Inflammatory bowel disease: Signs and Symptoms

Inflammatory Bowel Disease (IBD) is a broad term that describes conditions characterized by chronic inflammation of the gastrointestinal tract. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease. Inflammation affects the entire digestive tract in Crohn’s disease and only the large intestine (also called the colon) in ulcerative colitis. Both illnesses involved an abnormal response to the body’s immune system.

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IBD prevalence in the United States

In 2015, an estimated 1.3% of U.S. adults (3 million) reported being diagnosed with IBD (either Crohn’s disease or ulcerative colitis).2 This was a large increase from 1999 (0.9% or 2 million adults).

Some groups were more likely to report IBD, including those —

  • Aged 45 years or older
  • Hispanic or non-Hispanic white
  • With less than a high school level of education
  • Not currently employed
  • Born in the U.S. (compared with adults born outside the U.S.)
  • Living in poverty
  • Living in suburban areas

This estimate does not include children aged <18 years, who may also have IBD. Most people with IBD are diagnosed in their 20s and 30s.

What are the symptoms of Crohn’s Disease?

The most common symptoms include:

  • diarrhea
  • cramping and pain in your abdomen
  • weight loss

Other symptoms include

  • anemia
  • eye redness or pain
  • feeling tired
  • feverInflammatory bowel disease: Signs and Symptoms
  • joint pain or soreness
  • nausea or loss of appetite
  • skin changes that involve red, tender bumps under the skin

Your symptoms may vary depending on the location and severity of your inflammation.

Some research suggests that stress, including the stress of living with Crohn’s disease, can make symptoms worse. Also, some people may find that certain foods  can trigger or worsen their symptoms.

What causes Crohn’s disease?

Doctors aren’t sure what causes Crohn’s disease. Experts think the following factors may play a role in causing Crohn’s disease.

Autoimmune reaction

One cause of Crohn’s disease may be an autoimmune reaction—when your immune system attacks healthy cells in your body. Experts think bacteria in your digestive tract can mistakenly trigger your immune system. This immune system response causes inflammation, leading to symptoms of Crohn’s disease.


Crohn’s disease sometimes runs in families. Research has shown that if you have a parent or sibling with Crohn’s disease, you may be more likely to develop the disease. Experts continue to study the link between genes and Crohn’s disease.

Inflammatory bowel disease: Signs and Symptoms

Other factors

Some studies suggest that other factors may increase your chance of developing Crohn’s disease:

  • Smoking may double your chance of developing Crohn’s disease.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, antibiotics, and birth-control pills may slightly increase the chance of developing Crohn’s disease.
  • A high-fat diet may also slightly increase your chance of getting Crohn’s disease.

Stress and eating certain foods do not cause Crohn’s disease.

What are the signs and symptoms of ulcerative colitis?

The most common signs and symptoms of ulcerative colitis are diarrhea with blood or pus and abdominal discomfort. Other signs and symptoms include

  • an urgent need to have a bowel movement
  • feeling tired
  • nausea or loss of appetite
  • weight loss
  • fever
  • anemia—a condition in which the body has fewer red blood cells than normal

Less common symptoms include:Inflammatory bowel disease: Signs and Symptoms

  • joint pain or soreness
  • eye irritation
  • certain rashes

The symptoms a person experiences can vary depending on the severity of the inflammation and where it occurs in the intestine. When symptoms first appear,

  • most people with ulcerative colitis have mild to moderate symptoms
  • about 10 percent of people can have severe symptoms, such as frequent, bloody bowel movements; fevers; and severe abdominal cramping1

Points to remember about Ulcerative colitis

  • Ulcerative colitis is a chronic, or long lasting, disease that causes inflammation—irritation or swelling—and sores called ulcers on the inner lining of the large intestine.
  • The exact cause of ulcerative colitis is unknown. Researchers believe that factors such as an overactive intestinal immune system, genes, and environment may play a role in causing ulcerative colitis.
  • Ulcerative colitis can occur in people of any age. However, it is more likely to develop in people
    • between the ages of 15 and 30
    • older than 60
    • who have a family member with inflammatory bowel disease (IBD)
    • of Jewish descent
  • The most common signs and symptoms of ulcerative colitis are diarrhea with blood or pus and abdominal discomfort.
  • A health care provider diagnoses ulcerative colitis with the following:
    • medical and family history
    • physical examInflammatory bowel disease: Signs and Symptoms
    • lab tests
    • endoscopies of the large intestine
  • Which treatment a person needs depends on the severity of the disease and symptoms.
  • Good nutrition is important in the management of ulcerative colitis. A health care provider may recommend that a person make dietary changes.
  • People with ulcerative colitis should talk with their health care provider about how often they should get screened for colon cancer.

Race and Ethnicity of IBD

  • American Jews of European descent are four to five times more likely to develop IBD than the general population.
  • IBD has long been considered a predominantly white disease. The prevalence rate among whites is 149 per 100,000. Among African Americans, however, there has been a steady increase in reported cases of both Crohn’s disease and ulcerative colitis. An HMO with two million members reported hospitalization rates per 100,000 by race, over a six-year period, as:
    • 10.2 – Whites
    • 10.2 – African Americans

According to this study funded in part by the Crohns and Colitis Foundation, prevalence rates among Hispanics and Asians were lower than those for whites and African Americans.

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