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What is IBD?

Inflammatory bowel disease (IBD) covers a number of conditions that involve inflammation of the digestive system, especially the intestine. This is the part of the body involved in digesting food, absorbing nutrients and water and finally getting rid of the waste products (known as faeces or stools). Learn more about the digestive system.

People can sometimes get confused between irritable bowel syndrome (IBS) and IBD. Although the symptoms of diarrhoea and constipation are similar, the causes of IBD and IBS are different. IBS is a functional disorder, which means the digestive system looks normal but doesn’t always function properly. IBD is a chronic (on-going) condition which results in inflammation and sometimes damage to the structure of the intestines.

There are two main types of IBD: ulcerative colitis and Crohn’s disease. They affect different parts of the digestive system and result in slightly different symptoms.

Below is a quick overview of ulcerative colitis and Crohn’s Disease:

Table 1: The difference between ulcerative colitis and Crohn’s disease.
Part of intestine affected It always affects the rectum and colon (large intestine). It may affect the entire digestive system from the mouth to the rectum.
Characteristics The affected intestine sections form continuous blocks with no healthy sections in-between. The affected intestine sections take turns with healthy ones (‘skips’).
The inflammation affects only the lining of the intestine (mucosa). The inflammation affects the entire intestinal wall.
Fistulas develop rarely. It often involves development of fistulas.
Usually begins before the age of 30. But, it can occur at any age, and some people may not develop the disease until their 50s or 60s.


Can occur at any age, but usually starts young. Most people who develop Crohn’s disease are diagnosed before they’re 30 years old.
Symptoms Recurrent diarrhoea occurs very often. Stools may contain mucus or blood. Recurrent diarrhoea does not occur as often as in UC.
The stools almost always contain blood. Sometimes this may be visible to the naked eye. Bleeding is not as frequent as in UC but may occur.
Constipation may occur in UC but not as often as in CD. Constipation can occur at the time when the other symptoms of the disease are under control.
Variable abdominal (stomach) pain; the intensity and location (the place where it is felt) may change. It may cause unpleasant feelings in the bottom part of the abdomen, above the upper edge of the hip bone or result in spasms or cramp-like pain in the middle of the abdomen. The pain can become more severe during a flare-up of the disease. Other symptoms include nausea and vomiting.  Recurrent episodes of an agonising pain mainly in the bottom right part of the abdomen. This usually occurs before you go to the toilet. Nausea and vomiting can occur especially if there is an abscess or perforation of the intestinal wall.
Fever often accompanies intensive flare-up of the disease. Fever is mostly only slight; high temperatures and cold fever indicate possible complications.
Loss of appetite, loss of weight and retarded growth of children does not always occur in moderate or medium-serious patients with UC. However, growth of some children and adolescents may be limited due to the disease. Loss of appetite, loss of weight of about 10-20%. Impaired growth in children and adolescents is common.
Emptying difficulties – needing to go to the toilet more frequently. Or tenesmus (feeling like going to the toilet while the rectum is empty) as well retaining stools. Trouble emptying the bowel especially during a flare-up.
Anal ulceration occurs and fistula occur rarely. Anal ulceration and fistula may be one of the first symptoms that lead to suspicion of CD.
No neurological nor psychiatric symptoms occur. Neurological or psychiatric symptoms may be one of the first signs of CD.


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