Crohn's disease and UC: living with IBD
Inflammatory bowel diseases
Dr. Inès Bertin
Gastroenterologist
Two diseases, one family
Crohn's disease affects the entire digestive tract (from mouth to anus), in segments, with transmural inflammation. Ulcerative colitis (UC) affects only the colon and rectum, continuously. Evolves with relapses and remissions.
Symptoms
Chronic diarrhea (often bloody in UC), abdominal pain, weight loss, fatigue, fever, extra-intestinal manifestations (joints, skin, eyes).
Diagnosis
Colonoscopy with biopsies, intestinal MRI (Crohn's), fecal calprotectin (inflammation marker), biological assessment.
Treatments
- 5-ASA (mesalamine): mild to moderate UC
- Corticosteroids: flares, short-term
- Immunosuppressants: azathioprine, methotrexate
- Biotherapies: anti-TNF (infliximab, adalimumab), anti-integrins (vedolizumab), anti-IL-23 (ustekinumab, risankizumab)
- Surgery: necessary in some cases (strictures, fistulas, medical failure)
Daily living
Absolute smoking cessation (Crohn's), nutritional monitoring, psychological support, up-to-date vaccinations before biotherapies.
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