Chronic inflammatory bowel diseases (CIBDs) are immune-mediated disorders with a chronic or recurrent course, alternating latency periods and relapse periods. Such disorders are Crohn’s disease and ulcerative colitis. Two diseases whose symptoms may severely compromise the quality of patients’ life and ruin their social life.

Doctor Gionata Fiorino, gastroenterologist at the Chronic Inflammatory Bowel Disease Center of Humanitas, spoke about this in a recent interview.

What are their symptoms?

“The symptoms are always annoying and unpleasant, and they may become crippling. Crohn’s disease may affect the whole gastrointestinal tract, while ulcerative colitis mainly involves the rectum and, totally or partially, the colon.

Then, in different combinations, other symptoms are abdominal pain, chronic diarrhea, diarrhea with blood and mucus, the feeling of an incomplete evacuation, loss of weight, low-grade fever, asthenia. In some cases there are also extra-intestinal symptoms, such as articulatory or cutaneous issues (depending on the autoimmune nature of these diseases).

Symptoms may be so violent that patients have to go to the emergency room and put under urgent admissions at the hospital”, Doctor Fiorino explains.

What are the causes?

“CIBDs’ causes are not very clear. However, we know that genetic predisposition plays a role, although these diseases are not hereditary.

They generally start especially between 20 and 40 years, with an increase of cases among children and teenagers. In the last ten years, incidence and prevalence of these diseases increased more than twenty times all over the world”.

The risk of complications

The pharmacological therapy aims to induce the remission of the disease, avoiding the relapse of symptoms and the progression towards complications that may require surgery.

“In fact, in the long term Crohn’s disease may develop stenosis, fistulas or abscesses. This may require one or more surgical operations in a lifetime. Instead, ulcerative colitis may lead to typical complications such as toxic megacolon and irreversible alterations in the intestinal cells, with the likely development of cancerous lesions on the inflamed mucous membrane of the colon”, the specialist says.

In order to reduce the risk of complications, an early diagnosis and the right treatment in specialized centers are paramount. “It is also important to remember that you should follow your therapy even during periods of well-being. This is the only way you can reduce or avoid relapses. Thus you should follow your doctor’s prescription and never suspend the treatment”, Doctor Fiorino says.