Complications of CD may arise as bowel obstructions, or as inflamed ulcerous tracts or fistulas which form channels into adjacent intestinal segments or even into nearby organs such as urinary bladder, vagina or surface skin. Together these disorders affect more than 500,000 Americans, and although a compromised immune response is implicated in the typical inflammatory reactions in the intestinal wall, the triggering event, possibly a bacterial or viral infection, is as yet unknown. The disorders are diagnosed through physical exam, including tests for anemia resulting from blood loss in the stool, increased white blood cells indicative of an inflammatory condition, and endoscopy, whereby the intestinal lining is viewed directly through a flexible tube inserted through the anus. Samples of inflamed intestinal tissue may also be taken at the same time for microscopic examination. Abnormal inflammation, thickening or constriction of the intestine can also be seen by X-ray.
Symptoms are persistent abdominal pain, bowel sores, diarrhea, intestinal bleeding, or weight loss.
In some cases, the inflammatory processes associated with CD and UC trigger skin lesions, joint pain, inflammation of the eyes, and liver disorders. Treatment for both disorders includes dietary adjustments, medication, and surgery. No specific dietary regimens have proved efficacious, although avoidance of foods which exacerbate inflammation is recommended. Both CD and UC are initially treated with sulfasalazine and mesalamine. More serious cases of CD are treated with prednisolone, metronidazole or azathioprine.