Genetic data now suggests that Crohn’s disease and ulcerative colitis is a continuum or progression of disorders influenced by the location of inflammation in the gut.
About 1.4 million Americans have Crohn’s disease or ulcerative colitis. Diagnosis could be oversimplified though. This according to genetic data that shows the diseases are a complex continuum of disorders influenced by the site of the inflammation involved.
The location of disease in Crohn’s has always been considered important, but there has been a new observation that large bowel Crohn’s disease is halfway between ulcerative colitis and small bowel Crohn’s on the genetic spectrum, which suggests the vital aspects of the disease biology are linked to location.
Some previous studies on inflammatory bowel disease show that the genes involved are mostly shared by Crohn’s disease and ulcerative colitis, with just a small number of genes being specific to each disease. The latest study brought genetic information together with symptoms in an effort to understand the biology of the disease.
Experts believe at extreme ends of the continuum, genetic markers could have some diagnostic use. They reassessed the records of patients who had genetic factors that pointed to Crohn’s disease but who were originally diagnosed with ulcerative colitis and vice versa. They discovered that many doctors had raised doubts about diagnosis at least three times more often than for randomly chosen patients.
It’s believed that for a small subset of patients, genetics can uncover a misdiagnosis.
Genetic variation of inflammatory bowel disease seems to help indicate just how sick a person will become. A study, published last fall in The Lancet, shed new light on inflammatory bowel disease (IBD) and the rate the disease develops.
In the largest study of its kind, the DNA of 35,000 patients with Crohn’s disease and ulcerative colitis was analyzed. The findings indicated that we are looking at a number of different diseases hidden within Crohn’s and ulcerative colitis, which cover a large spectrum of inflammatory bowel disease.
Research into genetics and inflammatory bowel disease is relatively new and it is ongoing. Any type of study provides an opportunity to improve patient care. In this case, researchers reported that genetic analysis could potentially help identify patients who might benefit from earlier intervention and more aggressive treatments.
If you have Crohn’s or colitis it is important to monitor the disease properly. Patients should be examined on a regular basis and of course the frequency will depend on any complications that might arise. Laboratory workup and diagnostic testing should be performed regularly to monitor the safety, as well as the success of therapy.
So just how is Crohn’s disease diagnosed? There are in fact a number of tests that your doctor can order when inflammatory bowel disease is suspected. A colonoscopy could be conducted. This is a test that enables a doctor to view your entire colon using a thin, flexible, lighted tube with a camera attached. The doctor can take a small tissue sample for analysis, which could help in the diagnosis. There is also CT scans and MRI’s that can detect more than a normal x-ray does. In some cases, something called a capsule endoscopy is performed. It involves swallowing a capsule that has a camera in it. The camera takes pictures, which are transmitted to a computer and displayed on a monitor for the doctor to check.
An endoscopic ultrasound is a relatively new technique used to diagnose Crohn’s disease. Referred to as EUS, it includes an ultrasound probe that is attached to an endoscope, which is used to look deep below the lining of the intestines.
While an ulcerative colitis diagnosis can be made using some of the techniques above, a diagnosis of this inflammatory bowel condition can also be detected through a simple stool sample.
The main characteristic of both Crohn’s and colitis is inflammation. White blood cells are attracted to inflammation sites so a white blood cell test can be conducted for both of these conditions. The blood can be taken from your arm, tagged with a harmless amount of a radioactive substance then injected back into your body. A special camera is used to see where the radioactive white blood cells travel.
Crohn’s disease and ulcerative colitis can present a lot of challenges and a lot of complications, but having a good understanding of IBD and making sure you monitor and treat the condition properly means that you stand a good chance of living a full, happy, and productive life.