis). It is given as an injection and has been shown to be effective in reducing signs and symptoms of the diseases.
Age: Crohn’s Disease and UC most frequently appears in patients under the age of 30. Crohn’s is commonly shows up in people in their twenties, but can appear early and later in life. UC develops typically before 30 but can develop at any point in your life, even as late as in your 50s or 60s.
Allergies: Patients with Crohn’s and UC can form allergies to certain medications, like Remicade and Humira, either when first taking it or after being on it for a long period of time. Patients can also become allergic or intolerant to some foods when they have Crohn’s or UC (ex: lactose intolerance).
Anemia: This condition where you have too few red blood cells can develop in people with Crohn’s Disease and UC due to low iron levels caused by bloody stools or inflammation. Depending on your blood cell count, some doctors may recommend that patients with Crohn’s and UC take iron supplements.
Antibiotics: Crohn’s and UC patients take a lot of antibiotics to treat the illness throughout their life. Antibiotics may be used to treat a perforation, C.diff, and other infections that may occur.
Anti-inflammatory: Anti-inflammatories are often prescribed to control inflammation and help treat IBD.
Arthritis: This is the most common complication of Crohn’s and UC. In fact, as many as 25 percent of Crohn’s and UC patients will develop arthritis at some point. In IBD, arthritis commonly strikes younger patients in three forms: peripheral (large joints in arms and legs), axial (lower spine and sacroiliac joints), and ankylosing spondylitis. The latter is the rarest kind, causing not only pain in the spine and lower back joints but also inflammation of the eyes, lungs, and heart valves.
Asacol: A common medication used to treat Crohn’s Disease and UC. It is an anti-inflammatory medication that works locally in the gut to treat the disease.
Autoimmune: Crohn’s Disease and UC are autoimmune diseases. In the case of IBD, the body thinks that parts of its intestines are pathogens and begins attacking it.
Azulfidine: Also known as Sulfasalazine, Azulfidine is a sulfa drug used to treat inflammation, diarrhea, rectal bleeding, and abdominal pain in Crohn’s and UC.
Bacteria: The whole principal of Crohn’s and UC is based on bacteria in the gut. Normally, there is harmless bacteria in your GI tract. In a healthy person, this harmless bacteria is protected from attack by the immune system. However, in IBD patients, the body mistakenly recognizes the harmless bacteria as invaders. The immune system attacks them, causing cells to travel out of the blood to the intestines and create inflammation.
Barium: Barium sulfate is used in X-rays, other imaging of the GI tract, and other diagnostic procedures. It is administered orally or by enema.
Biologics: Biologics are the newest class of medications used to treat Crohn’s and UC. Also known as anti-TNF (tumor necrosis factor), these medications are used on patients suffering from moderate-to-severe Crohn’s Disease and UC. Chemically, antibodies attach to TNF and allow the body to destroy the chemical and reduce inflammation. Some common biologic therapies include Remicade (our medication of choice), Humira, and Enbrel.
Biopsy: Crohn’s and UC patients have biopsies performed typically during colonoscopies and endoscopies. The biopsied tissue is taken to pathology to determine the presence of disease. It’s common for biopsies to be taken to ensure that there is no presence of cancer cells in the gut.
Blockage: A blockage (bowel obstruction) occurs when there is a stricture in the diseased area of the intestines that becomes so narrow nothing can pass through. It is treated with a nasogastric tube or with surgery.
Bleeding: This is a common symptom of Crohn’s or UC- bleeding in your stool or from your rectum.
Bowel: The part of the body typically affected by Crohn’s and UC (although in rare cases it can develop elsewhere).
Cancer: Having IBD increases your risk of getting colon or colorectal cancer later in life.
CCFA: A non-profit organization dedicated to finding a cure for Crohn’s Disease and Ulcerative Colitis. Check them out at www.ccfa.org.
C. Diff: Clostridium difficile is a bacteria that causes the inflammation of the colon. People with other illnesses or have prolonged use of antibiotics are at greater risk of getting C.diff. It is transmitted through feces- if someone touches an item or surface with contaminated feces and then touch their mouth or mucous membranes (not sure why they would do that though). Symptoms of C.diff are watery diarrhea, fever, loss of appetite, nausea, abdominal pain/tenderness. Doctors and nurses can spread C.diff to patients or contaminate surfaces through hand contact.
Chronic: Everything with IBD is chronic. It is considered a chronic illness. Patients are often in chronic stomach pain. Caretakers are chronically worried. And all those involved are chronically annoyed.
Cimzia: Another biologic medication used to treat Crohn’s Disease. It is given through injection.
Colitis: Colitis generally refers to the inflammation of the large intestines. It can be acute (like when you have a stomach bug or other stomach illness) or chronic as with UC.
Colon: The colon is the last part of the digestive system and made up of four parts: the ascending colon, the transverse colon, the descending colon, and the sigmoid colon.
Colonoscopy: It’s when you get a scope up the rear end so the doctor can look at the interior lining of your intestines to see how your disease is progressing.
Colostomy: A colostomy occurs when an IBD patient has surgery to remove part of the intestines and then the healthy end of the intestines creates a stoma leading to the outside of the stomach. A pouch is attached to the stoma to collect feces. This procedure can be either temporary or permanent.
Corticosteroids: These are used to treat symptoms of moderate to severe Crohn’s Disease. Most patients will be on steroids at some point while battling the disease. Severe symptoms may need to be treated with IV steroids in the hospital. Commonly used corticosteroids include prednisone, hydrocortisone, and Entocort.
C-Reactive Protein: Doctors check levels of this in blood tests to gauge the degree of inflammation in the intestines.
Dr. Burrill Bernard Crohn: One of the first doctors to first describe Crohn’s Disease. Along with two colleagues from Mount Sinai Medical Center in NYC, Dr. Crohn published a paper in 1932 describing an unknown condition documenting 14 cases of what they called Terminal Ileitis. The name was then changed to regional ileitis before it was changed to Crohn’s Disease (after the doctor).
CT Scan: Stands for computerized tomography scan. IBD patients may have a CT Scan instead of a colonoscopy to check out how things are doing in the bowel. The CT Scan looks at the entire bowel and some surrounding tissue. It allows the doctor to see the location and extent of your disease and to check for complications like blockages, abscesses, or fistulas. It’s non-invasive but does emit more radiation than traditional x-rays.
Dehydration: A common side effect with IBD, dehydration can occur during bouts of vomiting or diarrhea or both when you are excreting a lot of fluids and not ingesting enough to replenish them. Signs of dehydration include dark urine and decreased output, thirst, light headaches, fatigue, dry skin, and dry or sticky mouth. Best way to avoid dehydration is to at least drink 64 ounces (2 liters) per day.
Depression: IBD is difficult for some to live with. It completely changes your life in every way impossible so its no surprise that some people with Crohn’s and UC can become depressed. If you are feeling depressed, there are some things you can do- talk to a professional about your feelings, do something positive for yourself, or look into taking antidepressants. Treatment is a personal choice but you shouldn’t let it linger- you heal better when you are feeling mentally healthy.
Diarrhea: self-explanatory and part of daily life for those with Crohn’s and Ulcerative Colitis.
Diet: Diet plays a huge role in the treatment of Crohn’s and UC. Because of the inflammation, some patients can be placed on limited diets. It’s important to monitor what foods you can tolerate and which are triggers to help you feel good. Read more about diet in this recent post.
Digestive Tract: This is the part of the body where Crohn’s Disease and UC most commonly occurs. In some rare cases, Crohn’s can manifest itself on the exterior of the body.
Dipentum: A medication used to treat UC. Dipentum is an anti-inflammatory that is used to reduce bowel inflammation, diarrhea, rectal bleeding, and abdominal pain.
Electrolytes: During a flare or bout with severe diarrhea, IBD patients can experience electrolyte imbalances. Electrolytes help to maintain the body’s electrical balance and the transfer of water among cells. Drinks like Gatorade and Powerade can help replenish electrolytes.
Endoscopy: The general medical term for looking inside the body using an endoscope. IBD patients typically undergo several types of endoscopic procedures including colonoscopy and sigmoidoscopy.
Enteroscopy: An endoscopy of the small intestine. There are a few kinds of enteroscopies that are performed on IBD patients including double-balloon enteroscopy, single-balloon enteroscopy, spiral enteroscopy, and capsule endoscopy.
Entocort: A corticosteroid used to treat Crohn’s Disease. Entocort works by decreasing inflammation in the digestive tract.
Environmental Factors: There are some environmental factors that trigger IBD. Some include substances from foods, microbes (bacterias or viruses), and cigarette smoke. These environmental factors either trigger an immune system response or directly damage the lining of the intestines.
ERCP: Endoscopic retrograde cholangiopancreatography, also known as ERCP, is used to diagnose diseases of the gallbladder, biliary system, pancreas, and liver. It looks upstream to where digestive fluid comes from to where it enters the intestines. ERCP is also used therapeutically; it can be used to remove stones, insert stents, and, in the case of some IBD patients, to dilate strictures in patients with Primary Sclerosing Cholangitis (75 percent of whom will have ulcerative colitis).
ESR: ESR stands for erythrocyte (red blood cell) sedimentation rate. It is a blood test performed on patients to test for IBD. The ESR is the rate at which blood separates into red blood cells, plasma, and other matter. An elevated ESR can be an indicator of Crohn’s Disease or UC.
Exercise: A routine that includes exercise can benefit IBD patients. Exercise not only helps patients have good health overall, it also can help you recover from surgery faster, rebuild weakened muscles, and prevent loss of calcium and protein from bones. It is also a good way to alleviate stress, which can make Crohn’s and Ulcerative Colitis worse. The best types of exercise for IBD patients include low-impact exercise (walking or swimming), weight training, and strength training depending on what areas of the body bother you the most.
Eye Inflammation: A rare but possible complication of Crohn’s Disease and Ulcerative Colitis.
Ethnicity: While IBD can affect people from all races and ethnicities, it is most commonly seen in Jews of Eastern European descent (also known as Ashkenazi).
Family: If a parent, sibling, or other family member has had Crohn’s Disease or Ulcerative Colitis, you have a higher risk of having the disease.
Fecal Occult Blood Test: A type of test used in diagnosing Crohn’s and UC. It can help to assess the severity of the disease.
Fever: IBD patients can experience fevers during flares from time to time. Fevers are also sometimes a symptom of the disease during diagnosis.
Fiber: Fiber makes the gut work harder when digesting and can cause all sorts of problems. A lot of patients are told to go on a low-fiber diet at one point when having Crohn’s and UC.
Fish Oil: Some patients have promoted fish oil supplements as a good way to treat Crohn’s and UC. However, there is no strong data showing whether or not it helps.
Fissure: According to the Mayo Clinic, a fissure is “a crack, or cleft, in the anus or skin around the anus where infections can occur. It’s often associated with painful bowel movements.” Fissures can lead to fistulae.
Fistula: Like the fissure, fistulae are common complications of Crohn’s and UC. A fistula is an abnormal connection between parts or your intestine, between your intestine and skin, or between your intestine and another organ. The most common fistulas are ones that occur around the anus (perianal).
Flagyl: An antibiotic commonly used in Crohn’s and UC patients. Flagyl can be used to treat infections after perforations and fistulas and abscesses.
Flare: A flare occurs when symptoms of Crohn’s or UC return after a period of either remission or low-disease activity. Bottom line: they suck.
Flexible Sigmoidoscopy: A kind of endoscopic procedure used to diagnose Crohn’s and UC.
Fulminant colitis: A rare and life-threatening form of UC. Fulminant colitis affects the entire colon and causes severe pain, diarrhea and, sometimes, dehydration and shock. Fulminant colitis can cause serious complications like colon rupture and toxic megacolon.
Gallstones: A complication associated with Crohn’s Disease & UC. Gallstones are hard deposits that form inside the gall bladder. They can be extremely painful. Doctors diagnose gallstones by performing an ultrasound of the abdomen. If a person experiences repeated bouts with gallstones, their doctor may recommend the removal of the gall bladder, typically done during a laparoscopic procedure that is simple and non-invasive.
Gastrointestinal Tract (GI Tract): The GI tract is traditionally made up of the stomach and intestines; however some believe that it encompasses everything from the mouth down to the anus. It is where Crohn’s Disease and UC most commonly presents itself. The upper GI tract includes esophagus, duodenum, and stomach. The lower GI tract is made up of most of the small intestine and all of the large intestine.
Gastroduodenal Crohn’s Disease: This type of Crohn’s Disease causes inflammation in the stomach and the duodenum, the first part of the small intestine.
Gengraf: This medication is an immunosuppressant that prescribed to treat Crohn’s and UC. In Crohn’s, Gengraf is used to treat fistulas. In UC, Gengraf is prescribed to patients who don’t respond well to other medications or are facing surgery. Gengraf, also known as Cyclosporine, is not meant for long-term use as it can cause severe side effects, including kidney damage, liver damage, seizures, and fatal infections.
Dr. Leon Ginzburg: A former Mount Sinai surgeon, Dr. Ginzburg was one of the doctors who collaborated with Dr. Crohn on the study that led to the discovery of Crohn’s Disease.
Granuloma: The presence of granuloma, clusters of inflammatory cells, help to diagnose Crohn’s Disease during a colonoscopy. They are not present in UC.
Granulomatous Colitis: Also known as Crohn’s Colitis, Granulomatous Colitis is a type of Crohn’s Disease that involves only the colon. Symptoms of it can include joint pain, skin lesions, and diarrhea, among others.
Hemoglobin/Hemocrit: These are measurements of red blood cell number and volume. The results help detect anemia.
Hemorrhoid: Hemorrhoids are the result of the veins in and around the anus and rectum becoming swollen due to frequent diarrhea and bowel movements. They can be either internal or external.
Herbal Supplements: While there is no solid information about the benefits of these supplements, there are some herbs that are considered good for the gut. These include probiotics, fish oil, lemongrass, turmeric, and green tea. Always check with your doctor before you start taking something new to get their input and suggestions.
Heredity: Heredity plays a factor in whether or not you will develop Crohn’s or UC. People who come from a family where a blood relative (parent, sibling, etc.) has either disease are more likely to develop the disease than others who do not have any occurrences of it in their family. That being said, heredity is not a sole cause in Crohn’s or UC, just one that can be attributed to the presence of the disease in some situations.
Humira: The third TNF inhibitor, after Remicade and Enbrel, to be approved for use in the US. Humira is used to treat Crohn’s and, as of recently, UC. Humira, which stands for Human Monoclonal Antibody in Rheumatoid Arthritis, is an alternative for patients who have not been helped by other medications. Humira neutralizes the TNF protein in the bloodstream and removes it before it causes inflammation in the GI tract.
IBD: IBD stands for Inflammatory bowel disease. IBD is the class of inflammatory diseases of the colon and small intestines. The main diseases that IBD refers to are Crohn’s Disease and Ulcerative Colitis. However, Collagenous colitis (inflammation of the colon that occurs often in the fifth decade of life and more frequently in women) and lymphocytic colitis (a rare condition characterized by non–bloody watery diarrhea) are sometimes categorized as IBD.
IBS: Also known as irritable bowel syndrome. Sometimes the wrong diagnosis before Crohn’s or Colitis is determined. It’s important to note that IBS is NOT the same as IBD.
Ileal Pouch-Anal Anastomosis: Also referred to as IPAA, it is a procedure that eliminates the need for a permanent stoma. During the IPAA surgery, the large bowel is removed and the small bowel is connected directly to the anus.
Ileocolitis: This is the most common type of Crohn’s Disease. It affects the ileum and the colon and is characterized by symptoms like weight loss, diarrhea, and cramps.
Ileitis: Another type of Crohn’s Disease that affects the ileum. It has the same symptoms as ileocolitis but also present are fistulas, which can develop in the lower right part of the stomach.
Ileostomy: This is a common procedure for those with IBD. During an ileostomy, an external opening in the abdomen is made during surgery by bringing the end of the small intestines out onto the surface, creating a stoma. A pouch is then connected to the stoma where intestinal waste passes into.
Ileum: The medical name for the final part of the small intestines. It is where Crohn’s Disease is commonly located and where my husband has the disease.
Immune System: The immune system is the part of the body that protects it from disease and illness. In a healthy body, the immune system attacks and kills foreign objects and viruses but leaves the normal bacteria found in our gut alone. However, in a person with IBD, the body senses that the bacteria in our gut is a foreign invader, and attacks it, ultimately attacking the body itself and causing inflammation.
Immunomodulators: One class of medication commonly used to treat Crohn’s Disease and Ulcerative Colitis, immunomodulators treat the diseases by weakening the activity of the immune system and thus, decreasing the inflammation found in IBD patients. Commonly used immunomodulators include mercaptopurine (6-MP, Purinethol), azathioprine (Imuran, Azasan), methotrexate (Rheumatrex, Trexall), cyclosporine A (Neoral, Sandimmune), and tacrolimus (Prograf).
Imuran: One of the aforementioned immunomodulators. Imuran works slowly and can take three months or more before any changes are felt. Because of that, it is sometimes paired with a corticosteroid to help treat the disease or a flare.
Iron: Many patients with Crohn’s and UC are iron deficient. Because the body has trouble absorbing nutrients, the body doesn’t absorb iron from food. Additionally, patients who have had part of the small intestine removed may have a harder time absorbing iron. If you are extremely iron deficient, your doctor may recommend you take an iron supplement. In extreme cases, you may need an infusion of iron.
Isotretinoin: Isotretinoin, most commonly known as Accutane, is used to treat acne or cystic acne among other things. There is conflicting information about whether or not there is actually a link between the medication and IBD.
Jejunoileitis: One of the types of Crohn’s Disease. Jejunoileitis affects the jejunum. Symptoms include cramps after meals, fistulas, diarrhea, and abdominal pain.
Jejunum: The upper half of the small intestines.
J-Pouch: One name for an ileo-anal pouch. The J-Pouch is an internal reservoir where the rectum would be. A J-Pouch is traditionally done through a multi-part surgery. The first surgery involves the removal of the large intestines and rectum and the fashioning of the pouch. At the end of the first surgery, the patient is given a temporary ileostomy in order to give the pouch time to heal. After a period of time (typically 6-12 weeks), a second surgery is performed known as the “take down” in which the ileostomy is reversed.
Kidney Stones: One of the most common kidney complications in Crohn’s patients. According to CCFA, kidney stones are common in patients who has Crohn’s in the small intestines because of fat malabsorption. You are at a higher risk for kidney stones if you’ve had a number of bowel resections because you are more prone to dehydration. Symptoms of kidney stones include sharp pain (particularly in your lower back), nausea, vomiting, and blood in the urine. Treatment calls for an increased fluid intake and a diet that is rich in juices and vegetables. If you are unable to pass the kidney stones on your own, you may have to have them removed which is through a simple procedure.
Kock Pouch: A Kock Pouch is an internal pouch formed by the terminal ileum after a colectomy. The pouch has a large volume so that feces can be stored temporarily without the need for a stoma bag. A Kock Pouch may be created if the patient cannot have an ileo-anal pouch or who develop incontinence after an ileo-anal pouch.
Lactoferrin: Fecal Lactoferrin is a protein that is slightly elevated in patients with IBD. FL is a marker of inflamation and is secreted by white blood cells invading the walls of the GI tract. FL levels are tested through a stool sample. The test is used to differentiate between IBD and IBS- IBD patients have elevated levels, IBS patients do not.
Lactose Intolerance: Many IBD patients develop secondary lactose intolerance, which occurs when your small intestine decreases lactase production after an illness, surgery or injury to your small intestine.
Large Intestine: One of the locations in the gastrointestinal tract where Crohn’s Disease can occur and where Ulcerative Colitis only occurs.
Laxatives: If you have a stricture, you might, at some point, be prescribed laxatives to treat the constipation caused by the stricture. However, don’t use over the counter laxatives; they might be too much for your already taxed GI tract.
Left-sided colitis: This is one of the several types of Ulcerative Colitis. Left-sided colitis extends from the rectum up through the sigmoid and descending colon. Symptoms include bloody diarrhea, cramping, pain on the left side of the stomach, and unintended weight loss.
Lialda: A medication prescribed to treat mild to moderate cases of Ulcerative Colitis. Lialda is in the same anti-inflammatory family as Asacol, mesalamine. Potential side effects of Lialda include headache, gas, abnormal liver function test results, stomachache, and inflammation of the pancreas. Patients taking Lialda may be able to use the drug’s Pharmacy Savings Card to help cover the medication’s copay.
Liver Disease: Due to its relationship to the intestines, complications, like liver disease, are common in patients with IBD. According to CCFA, some patients may develop active inflammation in their liver, which typically subsides with treatment of IBD. Serious liver disease occurs in only around five percent of IBD patients. Some symptoms of liver disease include low energy and fatigue, itching, jaundice, fluid retention, and a feeling of fullness in the upper abdomen. Diagnosis of liver disease is done through a blood test although sometimes an ultrasound, x-ray, or liver biopsy may be needed to confirm the diagnosis.
Malnutrition: IBD patients are particularly susceptible to malnutrition. According to the University of California San Francisco Medical Center, there are several things that cause malnutrition in IBD patients including inadequate food/fluid intake caused by IBD side effects; increased losses (protein losses, losses from fistula fluids, diarrhea and bleeding); increased nutritional needs; and malabsorption. To prevent malnutrition, there are supplements, like Ensure, that patients can take to help up their consumption of calories. You should talk to your doctor before starting any of them.
Microscopic Colitis: This is another kind of IBD. Live Ulcerative Colitis, Microscopic Colitis is a chronic, inflammatory condition of the large intestine. It causes watery diarrhea and sometimes stomach pain. There are two types of Microscopic Colitis: Lymphocytic colitis and Collagenous colitis. According to the Mayo Clinic, the difference between the two types is Lymphocytic causes an increase in white blood cells and Collagenous causes an increase in white blood cells and a thick layer of protein. Treatment is similar to other forms of IBD and includes the use of budesonide (Entocort).
Mineral Oil: Mineral oil is an intestinal lubricant. It can be used to relieve constipation. It is tasteless, odorless and colorless.
MRCP: Stands for Magnetic resonance cholangiopancreatography. It is a type of MRI that allows doctors to see images of the bile duct. It is similar to ERCP (endoscopic retrograde cholangeopancreatography) but is less invasive.
MRE: Stands for magnetic resonance enteroscopy. Similar to an MRI, during an MRE, patients drink barium sulfate prep beforehand and then, at the start of the procedure, are injected with dye that shows inflammation and disease in the GI tract on the scan.
MRI: Stands for magnetic resonance imaging. MRI’s are used to take images of the GI tract and the organs involved in it to look at a patient’s IBD.
Neoral: Neoral is an immunosuppressant used to treat Ulcerative Colitis. It is reserved for patients who don’t respond well to other medications or who face surgery. It begins working in one to two weeks but has the potential for severe side effects, including kidney damage, seizures and fatal infections. There’s also a small risk of cancer with this medication.
NG Tube: Stands for nasogastric tube. It is passed into the nose, down the esophagus and into the stomach. It is used for several reasons, including administering nutrients or medication; removing matter from the stomach (like in a blockage); adding contrast to the stomach for imaging; and protecting the bowel after surgery or during rest.
Obstruction: A bowel obstruction occurs when a part of the small or large intestines becomes partially or totally blocked, preventing stool from passing through. In IBD patients, this can occur if the patient has a stricture that is too narrow and stool cannot pass through it. Symptoms of a bowel obstruction include bloating, abdominal pain, vomiting, constipation, inability to pass stool, and a feeling of fullness in the abdomen, among others. In some cases, obstructions are treated a nasogastric (NG) tube. The NG tube goes through the nose and down into the stomach, decompressing the intestines. If the NG tube doesn’t work, surgery may be needed. Surgery also may be needed, in some cases, if tissue in the intestines has died as a result of the blockage.
Dr. Gordon D. Oppenheimer: One of the doctors who discovered Crohn’s Disease along with Drs. Crohn and Ginzburg.
Osteoporosis: According to the NIH Osteoporosis and Related Bone Diseases National Resource Center, “osteoporosis is a condition in which the bones become less dense and more likely to fracture.” People with IBD are at a higher risk to develop osteoporosis for several reasons. People with IBD are often treated with glucocorticoids like prednisone and cortisone which interfere with the development and maintenance of health bones. Additionally, patients who have severe inflammation in the small bowel or have parts of it removed may have difficulty absorbing calcium and vitamin D, which is a concern for bone health. Patients with IBD can protect their bone health by eating a diet rich in calcium vitamin D, exercising, not smoking or drinking excessively, and, in some cases, taking medication to prevent further bone loss.
Ostomy: An ostomy is a surgically created opening in the body for the discharge of body wastes. Ostomies are commonly created in IBD patients who have all or part of their small intestine, colon or rectum removed due to disease and inflammation. There are many kinds of ostomies, including colostomy (rectum is removed and colon is attached to the stoma), ileostomy (colon and rectum are removed and the ileum is attached to the stoma), and urostomy (the ureters are attached to either the small intestine or abdominal wall).
p-ANCA: Stands for perinulclear anti-neutrophil cytoplasmic antibodies, p-ANCA is a test that aids in diagnosing ulcerative colitis. The test distinguishes it from Crohn’s Disease.
Pain Relievers: OTC pain relievers, like Tylenol and Advil, may be effective in treating acute pain caused by IBD symptoms. However, patients should consult with their doctors before taking Advil and other ibuprofen products because they can cause adverse effects in IBD patients.
Pancolitis: One type of Ulcerative Colitis. Pancolitis extends for the entire length of the colon, including the cecum. Pancolitis poses the highest risk of developing sudden and severe inflammation that requires urgent surgery. Additionally, a high risk for colon cancer is associated with pancolitis. Pancolitis affects around 20 percent of Ulcerative colitis patients.
Perforation: One possible IBD complication that is potentially fatal and requires immediate medical attention. A perforation due to IBD is rare. It is more common during a first flare-up of Ulcerative colitis, especially if it’s severe. It can occur in Crohn’s Disease but it’s rare, only between one and three percent over the course of the disease. A perforation can also occur if the disease causes the walls of the intestine to become weak and develop a tear. Symptoms of a perforation include fever, chills, nausea, vomiting, severe abdominal pain, and rectal bleeding. Perforations are diagnosed using radiology (MRIs and CT Scans) and treated with antibiotics, an NG tube, or surgery, depending on the severity.
Pouchitis: A common complication that occurs in UC patients who have an ileoanal anastomosis. Pouchitis is the inflammation of the lining of this pouch. According to the Mayo Clinic, it occurs in up to half of the people who undergo this procedure. Symptoms of pouchitis include abdominal pain, cramps, increased number of bowel movements and strong urgency to have a bowel movement. Pouchitis is treated with a course of antibiotics.
PPD: Stands for purified protein derivative. It’s a tuberculosis (TB) skin test. Gastroenterologists advise all patients taking biologic therapies have PPD tests done to asses the presence of TB disease.
Probiotics: Some probiotics can help with IBD symptoms. According to a recent Northwestern study, the friendly bacteria in probiotics act as a calming agent to the diseased bacteria in the gut. The probiotic mobilized immune cells that enhanced the production of T-cells that rebalanced intestinal and systematic inflammation. Probiotics for IBD patients are still being studied and you should consult with your doctor before taking any.
Proctocolectomy: This is the surgery to remove the colon and rectum. According to UCSF, a proctecolectomy is the standard procedure for patients with Ulcerative colitis who are not responding to medication or have a serious life-threatening complication. Proctocolectomies are followed by either an Ileal Pouch Anal Anastomosis or an ileostomy.
Proctosigmoiditis: One form of Ulcerative colitis, it involves the rectum and lower end of the colon (sigmoid colon). Symptoms of proctosigmoiditis include bloody diarrhea, abdominal cramps and pain, and an inability to move the bowels despite the urge to do so.
Purinethol (6-MP): A common immunosuppressant used to treat Crohn’s Disease and Ulcerative Colitis. It is used to help keep patients feeling well and off steroids. 6-MP decreases the activity of the immune system, resulting in decreased inflammation in the intestine. 6-MP can also help close fistulas in patients with Crohn’s Disease. It is a slow acting medication and can take three to six months to begin working. It’s important to note that 6-MP is also a chemotherapy drug and comes with lots of possible side effects including headache, nausea, vomiting, diarrhea, and malaise.
Remicade: Remicade (infliximab) is a biologic used to treat Crohn’s Disease and UC. Remicade works by blocking the action of the protein tumor necrosis factor-alpha, or TNF-alpha. Patients with Crohn’s Disease and UC have excess amounts of TNF-alpha because their immune system becomes overactive and begins to produce excess amounts of it. The excess TNF-alpha causes your body to mistake healthy cells for foreign ones and attacks them, causing inflammation. By blocking the actions of TNF-alpha, Remicade inhibits the underlying causes of inflammation. Remicade is given through an IV drip over several hours. Patients who are on it only receive treatment once every few weeks. There are a lot side effects associated with Remicade, including headache, joint pain, fatigue, and pain/swelling at injection site. Remicade is extremely expensive if you don’t have health insurance. There is a program called Remistart to help pay for the out of pocket cost of the medicine.
Remission: Remission is defined as “a disease-free or limited-disease state.” During your battle with IBD, there will be times when your symptoms decrease or disappear entirely. Remission ranges from person to person and can last for days or years. Regardless of how long it lasts, the ultimate goal of IBD treatment is to induce remission.
Resection: A bowel resection is a surgical procedure that removes a part of the small or large intestines. It is a common procedure performed on IBD patients.
Rheumatrex: This drug is sometimes used to treat Crohn’s Disease in patients who don’t respond well to other medications. According to the Mayo Clinic, Rheumatrex (methotrexate) can cause “nausea, fatigue and diarrhea, and rarely, it can cause potentially life-threatening pneumonia. Long-term use can lead to scarring of the liver and sometimes to cancer. Avoid becoming pregnant while taking methotrexate.”
Sandimmune: Also known as cyclosporine, Sandimmune is an extremely potent drug that is used to help heal Crohn’s-related fistulas and in UC patients who don’t respond well to other medicines or are facing surgery. Sandimmune begins working in one to two weeks. However, it can have very serious side effects including kidney and liver damage, seizures, and fatal infections. This medication isn’t for long-term use.
SBFT/SBS: Stands for small bowel follow-through/small bowel series. It is an imaging test of the small intestine in which you drink barium prep and then have x-rays taken.
Sigmoidoscopy: An exam used to examine the lower part of the large intestine. There are two types of sigmoidoscopies: flexible and rigid. According to the Mayo Clinic, “a thin, flexible tube (sigmoidoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the rectum and most of the sigmoid colon — about the last two feet (61 centimeters) of the large intestine. If necessary, tissue samples (biopsies) can be taken through the scope during a flexible sigmoidoscopy exam.” A rigid sigmoidoscopy uses a rigid tube and is rarely used because of the improved technology of its flexible sister.
Small bowel enteroclysis: An x-ray of the small bowel with barium contrast.
Serology: The clinical term for a blood test that detects the presence of antibodies against a microorganism.
Small Intestine: The part of the GI tract that follows the stomach and is followed by the large intestine. It is where a lot of the digestion and absorption of food takes place. It is also where Crohn’s Disease commonly presents. The small intestine is divided into three parts: duodenum, jejunum, and ileum.
Stoma: According to Ostomy Lifestyle, “a stoma is an opening from either the digestive system digestive system or urinary system . This opening is the exit point for faeces or urine and is formed, surgically, to treat serious, often life threatening, diseases and medical conditions such as bowel or bladder cancer, inflammatory bowel disease (ulcerative colitis or Crohn’s Disease), diverticulitis, congenital abnormalities or injury.”
Stool Sample: Patients with IBD may have a stool sample taken as part of diagnosis. The presence of white blood cells in your stool indicates an inflammatory disease. Stool samples can also help rule out other disorders and allow your doctor to check for a bowel infection.
Strictureplasty: A common procedure to treat IBD, a strictureplasty opens up a narrowed section of bowel where a stricture has formed. Unlike a resection, no bowel is removed during a strictureplasty. The procedure can be done alone or paired with a resection.
Toxic Megacolon: This is a life-threatening complication of IBD and infections of the colon. Toxic megacolon is the rapid widening/enlargement of the colon. It is commonly associated as a complication of ulcerative colitis. Symptoms of toxic megacolon include abdominal pain, distention and tenderness; fever; rapid heart rate; and shock. A physical exam of someone with toxic megacolon may reveal signs of septic shock. Toxic megacolon is diagnosed through a physical exam, abdominal x-ray, blood electrolytes, and a complete blood count (CBC). According to the NY Times, patients with toxic megacolon will receive fluids and electrolytes to help prevent dehydration and shock and antibiotics to prevent sepsis. However, if the rapid widening continues, a perforation can form in the colon (which can lead to sepsis). Most cases of toxic megacolon will require surgery, such as a colectomy.
TPMT: According to CCFA, TPMT (thiopurine methyl transferase) is a laboratory blood test that checks for the activity of an enzyme that helps im breaking down 6MP and azathioprine (Imuran), which helps to establish proper dosing of these medications.
Turmeric: According to Everyday Health, turmeric is an herbal remedy that is good for your gut. Turmeric is the ingredient in curry that gives it their intense color. It is thought to be an anti-inflammatory. You can use it in your food but much of the clinical research surrounding turmeric is typically done using capsules containing curcumin (the clinical name for turmeric) because its a bit easier on the GI tract of those with Crohn’s.
Tysabri: An immunosuppressant used to treat Crohn’s Disease. Tysabri works by inhibiting integrins, certain immune cell molecules, from binding to other cells in your intestinal lining. It is thought that blocking these molecules reduces chronic inflammation that occurs when they bind to other cells. Tysabri is used for patients with moderate to severe Crohn’s with active inflammation who aren’t responding to other therapies. Tysabri isn’t widely used. According to the Mayo Clinic, “Because the drug is associated with a rare, but serious, risk of multifocal leukoencephalopathy — a brain infection that usually leads to death or severe disability — you must be enrolled in a special restricted distribution program to use it.”
Ulcerative Colitis: UC is an inflammatory bowel disease that causes long-lasting inflammation in the innermost lining of your large intestine and rectum. It occurs only through continuous stretches of your colon, unlike Crohn’s, which occurs anywhere in the digestive tract. UC can be debilitating and sometimes can lead to life-threatening complications like toxic megacolon. UC is a chronic condition and symptoms usually develop over time rather than suddenly. Like Crohn’s, there is no known cure for UC but there are therapies available that can reduce the signs and symptoms of the disease and bring about a long-term remission.
Ulcerative proctitis: A type of UC, ulcerative proctitis occurs in the area closest to the anus. Because of its location, rectal bleeding may be the only symptom of ulcerative proctitis. Others may have rectal pain and a feeling of urgency. Ulcerative proctitis tends to be the mildest form of UC.
Ulcers: Some patients with IBD may develop ulcers due to the chronic inflammation that occurs in the GI tract. Ulcers can develop anywhere in the digestive tract, including your mouth and anus, as well as in the genital area and anus.
Upper Endoscopy: According to Yale IBD, an upper endoscopy “is a diagnostic procedure that allows evaluation of the esophagus, stomach, and duodenum. In patients with inflammatory bowel disease, an upper endoscopy evaluates disease involvement in the upper region of the digestive tract.” An upper endoscopy is sometimes called an esophagogastroduodenoscopy or EGD.
Virtual colonoscopy: A procedure used to look for signs of pre-cancerous growths, cancer and other diseases of the large intestines. These are done by taking images of the large intestines through a CT scan or MRI. A computer then puts the images together to create an animated, 3D view of the inside of the large intestines. While this sounds awesome, according to CCFA, virtual colonoscopies are not recommended for suspected IBD because biopsies and direct viewing of the colon and small bowel are required.
Vitamins: Patients with IBD tend to have vitamin and mineral deficiencies due to inflammation, diet, and the therapies for IBD treatment. Common vitamin and mineral deficiencies include calcium, iron, Vitamin A, Vitamin D, Vitamin K, and Zinc. Your doctor will perform blood tests to check your vitamin and mineral levels. If they find you have deficiencies, they will recommend you take vitamins and will give you the correct dosage to take. Always consult with your doctor before you start taking a new vitamin.
X-ray: A barium X-ray is sometimes used to diagnose and check the prognosis of Crohn’s disease. A barium X-ray is also helpful for finding problems in parts of the small intestine that can’t be easily viewed by other techniques. According to WebMD, during a barium X-ray a chalky fluid containing barium is given by mouth (upper GI series) or through the rectum (barium enema). The barium fluid flows through the intestines and appears white on the X-ray film, making it easier to view problem areas. Barium X-rays allow doctors to see ulcers, strictures, fistulae, or other problems. If the X-ray shows signs of disease, your doctor may request additional X-rays or other imaging studies.
Zinc: A common nutritional deficiency in IBD patients. Zinc plays a role in helping tissues heal and in building strong bones. However, according to Everyday Health, “studies are not clear about whether adding zinc to your Crohn’s diet has direct benefits if you already get enough.” Foods that contain zinc include oysters, dark chocolate, and fortified cereals, as well as certain seeds or foods containing seeds, like watermelon. However, some IBD patients, especially those with strictures, may have trouble digesting seeds, so exercise caution.