Inflammatory bowel diseases (IBDs) are chronic or recurrent immune-mediated diseases, which are characterized by alternating periods of latency and phases of exacerbation. These diseases include Crohn’s disease and ulcerative retinitis, two diseases characterized by a symptomatology capable of seriously compromising the quality of life of the patient, with a strong social impact.

Dr. Gionata Fiorino, a gastroenterologist at the Centre for Chronic Inflammatory Diseases of the Intestine in Humanitas, spoke about this topic in a recent interview.


What are the symptoms of these diseases?

“The symptoms are always annoying and unpleasant and can become disabling. Crohn’s disease may affect the entire gastrointestinal tract, while ulcerative retinitis involves primarily the rectum, with total or partial involvement of the colon.

Then there may be, in varying combinations, abdominal pain, chronic diarrhea, diarrhea mixed with blood and mucus, incomplete evacuation sensation, weight loss, fever and asthenia. In some cases, extra intestinal symptoms may also occur, such as joint or skin problems linked to the autoimmune nature of these diseases.

The symptoms can be so violent that the patient is forced to go to the emergency room and need urgent hospitalization,” explains Dr. Fiorino.


What are the causes?

“The causes of IBDs have not yet been well clarified. We know, however, that there is a genetic predisposition or family history, that is to say the tendency towards greater risk in the relatives of the people affected, but they are not hereditary diseases.

The onset typically occurs at a young age, particularly between 20 and 40 years, with an increase in cases in children and adolescents. The incidence and prevalence in the world have increased about twenty times in the last ten years”.


The risk of complications

The aim of drug therapy is to induce the remission of the disease, avoiding the reappearance of symptoms and progression towards complications that may require surgery.

“Crohn’s disease can become more complicated over time by the formation of stenosis, fistulae or abscesses. This may require one or more surgical interventions in the course of one’s life. Ulcerative colitis, on the other hand, can lead to typical complications such as toxic megacolon and irreversible alterations of intestinal cells, with the possible development of cancerous lesions on the inflamed mucosa of the colon,” the specialist points out.

Early diagnosis and appropriate treatment in specialist centers are essential to reduce the risk of complications. “It is also important to stress the importance of continuing therapy during periods of well-being: only in this way can any repetition be reduced or avoided. It is therefore essential to follow the medical prescription and not suspend treatment even when you feel well,” recommends Dr. Fiorino.