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Summary & Participants

Few diseases generate as many misconceptions as Crohn's disease and ulcerative colitis. Listen to host Bettina Gregory and two gastroenterologists get down to the basics of Inflammatory Bowel Disease.

Medically Reviewed On: July 01, 2008

Webcast Transcript

BETTINA GREGORY: Hello. I'm Bettina Gregory. Crohn's Disease and Ulcerative Colitis affect as many as a million Americans. They can cause great discomfort and interfere with everyday life. While these are serious diseases, good therapies are available. Recently, I hosted a panel discussion sponsored by the Crohn's and Colitis Foundation of America. Two experts in gastroenterology helped us understand the possible causes and treatments of these diseases, which together are known as Inflammatory Bowel Disease... or I-B-D.

Dr. Tepper, let's start with you, and let's start at the very beginning. What is IBD?

ROBERT TEPPER, MD: IBD is a general term describing a number of chronic inflammatory conditions of the gastrointestinal tract. That encompasses the mouth, esophagus, stomach, small and large intestines, rectum and anus. The two most common conditions are ulcerative colitis and Crohn's disease. Because they have several similarities, they're grouped under the umbrella term IBD.

BETTINA GREGORY: What are the similarities, Dr. Heller, and the differences between ulcerative colitis and Crohn's disease?

ARTHUR HELLER, MD: Ulcerative colitis is a disease that starts in the rectum, the lowest-most part of the colon, and in a continuous manner can work its way up to a varying degree in the colon. Crohn's disease can affect the gut anywhere from lips to anus, often in a skip pattern, a segmental pattern.

Ulcerative colitis affects inflammation of only the superficial lining cells of the colon, whereas Crohn's disease involves inflammation of the full thickness of the gut.

BETTINA GREGORY: Dr. Tepper, what are the causes of IBD?

ROBERT TEPPER, MD: No one knows the specific cause. Currently, the most attractive theory is that in a genetically predisposed person there is some environmental trigger that causes an abnormal immune response. Of the factors involved, there are certainly genetic factors.

We know this because of patients who have IBD, in 15% of them, they will be able to identify a first-degree relative, a parent, child or sibling, who also has the disease. Secondly, we know that identical twins are more likely to both have the condition than non-identical twins.

We know that there are certain ethnic groups, such as Ashkenazi Jews, who are more likely to have the condition than others. And finally, there's been a recent discovery of a gene called the nod-2 gene, which is twice as likely to occur in Crohn's patients than in patients who do not have the disease.

BETTINA GREGORY: You've been talking about the genetic factors, and you did mention that certain groups, such as the Ashkenazi Jews, are more prone than the general population to have this disease. But can you mention any other populations of who is likely to get it, such as men or women, old or young, things like that?

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