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THE LANGUAGE OF INFLAMMATORY BOWEL DISEASE
What are the meanings of the names Enteritis; Colitis; Crohn's
Disease; Ileitis; Crohn's Colitis; Ulcerative Proctitis?
All of these terms refer to inflammatory bowel disease (IBD).
Inflammation of any part of the small intestine can be called
'enteritis' (from the Greek word 'enteron' meaning intestine).
Inflammation of the colon is called 'colitis'. Crohn's Disease
(named after the doctor who, with Doctors Ginsburg and Oppenheimer,
first described the condition in 1932) is an ulcerating inflammation
affecting the lining and deeper layers of the wall of the bowel-
it can be in the ileum (small intestine) when it is sometimes
called ileitis and/or it can be in the colon when it is called
Crohn's Colitis. Ulcerative colitis is an ulcerating inflammation
of the inner lining of the colon. Ulcerative proctitis is the
name given to ulcerative colitis limited to the rectum.
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abscess-a localised collection of pus which may form
in the abdominal cavity or in the rectal area of persons with
inflammatory bowel disease.
acute (illness)-short lived or sudden.
aetiology-cause.
5-aminosalicylic acid-a substance which reduces inflammation
in colitis and may decrease the risk of relapse. The active ingredient
in drugs such as Asacol® and Pentasa®.
anaemia-a lowered concentration of haemoglobin in the
blood. Haemoglobin is the pigment which carries oxygen in the
red cells.
anastomosis-the surgical joining of two ends of healthy
bowel.
ankylosing spondylitis-a chronic inflammatory disease
of the spine and adjacent joints which causes pain and stiffness
in the spine, neck, hips, jaw and rib cage.
antigen-a substance, usually a protein, which is recognised
as 'foreign' by a patient's body, so that antibodies are produced
against it. Reaction between antigen and antibody may cause inflammation.
anus-the opening at the lower end of the gastrointestinal
tract at the end of the rectum.
appendix-a thin blind-ending pouch of intestine attached
to the caecum; that part of the colon situated in the right lower
abdomen.
appliance-the combination of flange and bag worn over
a stoma to collect bodily waste.
arthralgia-pains in the joints frequently experienced
by persons with IBD.
arthritis-inflammation of a joint accompanied by pain,
swelling and stiffness.
azathioprine-(Imuran®)-an immunosuppressant drug
used to treat IBD.
bacteria-minute organisms, millions of which are normally
present in the large intestine, but some of which can cause infection.
barium enema-a liquid suspension of barium sulphate
which, when introduced into the rectum and colon via the anus,
fills the bowel and adheres to the lining enabling X-ray pictures
of the bowel to be taken.
barium meal-a liquid suspension of barium sulphate
which, when drunk, enables X-ray pictures to be taken of the
gullet and stomach. It can be followed through into the small
intestine with further pictures.
biopsy-a small piece of tissue taken from the body
for examination under the microscope by a pathologist. It helps
in the diagnosis of IBD.
borborygmi-characteristic rumbling sounds in the bowel
caused by the movement of air through the intestine. Everybody
has them whether or not they have IBD.
bowel-another name for the intestines-the small bowel
(duodenum, jejunum and ileum), and the large bowel (colon).
breath tests-simple painless tests which help detect
lactose (milk sugar) intolerance, and other abnormalities of
intestinal function.
bypass-a surgical re-routing of the intestine (see
also resection).
caecum-the first 10-15 cms of the colon, situated in
the right lower abdomen.
cholestyramine-(Questran®)-a drug taken to absorb
excessive amounts of bile acid reaching the large intestine,
and hence to treat certain forms of diarrhoea.
chronic (illness)-long lasting or slow.
clubbing-an abnormal curved shaping of the finger nails
seen in some persons with IBD.
colectomy-surgical removal of the colon.
colestipol-(Colestid®)-a drug which binds bile
salts to prevent diarrhoea.
colon-the large intestine; the function of the colon
is to absorb water; it is about 1.5 metres long.
colonoscopy-an examination of the rectum and colon
performed by passing a lighted flexible telescope (colonoscope)
via the anus.
colostomy-a surgical operation in which the cut end
of the colon is brought through an opening in the abdominal wall.
Waste is then collected in a bag attached to the skin and fitted
over the colon, which is fashioned into a spout.
constipation-infrequent passage of hard stools.
continent ileostomy-(or Kock ileostomy) the surgical
creation of an ileal pouch inside the lower abdomen to collect
waste after a colectomy for ulcerative colitis. The pouch is
emptied regularly with a small tube inserted through an opening
in the abdomen- no external bag is required.
corticosteroid-a type of hormone produced by the adrenal
glands naturally. Prednisone and Prednisolone are synthetic corticosteroids
used to dampen down inflammation.
cyclosporin-an immunosuppressant drug commonly used
after kidney and other transplant operations, and occasionally
used in IBD.
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diarrhoea-excessive number of loose and watery stools.
dietitian-a specially trained individual who is qualified
to asses nutritional status and work closely with the patient
and doctor to ensure that an appropriate diet is being followed.
dilated-widened.
Dipentum®-see olsalazine.
distension-an uncomfortable swollen feeling in the
abdomen often caused by excessive amounts of gas and fluid in
the intestine.
diverticulosis-a very common condition of the lower
colon of older people, characterised by a thickened muscle coating
round the bowel, and multiple small out-pouchings (diverticula)
which may become infected (diverticulitis) .
dysplasia-alterations in the cells of the colon lining
seen on microscope examination of a biopsy, suggesting a possible
increased risk of cancer developing subsequently.
elemental diet-a specially prepared liquid meal without
residue, but containing all the necessary nutrients.
endoscopy-a general term for the examination of the
inside of the body using a lighted telescope inserted through
a natural body opening, e.g. colonoscopy and sigmoidoscopy via
the anus, and gastroscopy via the mouth. The endoscopist is a
specially trained physician or surgeon.
enema-a liquid inserted into the bowel via the anus,
for diagnosis or treatment.
erythema nodosum-red, tender swellings occasionally
seen on the shins and lower legs during a flare-up of IBD. They
usually subside when the disease is in remission.
exacerbation-an aggravation of symptoms; an increase
in the activity of the disease; a relapse.
faeces-motions; stools; wastes.
faecal fat test-a three or five day measurement of
the amount of fat in the stools to determine if there is poor
absorption of fat by the small intestine. This test is now rarely
performed.
familial-a family characteristic.
febrile-running a fever, having a temperature.
ferritin-a blood test which measures the patient's
iron reserves, and hence the need for iron treatment.
fissure-a crack or split in the skin, usually in the
area of the anus.
fistula-an abnormal channel (false passage) between
two loops of intestine, or between the intestine and another
organ, or between the intestine and the skin.
flatus-an awareness of the passage of gas through the
rectum, not necessarily in excessive amounts.
folic acid-one of the vitamins responsible for the
formation of the red blood cells; folate deficiency may occur
as a result of poor diet, or due to poor absorption by the small
intestine. Folate deficiency due to sulphasalazine treatment
is fairly rare but it can easily be corrected by taking oral
supplements .
gastroenterologist-a physician or surgeon specially
trained in the diagnosis and treatment of disorders of the intestine,
including Crohn's disease and ulcerative colitis.
granulomata-microscopic collections of inflammatory
cells seen in the bowel wall of patients with Crohn's disease
when a pathologist examines a biopsy or an operation specimen.
gut-another word for bowel or intestine.
haemorrhoids-(piles)-swollen veins in the area of the
anus which bleed easily. They may become painful.
heartburn-a burning pain usually felt in the chest
and due to reflux of stomach acid and bile into the gullet. Common
in the whole population.
hydrocortisone-a corticosteroid drug given intravenously
or as a foam enema.
hyperalimentation-extra nutrition given into a vein.
I.B.D.-abbreviation for 'Inflammatory Bowel Disease'.
ileum-the lower part of the small intestine, which
joins the colon at the ileocaecal valve.
ileoanal anastomosis-a surgical operation for ulcerative
colitis where, after total colectomy, an internal pouch is made
from the ileum and attached to the anus, thus preserving continence
and allowing evacuation in the normal manner. (This operation
is also known as the 'reservoir' or Parks operation) .
ileostomy-a surgical operation in which the cut end
of the ileum is brought through an opening in the abdominal wall.
Waste is then collected in a bag attached to the skin and fitted
over the ileum, which is fashioned into a spout.
immunology-the study of the body's immune system.
Imuran®-see azathioprine.
incontinence-inability to retain stools or urine.
iritis-painful inflammation of the eyes sometimes occurring
in IBD.
irritable bowel syndrome-irritable colon-a common condition
caused by altered motility of the bowels. It produces diarrhoea
or constipation and abdominal discomfort. Such symptoms can be
troublesome in patients with IBD even when the inflammation is
quiescent.
intravenous pyelogram-(IVP) an X-ray examination of
the kidneys, ureters and bladder.
-itis-indicates inflammation e.g. colitis is inflammation
of the colon; proctitis is inflammation of the rectum; ileitis
is inflammation of the ileum.
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lactase-is the enzyme which enables the small intestine
to digest lactose.
lactose-milk sugar.
lactose intolerance-a common and harmless disorder
producing abdominal discomfort, diarrhoea and gas after the ingestion
of milk or milk products. This may need treatment with a milk-free
diet.
lesion-a term used by doctors to describe any structural
abnormality.
leucocytosis-an increased number of white cells in
the blood.
leucopenia-a decrease in the number of white cells
in the blood.
loperamide-(Imodium®, Dicap®)-an anti-diarrhoeal
drug which slows the contraction of muscle in the gut.
6-mercaptopurine-(6-MP)-an immunosuppressant drug closely
related to azathioprine, used for reducing flare-ups of IBD.
mesalazine-a coated formulation of the drug 5-amino-salicylic
acid to deliver the drug to the ileum and colon (e.g. Asacol®,
Pentasa®).
Methotrexate-(Ledertrexate®, Methoblastin®)-an
immunosuppressant drug with some use in IBD which is not responding
to other drugs.
metronidazole-(Flagyl®)-an antibiotic which may
be helpful in treating anal inflammation in IBD.
mucus-a white slimy lubricant produced by the intestines.
It is found in excess in the stools of patients with colitis.
nasogastric tube-a thin flexible plastic tube passed
through the nose into the stomach.
obstruction-a blockage of the small or large intestine,
often due to narrowing of one part of it.
occult blood-non-visible blood in the stool, which
can easily be detected by a simple laboratory test.
oedema-accumulation of excessive amounts of fluid in
the tissues resulting in swelling.
olsalazine-(Dipentum®)-two 5-ASA molecules joined
together chemically so they can be broken down by bacteria in
the colon to release the 5-ASA.
ostomy-an artificial opening of the intestine onto
the wall of the abdomen (see stoma).
pathologist-a doctor who is a specialist in the examination
of tissues under the microscope.
Pentasa®-preparation of the drug 5-aminosalycylic
acid.
perforation-an abnormal opening in the bowel wall which
causes the contents of the bowel to spill into the normally sterile
abdominal cavity.
perianal-the area round the anal opening.
peritoneum-the membrane lining the inside of the abdominal
cavity.
peritonitis-inflammation of the peritoneum often due
to a perforation.
"pouch" operation-(ileoanal anastomosis)-an
operation involving the removal of diseased colon and rectum
and formation of an internal pouch using a length of ileum which
is attached directly to the anus. Performed commonly in young
people with ulcerative colitis.
pouchitis-inflammation of the pouch. The exact cause
in unknown.
prednisolone/prednisone-are drugs of the corticosteroid
group used to reduce inflammation in IBD. It can be taken as
tablets, intravenously by injection, or through the rectum as
an enema or suppository.
proctocolectomy-removal by surgical operation of the
colon and rectum. The patient is left with an ileostomy.
prognosis-what might happen in the future (to the progress
of the disease).
prophylactic therapy-preventive treatment.
Purinethol®-see 6-mercaptopurine.
pyoderma gangrenosum-a type of chronic skin ulceration
which sometimes occurs on the extremities of persons with IBD.
radiologist-a doctor who specialises in X-ray, ultra-sound
and similar examinations.
recurrence/relapse-return of the disease activity.
remission-a lessening of symptoms of the disease and
a return to good health.
resection-the surgical removal of a diseased part of
the intestine.
reservoir-an internal pouch created from loops of small
intestine.
rheumatologist-a medically qualified doctor with special
training in the diagnosis and treatment of patients with diseases
of the joints and muscles.
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sigmoidoscopy-the passing of a short lighted telescope
through the anus to inspect the lining (mucosa) of the rectum
and the lower colon.
small bowel enema-barium sulphate is introduced into
the small intestine through a tube. The barium sulphate adheres
to the lining of the small bowel allowing x-ray pictures to be
taken.
small intestine-that section of the gastrointestinal
tract which digests food and absorbs nutrients after they have
passed through the stomach.
spastic colon-see irritable bowel syndrome-it is not
an inflammatory bowel disease although some of the symptoms are
similar.
spastic colitis-see irritable bowel syndrome and spastic
colon.
steatorrhoea-excessive amounts of fat in the stool
due to poor absorption by the small intestine.
stoma-a surgically constructed opening of the intestine
onto the abdominal wall over which a bag can be fitted and sealed
to the skin.
stool-bowel motion, faeces.
stricture-an irreversible narrowing of the gut due
to scarring
sulphasalazine-(Salazopyrin®, Colizine®)-a
drug which combines 5-aminosalicylic acid with a sulphonamide
derivative. It is used to treat flare-ups and to maintain remission
in IBD.
suppository-a bullet-shaped plug containing a drug
for insertion into the rectum. For use where medication is required
only in the last 8-15cm of colorectum.
tenesmus-a persistent urge to empty the bowel usually
caused by inflammation of the rectum.
terminal ileum-the lowest end of the small intestine
before it joins the large intestine.
toxic megacolon-dilatation of the colon which may lead
to perforation, usually in a very severe attack of ulcerative
colitis, or Crohn's colitis. Urgent surgery is almost always
performed.
total parenteral nutrition-intravenous infusion of
all the patient's requirements of nutrients through a fine tube
(catheter) placed in a large vein.
upper G.l. series-an American term for a barium meal
and follow through X-ray examination .
viruses-microorganisms which can replicate only within
other cells. They do not usually respond to antibiotics.
