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Abstract
Ulcerative colitis and Crohn’s disease are chronic, relapsing, immunologically mediated disorders that are collectively referred to as inflammatory bowel disease.
The prevalence of IBD rapidly increased in Europe and North America in the second half of the twentieth century and is becoming more common in the rest of the world as different countries adopt a Western lifestyle. CD causes damage of the whole length of the digestive tract causing local and systemic manifestations. UC affects mainly the colon causing specific ulcers that may affect part of the colon or may extend to involve the entire length of the colon.On the other hand many cases described as IC (Intermediate Colitis) as they have features of both diseases, their definite diagnosis cannot be established.
The etiology of IBD is uncertain and many hypothesis describe the etiology as various factors that interact to develop the disease,these factors are aggressive immune responses to the luminal microbial antigens and adjuvants ,this occure in genetic susceptible host under the effect of environmental factors which may precipitate or reactivate the disease.
The intestinal manifestations include bloody diarrhea, abdominal pain and cramps, malabsorption with vitamin deficiency, the intestinal complications include intestinal obstruction, ulcers, fistulae, massive hemorrhage, toxic megacolon and cancer colon.
The extra intestinal manifestations include arthritis, eye, liver and kidney complications and haematological disorders as anaemia, leukaemia and thromboembolic disorders.
There is many disorders that give clinical picture similar to that of IBD so differential diagnosis is important to get early diagnosis and to avoid misdiagnosis that may lead to serious complications.So we can prevent or delay the miserable surgical intervention.
The diagnosis include clinical diagnosis, imaging studies that consider the corner stone in the diagnosis of IBD but they carry many hazards that limit its value in monitoring the activity of the disease and in detection of relapse. So the laboratory diagnosis is very important especially the acute phase reactants as CRP and ESR but they are elevated in other systemic inflammatory conditions so the scientists work to find specific inflammatory markers such as the faecal markers (as calprotectin and lactoferrine), they are ideal markers as they are rapid, non invasive, simple, specific and sensitive tools. They help in detecting gut inflammation in patients with established IBD, monitoring disease activity, prediction of relapse and differentiate organic and functional bowel disorders as IBS.