Crohn disease and ulcerative colitis are inﬂammatory bowel diseases (IBDs) of undetermined cause. The diseases strike rich and poor, men and women, whites, blacks, and Asians. It is most frequently diagnosed in individuals between ﬁfteen and thirty years of age. The Crohn’s & Colitis Foundation of America (CCFA), the national organization that coordinates much research on inﬂammatory bowel disease, extrapolates from epidemiological studies of small populations that between 750,000 and 1 million Americans suffer from IBD. Anumberofothertypes Colitis (inﬂammationofthecolon, or large intestine) exist; among them are colitis brought on by certain medications or infections and ischemic colitis, caused by a lack of blood ﬂow to the colon.
While the causes of Crohn disease and ulcerative colitis are not known, our understanding of the immune system and the mechanisms of inﬂammation within the bowel has led to improved treatment of both conditions since the 1970s. Some researchers look for a genetic or molecular key that will unlock the mystery of Crohn disease and ulcerative colitis; others seek medications that relieve symptoms and have fewer side effects thanthosecurrentlyinuse.Onthesurgicalfront,new techniques for connecting a healthy small intestine to the rectum mean that fewer people who undergo total colectomy (removal of the colon) must live with an ostomy (an opening in the side of the abdomen for removal of waste).
Ulcerative colitis can be “cured” through a total colectomy, but Crohn disease has no cure. Crohn disease is a lifelong, recurring disease, even after surgery to correct an obstruction, an abscess,oraﬁstula(an irregular pathway from the intestine to another portion of intestine, to another organ, or to the outside via the abdominal wall). People who suffer from IBD, and especially those with Crohn disease, are likely to experience the emotional and psychological anguish associated with a chronic illness that can ﬂare up at any time, changing one’s short-term and even long-term plans. Inﬂammatoryboweldiseaseaffectsmenandwomeninalmost equal numbers. Northern European countries have a higher prevalence than southern European countries; in the north the rate approaches that of America And Canada.Jews of Ashkenazi (European) descent—about 90 percent of the North American Jewish population—have the highest incidence. Inﬂammatory bowel disease in North America is more prevalent in the white community than among blacks or Asians. Black Americans have a higher incidence than Africans, and Asian Americans have a higher incidence than Asians. The rate among the Japanese is rising, bringing that population closer to the levels found in America and northern Europe than in the rest of Asia.