Questions & Answers

1.

What is the difference between Crohn's disease and ulcerative colitis?

Crohn's disease and ulcerative colitis are both chronic inflammatory conditions affecting the bowel. Although they cause similar symptoms, they differ in many ways.

Ulcerative colitis is limited to the inner layer of the large intestine; Crohn's disease can affect any part of the digestive tract from the mouth to the anus and includes some or all layers of the gut, causing deep ulceration.

Ulcerative colitis can affect the whole lining of the large intestine; Crohn's disease doesn't affect the whole of the bowel at once, but instead produces 'skip lesions' in different areas.

Crohn's disease can be treated by diet in some situations and, unlike ulcerative colitis, surgery does not provide a cure.

For more detailed information see the leaflets on 'What is Crohn's disease?' and 'What is ulcerative colitis?'.

Don't worry if you haven't got these leaflets - just click here to find out how you can order them or read a summary online.

2.

Will I always have to take medication for my IBD?

The medicines used to treat IBD do not provide a permanent cure, they merely 'dampen down' the inflammation. Therefore if the treatment is stopped, the disease is likely to come back. It is most important that you keep taking your medication as prescribed by your doctor, even when you feel well, in order to control the disease and prevent complications in the future.

For more detailed information see the leaflets on 'Treatments' and 'Preventing flare-ups/useful tips'.

Don't worry if you haven't got these leaflets - just click here to find out how you can order them or read a summary online.

3.

Can alcohol affect IBD?

You don't have to avoid alcohol just because you have IBD, but for general health reasons you should not exceed the current recommended limits, i.e. 21-28 units per week for men and 14-21 units per week for women. These are only guidelines and individual tolerance may be affected by a number of factors.

Alcohol should certainly be avoided if it appears to make your symptoms worse. Also, alcohol can interact with certain medications and so you should read the leaflet accompanying your medication carefully and discuss it further with your doctor or IBD nurse if necessary.

4.

I have IBD, but my doctor says that sometimes my symptoms are due more to IBS. Can I have both, and what are the differences between the two conditions?

It is possible to have both IBD and IBS (irritable bowel syndrome) at the same time. IBS is a functional bowel disorder, which means that the bowel does not work properly and often goes into spasm, causing pain, bloating and an altered bowel pattern. Bleeding is not a feature of IBS. The symptoms of IBS can be very similar to those of IBD, but in IBS the intestine does not become inflamed.

If your blood tests and inspection of the bowel are both normal, your symptoms may be related to an irritable bowel. This may respond to a change in diet, such as low fibre, or cutting out certain foods.

5.

I am a student with IBD and will soon be looking for employment. What should I tell my employer?

It is important to be open and honest with your employers in order for them to be supportive of your condition and for any allowances to be made where necessary. Although most areas of employment are open to people with IBD, you should also consider whether you can manage the demands of a particular job.

It may be helpful to give your future employer some simple information on IBD. Research has shown that people with IBD are generally reliable and hard working and tend not to have time off for trivial illnesses.

For more detailed information see the leaflet on 'Employment and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

6.

Whenever I get stressed my IBD flares up. Is there a link?

Many patients feel that their IBD is triggered by stress. Although stress does not cause IBD, it can make attacks worse. If you know that stress does affect your IBD, you should try and avoid unnecessary stress as much as possible. You can't avoid stress altogether, but there are some very effective ways to deal with it.

It may be helpful to give your future employer some simple information on IBD. Research has shown that people with IBD are generally reliable and hard working and tend not to have time off for trivial illnesses.

For more detailed information see the leaflet on 'Stress and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

7.

My friend has Crohn's and has to follow a special diet. Can a diet help my colitis?

Unlike Crohn's disease, which can be treated by diet alone in some patients, colitis is not generally affected by diet. However, you might find that certain foods can provoke symptoms, particularly when the colitis is active. The general rule is to eat a wide and varied diet and to avoid only those foods that appear to make symptoms worse.

For more detailed information see the leaflet on 'Diet and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

8.

I am having trouble getting insurance because of my IBD. What advice can you give me?

It is important to 'shop around' for insurance policies, as many companies weight premiums differently and some are more sympathetic towards people suffering from chronic illnesses. It is also important to be honest when completing the application form, as any false information can make the policy void.

It is better to be specific about which part of your body is affected by IBD (rather than just stating IBD), as 'IBD' can mean many things to insurance companies. If you have fairly infrequent attacks, it may also be helpful to state how long you have been in remission for.

For more detailed information see the leaflet on 'Insurance and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

9.

I have IBD and I am planning to go abroad on holiday. What special precautions do I need to take?

When planning a holiday abroad, first of all it is important to get good holiday insurance with a policy that covers treatment abroad, if this is necessary. Secondly, make sure that you take sufficient supplies of your regular medication, as they may not be available if you run out. Try to choose somewhere with good sanitation facilities and be very careful to avoid doing or eating anything that might lead to gastro-enteritis.

Check carefully what vaccinations may be required, as some are not recommended while you are on certain drugs, particularly steroids and immunosuppressants.

Some medicines have specific storage instructions (e.g. temperature) - check that you can store your medicines correctly whilst on holiday.

For more detailed information see the leaflet on 'Holidays, travel and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

10.

I have been on medication from my doctor for IBD but nothing seems to work for long. Can alternative therapies help, and which ones might be most beneficial?

Before seeking any type of alternative therapy it is very important to discuss your options with your doctor or IBD nurse first, as some treatments can be harmful, despite being labelled 'herbal' or 'homeopathic'.

Alternative or complementary therapies may be helpful in IBD, although most have not generally been subjected to controlled clinical trials. Many of the benefits are derived from stress reduction or, in the case of visiting an alternative therapist, simply from talking to someone who has time to listen and to take an interest in you as a whole, not just your IBD. Some effects of alternative therapies may be due to a placebo effect; simply believing that something will make you better might just have that desired effect.

For more detailed information see the leaflet on 'Alternative medicine''.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

11.

I have been told to give up smoking, as this is bad for my Crohn's disease. Is this true?

It is true that smoking is bad for Crohn's disease. It has been shown to be one of the single most important risk factors in the development of Crohn's disease, and can increase the risk of a relapse. Individuals who smoke generally suffer more complications and require surgery more often. Research has shown that quitting smoking reduces the risk of a relapse by 65% and considerably reduces the need for steroids and immunosuppressant therapy. It may not be easy for you to give up smoking, but there are many practical approaches to help you begin the process.

Hypnotherapy, nicotine replacement and regular counselling sessions can be very helpful. Talk to your doctor or IBD nurse for further advice on these options.

For more information, contact Quit Line on Freephone 0800 002200 and see the leaflet on 'Smoking and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

12.

I am a young girl with IBD. Will I be able to have children?

Most women with IBD are able to get pregnant and go on to have a normal and healthy baby. In fact many women report that their disease is at it's best during pregnancy. However, repeated episodes of inflammation may affect the fallopian tubes and therefore fertility. If after months of trying you have not become pregnant, you should see your doctor for further advice and referral to a specialist. The most important thing is to be free from attacks at conception as this will usually lead to a trouble-free pregnancy.

For more detailed information see the leaflet on 'Fertility, women and IBD''.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.