Inflammatory bowel disease
Ulcerative Colitis and Crohn’s disease
Inflammatory bowel disease refers to two main diseases, Ulcerative colitis and Crohn’s disease that cause inflammation of the bowel.
Ulcerative colitis causes inflammation of only the inner lining of the large bowel (colon and rectum). When only the rectum is involved it is sometimes called proctitis. When the entire colon is involved it is sometimes called pan-colitis.
Crohn’s disease causes inflammation of the full thickness of the bowel wall and may involve any part of the digestive tract from the mouth to the anus (back passage). Most frequently the ileum, which is the last part of the small bowel, the large bowel (or colon) or both are involved. These patterns of disease location are referred to as ileitis, colitis and ileo-colitis respectively.
Ulcerative colitis symptoms
Ulcerative colitis usually presents with diarrhoea, bright or dark red per rectal bleeding (from back passage). There may be tiredness due to inflammation and anaemia from bleeding and iron deficiency.
Crohns disease can present in a variety of ways and it can silently progress in some cases until bowel obstruction. But commonly, there is a change to bowel habits with diarrhoea and abdominal pain with or without bleeding. Some patients may present with recurrent anal tears or infections called fissures and fistulas and perianal abscesses.
Despite a lot of research the exact cause of ulcerative colitis and Crohn’s disease remain unknown. In both cases damage occurs to the bowel due to inflammation that is driven by a dysfunctional and overactive immune system. Treatments are therefore targeted at reducing inflammation and dampening down the immune system.
Both of these are chronic diseases. Dr Premitalake is able to control these with medications until you have no symptoms but you will needs to see him at least 6 monthly when you are well and continue medication similar other diseases like high cholesterol or high blood pressure. The condition can recur rapidly if you stop treatment.
Specialised Services Provided
- Accurate diagnosis of Ulcerative Colitis and Crohn’s disease using high definition endoscopy/colonoscopy, blood tests and biopsy.
- Capsule endoscopy to investigate the small bowel, Crohn’s where appropriate.
- Use of TNF antagonist biological drugs such as Infliximab (Remicade) or Adalimumab (Humira) or Vedolimumab in patients with severe disease
- Access to mycophenolate, cyclosporine and other specialised therapies where standard medications are ineffective or not tolerated
- Attention to disease control and patient quality of life as the highest priority.
If you have a flare up or acute disease, to get you back on track, you may be admitted to manning Base Hospital or to the Mayo Private Hospital if you are very unwell. if required, you may be referred for specialised treatment to tertiary hospitals. We can monitor you for safety of medications and during pregnancies etc.
Our Clinic is up-to-date with current treatment and management of Irritable Bowel Disorders (IBD) with variety of resources.