Inflammatory bowel disease (IBD) is an immunological disorder with two main forms: Crohn’s disease (CD) and ulcerative colitis (UC). Both are chronic conditions characterised by inflammation of the gastrointestinal tract. 

Crohn’s and Colitis UK estimates that there are more than 300,000 patients with IBD in the UK. IBD can occur at any age, but typically presents in late adolescence or early adulthood, with another small peak of incidence in the sixth decade. People diagnosed younger generally have a more aggressive form of IBD than those diagnosed later in life. 

Symptoms of active IBD

Bowel inflammation leads to diarrhoea, which can be bloody, especially in UC. When the bowel is inflamed, absorption of nutrients is less efficient. This can lead to nutritional deficiencies including calcium, zinc, magnesium, phosphate and vitamins; and anaemia from blood loss, iron and folate deficiencies and weight loss.

Diarrhoea, weight loss and abdominal pain may not always be present in all patients with active IBD. It is important to rule out other causes before assuming the patient has IBD or is having a flare of their disease. Patients having an acute flare may also be systemically unwell, such as experiencing a fever.

IBD patients may also suffer from extra-intestinal manifestations (EIM), which often affect the joints, eyes, skin and hepatobiliary system. Generally, the severity of EIM is worsened when IBD is more active. 

Symptoms and disease severity range from mild to moderate or severe, present differently and vary for each patient. Patients will have phases of being in remission and having active relapses or flare ups.