IBD Academy 101: Back to Basics

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Welcome to IBD Academy! We're excited to present this series and help to shed some light on the ins and outs of the disease, its treatments, and the ongoing research in the field. First, let's start with the basics:

What is autoimmunity?

The immune system can protect the body because of its fundamental ability to distinguish between it’s own cells and substances and something foreign from the outside. These outside substances, usually bacteria, viruses, toxins, or other chemicals, are called antigens. When it detects the presence of an antigen, the body produces antibodies, which are proteins called immunoglobulins. Antibodies are a critical defense mechanism against an array of substances from outside the body. 

Autoimmunity is a disease state in which the immune system identifies some of the body’s own tissue as foreign and attacks it. This can occur in the presence of autoantibodies, which are antibodies that have formed against a substance made by the body. The NIH estimates that 5-8% of US population has an autoimmune disease. In general, siblings and twins of individuals with autoimmune disorders have a higher risk of also developing such a disease, indicating that there is a hereditary component to the development of these disorders. 

Autoimmune disorders are identified by which body tissue(s) are attacked. In inflammatory bowel disease (IBD), the lining of the gastrointestinal (GI) tract, called the intestinal mucosa, is primarily targeted. The skin, eyes, and joints may also be affected. Up to 20% of people with IBD have a blood relative who also has the disease. Like all autoimmune diseases, IBD is a chronic and lifelong illness with no cure, although symptoms can be managed. The two main types of IBD are Crohn’s disease and ulcerative colitis.

(Important note: While irritable bowel syndrome or IBS, also affects the GI tract, the key difference between IBS and IBD is that IBS is NOT an autoimmune disorder.)

What is Crohn’s disease?

Crohn’s disease in an autoimmune disorder in which the immune system attacks the walls of the digestive system anywhere from the mouth to the anus. It is most often seen in the ileum (the last section of the small intestine) and/or the colon (the large intestine). The entire thickness of the affected bowel wall may thicken and swell and ulcers often appear. This can lead to blood in the stool and anemia (a low number of red blood cells). Common symptoms include diarrhea, abdominal pain, nausea, fatigue, weight loss, and malnutrition. More rarely, intestinal blockages and fistulas (an tunnel formed between the intestine and another tissue) are seen. People are most often diagnosed with Crohn’s disease between the ages of 15 and 35, but it can appear at any age. Approximately 700,000 people in the US are affected by Crohn’s disease. 

What is ulcerative colitis?

Ulcerative colitis (UC) is an autoimmune disorder in which the immune system attacks the innermost lining of the large intestine (colon and/or rectum). This usually results in ulcers and blood, mucous, or pus in the stool. Like those with Crohn’s disease, individuals with UC often experience anemia, diarrhea, abdominal pain and cramping, nausea, fatigue, weight loss, and malnutrition. Unlike those with Crohn’s, UC patients do not typically have fistulas, but may develop a severe infection called toxic megacolon. Individuals who have had UC for more that eight years and whose entire colon is affected have a greater risk of developing colon cancer. People are most often diagnosed with UC between the ages of 15 and 30, but can begin at any age. Approximately 700,000 people in the US are affected by ulcerative colitis. 

That's it for this week! The sources for the information in this post are listed below if you'd like to read more yourself. Coming up next: the diagnostic process.

  1. National Cancer Institute Dictionary of Cancer Terms: https://www.cancer.gov/publications/dictionaries/cancer-terms
  2. Johns Hopkins Medical Institutions Autoimmune Disease Research Center: http://autoimmune.pathology.jhmi.edu/whatisautoimmunity.htmlhttp://autoimmune.pathology.jhmi.edu/faqs.cfm
  3. NIH U.S. National Library of Medicine: Genetics Home Reference: https://ghr.nlm.nih.gov/condition/crohn-disease#definitionhttps://ghr.nlm.nih.gov/condition/ulcerative-colitis
  4. Mayo Clinic: Crohn’s Disease/Ulcerative Colitis: https://www.mayoclinic.org/diseases-conditions/crohns-disease/symptoms-causes/syc-20353304https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326
  5. Crohn’s and Colitis Foundation: https://www.crohnsandcolitis.com/crohns; https://www.crohnsandcolitis.com/ulcerative-colitis 


Kristen Weiss Sanders is a proud ostomate and third generation girl with guts diagnosed with IBD in 2004. She is passionate about patient education and encourages those with chronic illness to be a knowledgable part of their healthcare team. Kristen credits the constant example and support of the strong women in her family for her determination to thrive with Crohn’s disease and use her IBD journey to empower others.