Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a term for two conditions (Crohn's disease and ulcerative colitis) that are characterized by chronic inflammation of the gastrointestinal (GI) tract. Prolonged inflammation may lead to damage to the GI tract, including ulcerations, bleeding, perforation, and fistula formation.
Crohn's disease (sometimes called "Regional Enteritis") can affect any part of the GI tract (from the mouth to the rectum and anus). Most of the time, it affects the small intestine, just before it joins the colon.
Ulcerative colitis affects the colon (large intestine) and rectum.
Symptoms of both Crohn's Disease and Ulcerative Colitis are:
Rectal bleeding/bloody stools
What is the Cause of IBD?
The exact cause of IBD is unknown, but IBD is the result of a defective immune system. A properly functioning immune system attacks foreign organisms, such as viruses and bacteria, to protect the body. In IBD, the immune system responds incorrectly to environmental triggers, which causes inflammation of the gastrointestinal tract. There also appears to be a genetic component—someone with a family history of IBD is more likely to develop this inappropriate immune response
How is IBD Diagnosed?
IBD is diagnosed using a combination of endoscopy (for Crohn's disease) or colonoscopy (for ulcerative colitis) and imaging studies, such as contrast radiography, magnetic resonance imaging (MRI), or computed tomography (CT). Physicians may also check stool samples to make sure symptoms are not being caused by an infection or run blood tests to help confirm the diagnosis.
How is IBD treated?
Several types of medications may be used to treat IBD: aminosalicylates, corticosteroids (such as prednisone), immunomodulators, and the newest class approved for IBD—the "biologics".
Severe IBD may require surgery to remove damaged portions of the gastrointestinal tract, but advances in treatment with medications mean that surgery is less common than it was a few decades ago.
Since Crohn's disease and ulcerative colitis affect different parts of the GI tract, the surgical procedures are different for the two conditions.
Irritable Bowel Syndrome (IBS)
IBD should not be confused with irritable bowel syndrome or IBS. Although people with IBS may experience some similar symptoms to IBD, IBD and IBS are very different. Irritable bowel syndrome is not caused by inflammation and the tissues of the bowel are not damaged the way they are in IBD. Treatment is also different.
Celiac disease is another condition with similar symptoms to IBD, but it is not IBD. It is also characterized by inflammation of the intestines. However, the cause of celiac disease is known and is very specific. It is an inflammatory response to gluten (a group of proteins found in wheat and similar grains). The symptoms of celiac disease typically go away after starting a gluten-free diet, although it usually will be months before the full effects of the new diet will be reached.
Epidemiology of IBD
In the United States, it is currently estimated that about 1 –1.3 million people suffer from IBD. The cause of IBD is unknown, and until we understand more, prevention or a cure will not be possible.
We do understand that IBD affects some subpopulations more than others.
Sex: Ulcerative colitis is slightly more common in males, while Crohn's disease is more frequent in women.
Ethnicity: IBD occurs more in people of Caucasian and Ashkenazic Jewish origin than in other racial and ethnic subgroups.
Data and Statistics
In 2015, an estimated 1.3% of US adults (3 million) reported being diagnosed with IBD (either Crohn's disease or ulcerative colitis).
This was a large increase from 1999 (0.9% or 2 million adults).
Some people were more likely to report having IBD, including persons aged 45 years or older, Hispanic of non-Hispanic white, with less than a high school level of education, not currently employed, born in the United States, living in poverty, or living in suburban areas.
Compared with adults without IBD, those with IBD are more likely to have certain chronic health conditions that include cardiovascular disease, respiratory disease, cancer, arthritis, kidney disease, and liver disease.
Disability Benefits Related to Inflammatory Bowel Disease
The symptoms of IBD and the disability related to those symptoms varies from patient to patient. In some cases, the abdominal pain and the frequency of diarrhea may be severe enough so as to prohibit even sedentary ("desk job") work. For example, if you are unable to sit for at least 6 hours out of an 8 hour day because of abdominal pain and diarrhea and the need for frequent bathroom breaks, then your work capacity may be less than sedentary and that may qualify you for disability benefits.
In order to obtain disability benefits, your medical records must properly document your diagnosis and symptoms, their severity and frequency, and endoscopic, radiographic, and laboratory findings that support the diagnosis of IBD and its severity.
Communicate with your doctor and have your doctor document these findings with specificity in your medical records. That's essential if you are to obtain a disability award from either the Social Security Administration (SSDI) and/or from your employer-provided group long-term disability plan (ERISA).