Diagnosis and Comorbidities
Diagnosis
The 2 most common types of IBD are Crohn’s disease (CD) and ulcerative colitis (UC), and both are distinguished by a dysregulated immune response. However, CD is typified by inflammation throughout the digestive tract, whereas UC is limited to the large intestine.1-4
Establishing a diagnosis of UC or CD involves a combination of several assessments that may include:
- History and physical
- Labs: both general and specific (TPMT, CRP)
- Stool markers (fecal calprotectin)
- Endoscopic evaluation
- Imaging: CT, CTE, MRE, SBFT, rectal EUS, WCE
- Risk stratification
Comorbidities
Compared with adults without IBD, those with IBD are more likely to have certain chronic health conditions, which include, but are not limited to:5-7
- Acid-related disorders
- Arthritis
- Bone diseases
- Cancer
- Cardiovascular disease
- Iron-deficiency anemia
- Kidney disease
- Liver disease
- Pain
- Psoriasis
- Respiratory disease
- Severe headache
- Uveitis
Definitions: TPMT = thiopurine methyltransferase; CRP = C-reactive protein; CT = computed tomography (scan); CTE = computed tomography enterography; MRE = magnetic resonance enterography; SBFT = small-bowel follow-through; EUS = endoscopic ultrasound; WCE = wireless capsule endoscopy.
References
- Kornbluth A, Sachar DB; Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010;105:501-523.
- Lichtenstein GR, Hanauer SB, Sandborn WJ; Practice Parameters Committee of American College of Gastroenterology. Management of Crohn’s disease in adults. Am J Gastroenterol. 2009;104:465-483.
- Silverberg M, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol. 2005;19(suppl A):5A-36A.
- McDowell C, Farooq U, Haseeb M. StatPearls [Internet]. Inflammatory bowel disease. May 1, 2022. https://www.ncbi.nlm.nih.gov/books/NBK470312/.
- Centers for Disease Control and Prevention. IBD comorbidities. https://www.cdc.gov/ibd/data-and-statistics/ comorbidities.html#:~:text=Compared%20with%20adults%20without%20IBD,and%20migraine%20or%20severe%20headache
- Argollo M, Gilardi D, Peyrin-Biroulet C, et al. Comorbidities in inflammatory bowel disease: a call for action. Lancet Gastroenterol Hepatol. 2019;4(8):643-654.
- Bähler C, Schoepfer A, Vavricka S, et al. Chronic comorbidities associated with inflammatory bowel disease: prevalence and impact on healthcare costs in Switzerland. Eur J Gastroenterol Hepatol. 2017;29(8):916-925.
