Understanding Crohn’s disease and colitis

Dr. Louis Liu and his colleagues at the Driscoll Family Digestive Health Centre.
Dr. Louis Liu and his colleagues at the Driscoll Family Digestive Health Centre. (Photo courtesy: Dr. Louis Liu)

November is Crohn’s and Colitis Awareness Month, a time to support those living with Crohn’s disease or ulcerative colitis and to raise awareness about the realities of these diseases.

At the Driscoll Family Digestive Health Centre at UHN, a multidisciplinary team of specialists is led by Dr. Louis Liu, Head of the Division of Gastroenterology and Hepatology. A world-renowned expert and educator in digestive health, Dr. Liu was able to provide answers to several questions about Crohn’s disease and ulcerative colitis, and the care provided to patients for these diseases at UHN.

What are Crohn’s disease and ulcerative colitis?

Crohn’s disease (Crohn’s) and ulcerative colitis (UC) are the two main forms of a group of conditions called inflammatory bowel disease (IBD).

Both diseases inflame the lining of the gastrointestinal (GI) tract and disrupt the body’s ability to digest food, absorb nutrition, and eliminate waste in a healthy manner. These diseases are lifelong, painful and negatively impact the quality of life of people. These conditions can have acute periods of active symptoms (active disease or flare), and times symptoms are absent (remission).

What are the differences between Crohn’s and ulcerative colitis?

UC is characterized by inflammation of the colon that only affects its innermost lining. Crohn’s can occur anywhere along the GI tract, from mouth to the anus, and can affect all the layers of the bowel walls. Further, in Crohn’s, healthy parts of the intestine are mixed in between inflamed areas.

How widespread are Crohn’s and ulcerative colitis?

More than 300,000 Canadians are living with IBDs. By 2030, this figure is expected to reach 403,000, or about one in 100 people.

What are the symptoms of Crohn’s and ulcerative colitis?

While no two people experience digestive conditions in the exact same way, the most common are abdominal pain and diarrhea. There may also be rectal bleeding, weight loss and fever.

Outside the gut, IBD can be associated with aching, sore joints, skin and mouth sores, and red, inflamed eyes. Besides the physical symptoms, the emotional and psychological stress can take a serious toll, leading to anxiety, isolation and depression.

What causes Crohn’s and ulcerative colitis?

While it involves an abnormal immune response – and genetics and microorganisms in the GI tract could play a role – the exact causes of IBD are being actively investigated.

How are Crohn’s and ulcerative colitis treated?

Digestive diseases are some of the most complex to care for. Treatment for IBD varies. A few examples of many include immunosuppressants and immunomodulators, both of which target the immune system. Other categories of treatment include medications containing 5-aminosalicylic acid (5-ASA), an anti-inflammatory for the colon – specifically for ulcerative colitis – and other biological drugs.

In addition, alterations in diet and nutrition are often prescribed, and surgical procedures are sometimes used to repair or remove affected portions of the GI tract and manage complications.

What is being done at UHN to better understand Crohn’s and ulcerative colitis?

The Inflammatory Bowel Disease Program at the Driscoll Family Digestive Health Centre at UHN, is home to a team of esteemed experts from multiple disciplines who target a better understanding and treatment of Crohn’s and colitis. In addition, training is offered to the next generation of digestive health leaders, and support is extended to community physicians who may not have access to specialized health centres when diagnosing and treating patients with digestive diseases.

What services are available at UHN for those who have Crohn’s disease and ulcerative colitis?

Patients coming to the Driscoll Family Digestive Health Centre at UHN receive the latest treatments for complex digestive problems. Holistic and specialized care offered includes diagnosis, treatment, symptom management, education and urgent care. Here, the importance of approaching patient care from all directions is emphasized to help individuals find a sustainable way to manage their illness. This includes ensuring patients optimize their diets in order to reduce their burden.

Due to the generosity of donor support to the Driscoll Family Digestive Health Centre at UHN, we have been able to develop the most advanced health care and research programs for patients living with digestive diseases, ranking it as the top digestive health program in Canada.

For information about the referral process and to download a referral form, please visit the Driscoll Family Digestive Health Centre.

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