Inflammatory bowel disease (IBD)

What is inflammatory bowel disease (IBD)?

Inflammatory bowel disease (IBD) is characterised by the inflammation of the intestine. A distinction is made between two conditions: Crohn's disease and ulcerative colitis.

• Crohn's disease is a chronic inflammation that can occur throughout the digestive tract. However, the inflammation is usually located in the lower part of the small intestine, in the colon or in a combination of the two.
  In Crohn's disease, the entire intestinal wall becomes inflamed at the site of inflammation. The size of the resulting intestinal ulcers can vary. In addition, there can be narrowing of the intestine, and fistulae (tubular ulcers between adjacent parts of the intestine and internal organs).
• Ulcerative colitis is a chronic, localised inflammation of the large intestine (the colon) and/or rectum. The symptoms usually begin in the rectum and they can spread throughout the colon. The inflammations remain confined to the colon and rectum. If only the rectum is affected, the term used is 'proctitis'; when the section of the intestine before the rectum (the sigmoid colon) is involved, the term used is proctosigmoiditis. Pancolitis is when the entire colon and rectum are affected. Proctitis is considered to be a form of ulcerative colitis. In ulcerative colitis, inflammation often begins at the extremity of the colon, often spreading in the direction of the mouth. The inflammation is confined to the mucosa of the intestinal wall and it is accompanied by redness, minor haemorrhaging, large and small ulcers, and bleeding mucosa.
  
  

What are the complaints associated with inflammatory bowel disease (IBD)?

• The main symptoms of Crohn's disease are: diarrhoea, abdominal pain, general malaise and weight loss. The disease sometimes begins with blood loss through the anus, closure of the bowel, or symptoms around the anus. ⁵⁶⁴
  
• The main symptoms of ulcerative colitis are diarrhoea, with or without visible blood loss through the anus, or normal stools containing blood, pus and mucus. Most patients suffer from abnormal urge, difficulty in controlling bowel movements, anal cramps and abdominal cramps/abdominal pain before and during defecation. ⁵⁶⁴
  
  

People with intellectual disabilities will sometimes find it impossible to communicate the pain caused by Crohn's disease and ulcerative colitis. The people around them may then notice only a change in behaviour.

How common is inflammatory bowel disease (IBD) in the general population?

The one-year prevalence of inflammatory bowel disease (both Crohn's disease and ulcerative colitis) is 0.55%. ³¹⁴

How common is inflammatory bowel disease (IBD) in people with intellectual disabilities?

It is not known how prevalent inflammatory bowel disease is in people with intellectual disabilities. There is information about the condition in people with Down syndrome. ³¹⁵

0.55% General population Not known for people with intellectual disabilities