Inflammatory Bowel Disease

More than 1.5 million Americans – nearly one in every 250 people - are currently living with inflammatory bowel disease (IBD). IBD refers to two related but different diseases: Ulcerative Colitis and Crohn’s disease, which cause chronic inflammation of the intestinal tract. By increasing awareness about these conditions, research into new treatment options may be advanced, improving the lives of individuals with IBD.

Though the exact cause of the condition is not known, inflammatory bowel disease is thought to occur when the body’s immune cells attack the intestine. According to experts, there may be an initial trigger, such as an infection or something taken in from the diet or environment, that activates this immune response. IBD is frequently viewed a spectrum, as some patients exhibit symptoms associated with both UC and Crohn’s disease. The inflammation seen in Ulcerative Colitis (UC) occurs only in the large intestine (colon) and is limited to the inner lining of the intestinal wall. In contrast, Crohn’s disease can involve any portion of the intestinal tract from the mouth to the anus but is frequently confined to the terminal portion of the small intestine (ileum). While Crohn’s and UC affect different areas of the digestive system, both are marked by diarrhea, rectal bleeding, urgency to have bowel movements, abdominal cramps and pain, fever, and weight loss. In addition to painful and frequently debilitating symptoms, individuals with IBD can experience complications of their condition including bowel obstruction, ulcers, and malnutrition.
Treatment options for Crohn’s and UC are frequently limited to anti-inflammatory, immunosuppressant, and steroid-based medications. These medications are used to control acute attacks or “flare ups”, prevent repeated attacks, and help the colon and intestinal tract to heal. In addition, UC can sometimes be treated through surgical removal of the affected portion of the bowel, after which patients may require an ileostomy to allow waste to leave the body. Because Crohn’s disease frequently spreads deep into the layers of affected bowel and intestinal tissue, surgical removal of the affected regions is often not possible.
Experts continue to strive to identify new treatment options for individuals with IBD. New research suggests that while UC and Crohn’s affect a relatively high rate of individuals in the U.S., the conditions are extremely rare in the developing world. According to some experts, there may be a correlation between parasitic worm (helminth) infection – which is common in the developing world but not in the United States – and the number of patients presenting with UC. Though the practice is not recommended, Dr. Joel Weinstock, chief of gastroenterology at Tufts University Medical School, notes that some UC patients have seen relief from symptoms after ingesting the trichuris suis worm, a parasite that lives in the intestines of pigs. Researchers are also investigating the use of live bacterial cultures (probiotics), including a genetically altered version of the common bacteria Lactobacills acidophilus, which have been found to nearly eliminate colon inflammation in rodent studies.
While experts work to develop new treatments, individuals with IBD can manage their condition using medications and monitoring their diet to avoid foods that exacerbate their symptoms. Participating in support groups, either online or in person, can help some individuals with IBD learn more about their condition, ways to cope with it, and available treatment options.

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Finding Health Information Online

More than ever before individuals have begun turning to the Internet for health-related information, including information about specific conditions and medications. Though the wealth of information online allows patients the opportunity to be better informed and take a more active role in their care, not all information comes from reliable sources. While individuals should be encouraged to become informed about issues that affect their health and well-being, it is also important to ensure that they are able to identify information that is from a credible source.



The United Nations (UN) reports that approximately 1.8 billion people worldwide are now using the Internet. A recent survey which included over 12,000 individuals in 12 nations, found that individuals are looking online for health-related information more frequently than in previous years. Globally, 81 percent of individuals with Internet access use it to search for advice about health, medicines, or medical conditions. A reported 80 percent of Americans look online at least some of the time for health information, frequently to find information about a specific disease, a treatment procedure, or exercise and fitness. Nearly half of all Americans looking for health information online are attempting to self-diagnose a condition based on symptoms they are experiencing.

While some experts endorse the use of the Internet for patient self-education as it allows patients to play a more active role in their care, they stress the importance of verifying health information found online. A recent report from the London School of Economics indicates that the amount of health information available online is abundant, and its accessibility is increasing as personal computers, tablets, and smartphones become more common. David McDaid, senior research fellow at the London School of Economics, notes that only a reported one in four people validate the sources of information posted online. Further, Dr. Karthik Murugiah, author of a recent study on the use of YouTube to provide information on CPR techniques, states that without some type of verification of credentials of an individual posting health-related information online, there is a “risk of dissemination of incorrect information.” While some government and health-related organizations and medical associations do put information online, it is sometimes difficult for patients to separate these posts from less credible information when searching online.

Findings of another recent study show that a typical health-related search produced a list of 93 links, only about one-third of which were “relevant.” According to Eric Horvit an artificial intelligence researcher at Microsoft Research, “People tend to look at just the first couple results” of a Web search, resulting in what experts have termed “cyberchondria.” Dr. Brett Taylor, an emergency department pediatrician at the IWK Health Center in Helifax, notes that “Misinformation travels along exactly the same social pathways as accurate, useful knowledge.” Echoing this point, Dr. Jan Maurer, Vice President and Medical Director of Health Dialog, “Increased and easier access to online health information creates a double-edged sword,” as there is a benefit to the wide and varied health information available online, however it must be carefully scrutinized.

By helping patients to learn where to find credible health information, physicians can guide patients to more valuable search results. While some sites provide diagnostic tools which can be problematic if used improperly, others provide information that patients can access after they have received a diagnosis from their physician. There is a benefit to be seen by allowing patients to become better informed, and thus more involved in their healthcare decisions, provided steps are taken to insure that information is credible.

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