Inflammatory bowel disease causes inflammation of the intestinal tissues and disrupts your body's ability to digest food, absorb nutrients and eliminate waste in a healthy way. These diseases of unknown origin are a group of chronic inflammatory conditions, primarily affecting the gastrointestinal tract. They include Crohn's disease and hemorrhagic rectocolitis also known as ulcerative colitis. Little is known about these diseases and they can be particularly disabling. These pathologies induce an abnormal response of the body's natural defenses and their prevalence among populations is increasing.

Crohn's Disease

Crohn's disease is characterized by attacks of abdominal pain and diarrhea which can last several weeks or months. Discomfort is accentuated after meals, because food puts pressure on the inflamed bowel wall. The sufferer feels weak and can lose weight if no treatment is undertaken. Inflammationcan form in various parts of the digestive tract from the mouth to the anus. However, it occurs most often at the junction of the small intestine and large intestine (colon). Chronic inflammation causes thickening of the intestinal wall, the appearance of fissures in the mucosa and abnormal wound healing. Most people with Crohn's disease experience periods of remission for several months and recurrences follow in unpredictable ways.

 During the flare-up period, the main clinical signs are chronic diarrhea frequently accompanied by abdominal pain. Weight loss often occurs due to malabsorption of nutrients. It is not unusual for symptoms to be accompanied by fever. Fatigue is a persistent symptom experienced by sufferers. Crohn's disease can cause certain complications including partial obstruction of the intestine causing vomiting and constipation. In fact, wound healing can lead to stenosis, i.e., a narrowing of the intestine.

 Etiologies

 The cause of Crohn's disease is unknown. It seems increasingly clear that the inflammation is autoimmune and multifactorial in nature. The most likely hypothesis is a breach of immune tolerance against the intestinal bacteria. It is now generally accepted that inflammation as a result of Crohn's disease results from an interaction between genetic predisposition and environmental factors. There is therefore an exaggerated inflammatory response against parts of the intestinal flora as a result of tissue damage.

 The intestinal flora plays a central role in the development of Crohn's disease. The most frequent damage occurs in areas of high bacterial concentration of Gram-negative type. Following interaction of the latter with the immune system, an inflammatory response occurs.

Prevalence 

 Approx. 140 in every 100,000 people suffer from the condition. Approx. 170,000 Canadians are affected by Crohn's disease or ulcerative colitis, both of which are inflammatory diseases of the intestine. Unfortunately, this makes Canada one of the countries with the highest rates of inflammatory bowel diseases, or one in 180 (approx. 0.5% of the population). In addition, two age groups with a higher incidence of the condition can be distinguished, the first being aged between 15 and 30 and the second aged between 60 and 80.

Ulcerative colitis (UC)

 Ulcerative colitis is very similar to Crohn's disease. It is a chronic inflammatory disease of the colon and rectum and is autoimmunein nature.Crohn's disease can occur anywhere in the gastrointestinal tract and affect the deep tissue, whereas ulcerative colitis affects only the lining of the colon and rectum. It is characterized by bloody lesions in the colonic mucosa and mucus in the stool.

The clinical signs are essentially the same as Crohn's disease and appear during attacks. These include painful abdominal cramps, especially in the lower abdomen. Chronic diarrhea with rectal bleeding and anemia caused by blood loss during diarrhea and urgent bowel movements are other symptoms associated with ulcerative colitis.

Etiologies

 The causes are similar to those of Crohn's disease. Scientists suggest that the deterioration of the lining of the colon is caused by unknown viruses or bacteria which cause an immune response. This is followed by the formation of ulcers which may bleed and produce mucus. Genetic and environmental factors affect the development of this disease.

 Prevalence

 In Canada, an estimated 150,000 people suffer from ulcerative colitis. Both men and women are affected in similar proportions. The disease is diagnosed mostly in people aged 15 to 40 years, but it can occur at any age.

 Involvement of probiotics

 The mechanism of action of probiotics is still a subject of discussion. Lactic acid bacteria with probiotic properties can easily dominate other microorganisms in the digestive tract due to their ability to produce various antimicrobial substances including organic acids, diacetyl, hydrogen peroxide and bacteriocins which give them a competitive advantage. In addition, the immunomodulatory capacity of probiotics increases the ability of regulatory T cells to restore the balance of pro and anti-inflammatory cytokines of the intestinal mucosa.        

 References

1. Association médicale du Canada (Ed). (Canadian Medical Association) Grand public, Maladies - Maladie de Crohn, (General public, Diseases – Crohn’s Disease) Amc.ca. www.cma.ca. Page consulted June 17, 2009.
2. Baumer Philippe. La maladie de Crohn... informations pour les patients et leur famille. (Crohn's disease ... information for patients and their families) Association François Aupetit. http://afa.asso.fr Blumenthal M. Page consulted June 19, 2009.
3. Association médicale canadienne (Ed). (Canadian Medical Association) Grand public, Maladies – Rectocolite hémorragique (General Public, Diseases – ulcerative colitis), Amc.ca. www.cma.ca. Page consulted June 12, 2009.
4. Canadian Inflammatory bowel disease Foundation. Maladie de Crohn et colite ulcéreuse. (Crohn’s disease and ulcerative colitis) www.fcmii.ca. Page consulted June 11, 2009.
5. KWON, H John and FARREL, J Richard. Probiotics and inflammatory bowel disease, therapy review. Biodrug. 2003; 17 (3): 179-186.
6. ANDOH, Akira. FUJIYAMA, Yoshihide and al. Therapeutic approaches targeting intestinal microflora in inflammatory bowel disease. World Journal of Gastroenterology. 2006.
7. SEKSIK, Philippe and MARTEAU, Philippe. Probiotics in inflammatory bowel disease: controlled trials and perspectives. Société française de Pharmacologie Thérapie. (French Society of Pharmacology Therapy) 2004.