Inflammatory bowel diseases

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Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

Inflammatory bowel diseases are chronic inflammatory diseases of the gastro-intestinal tract, and include Crohn 's disease and ulcerative colitis.

Crohn's disease, a chronic gastro-intestinal inflammation

Crohn´s disease is a chronic inflammation of the entire gastro-intestinal tract, which evolves in spurts, affecting mostly the small intestine and the colon, but able to affect the entire gastro-intestinal tract. Crohn’s disease causes scarring, stenosis and fistulas.

Ulcerative colitis, an inflammation of the mucous membranes of the rectum and colon

Ulcerative colitis (formerly known as ulcero- hemorrhagic recto-colitis), on the other hand, consists of a continuous  inflammation limited to the mucous membranes, i.e. the lining, of the rectum and colon.

Intestinal and extra-intestinal symptoms

Inflammatory bowel diseases usually start between the ages of 15 and 30 years, or between 50 and 80 years. Symptoms usually include diarrhea, bloody stool (especially with ulcerative colitis), abdominal pain, fever, fatigue, and weight loss. These conditions can also have extraintestinal manifestations, such as mouth ulcers, skin and joint lesions, ophthalmological manifestations, and others. 

Diagnosis is made by colonoscopy and biopsy

Generally, these diseases progress by relapses alternating with phases of remission. Their diagnosis requires blood tests, stool sampling and, most importantly, colonoscopy with biopsies.

Regular follow-up is essential

Due to an increased risk of colorectal cancer, regular colonoscopy follow- up is recommended. Abdominal CT scan can be done in case of acute presentation and/or to rule out any potential complications. In selected cases, a dedicated MRI may also be necessary.

Immunosuppression therapy

The Division of Gastroenterology is in charge of the management of patients suffering from inflammatory bowel diseases. Treatment is based on immunosuppressive drugs and depends on the frequency and severity of disease recurrences.

Surgical management of complications

Surgical management may be necessary in the event of a complication (such as strictures, abscess, fistula, etc.), resistance to drug treatment, or in case of cancer.

Stenosis
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narrowing
Colonoscopy
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Visual exploration of the gastro-intestinal tract, carried out using a probe fitted with a camera inserted into the rectum, used to highlight lesions of the inner lining of the colon
Immunosuppressive drugs
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Drugs that prevent the immune system from seeing the transplant as “foreign” and destroying it (rejection).
Last update : 04/01/2022