Inflammatory Bowel Diseases comprises two main diseases: Crohn’s disease and Ulcerative Colitis. Many scholars argue about what are the factors, which led to the onset of the disease. Also it is unsure, if Crohn’s disease and Ulcerative Colitis are two different diseases, with different pathogenesis, course and outcome, or if they are two different results of the same disease. There are still many questions unanswered about Inflammatory Bowel Diseases. What they both have in common, is that they are a result of misregulation between three factors: intestinal microbiota, intestinal epithelium and the immune system. They differ in many ways as well: the regions of colon they attack, layers of intestine wall that is in the state of inflammation, natural course and complications.
Inflammatory Bowel Disease – The Prevalence
Over the last century we observe a large growth in the number of people suffering from all types of colitis, main form being the inflammatory bowel disease (IBD). This growth is typical for developed and industrialized societies of Europe, Northern America and Australia. From estimated 28 patients per 100,000 people in early seventies, we are now dealing with approximately 199 patients per 100,000 people suffering from all types of colitis each year.
Although the descriptions of bowel diseases resembling cases of Crohn’s disease are present in the medical literature from sixteenth century, they have not become a subject of analysis until past few decades. Growing incidence and difficulties with proper diagnoses and treatment of inflammatory bowel disease were the reasons, why many studies were made over the last few decades in order to determine the causes and risk factors for these diseases.
What Causes Inflammatory Bowel Disease?
After many years of hard work, we are still not much closer to getting answers to our questions about inflammatory bowel disease. The most popular theory, which is trying to explain why people suffer from inflammatory bowel disease is hygiene hypothesis. Over the last few decades, we developed many new ways to improve our food storage conditions and to preserve our food, making it eatable for a longer period of time. That, and also deceased level of consumed food contamination, are the reasons, why the overall frequency of enteric infections has decreased.
Without having something to fight with (in that case, that would be all the pathogens causing enteric infections), our immune system responsible for taking care of our digestive system starts to overreact when a pathogen, that in a healthy person would cause only a little inflammatory response that would limit itself and not cause any trouble, shows up in digestive system of susceptible host, it triggers an overwhelming immune response, that leads to chronic inflammations of most of digestive tract. Of course, now we should ask who these susceptible hosts are. Many studies indicate, that there are genes, which may be responsible for susceptibility to those kinds of overwhelming inflammatory responses.
Inflammatory Bowel Disease Is Idiopathic
This theory discussed above is just one of many theories trying to explain the complex nature of Inflammatory Bowel Disease. If we were to tell the actual state of our knowledge about inflammatory bowel disease, we would say that these diseases are idiopathic, which means that the processes responsible for them are not yet discovered. Right now the scientists believe that Inflammatory Bowel Disease originates from a combination of dysfunction of intestinal epithelium, immune mucosal tissues overreaction and some defects in host interaction with intestinal micro biota. All those factors combined may produce a disease in a susceptible host.
The image of inflammatory bowel disease is not yet optimistic. But if we remember the 90’s, we may see that cardiovascular diseases were a similar problem. Origins were not well known, we were not that good at treating them, but after few years we became capable of managing them.
One of the factors, that was so important and of great significance in our fight with cardiovascular diseases was patient’s self-awareness and their ability to control risk factors responsible for the rapid onset of cardiovascular diseases on their own at their homes. It quickly revealed, that if properly educated, people can easily modify their lifestyle and become “immune” to cardiovascular diseases by choosing a right diet or starting to exercise.