ASGE Recognized Industry Associate (ARIA) Training Program OPEN | October 2025-GI Tract in Disease_Large Intestine_IBD

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This document provides an overview of diseases affecting the large intestine, focusing on Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS).<br /><br />IBD primarily includes Crohn’s Disease and Ulcerative Colitis (UC). Crohn’s Disease involves transmural inflammation leading to symptoms like abdominal pain, diarrhea, nausea, weight loss, and perianal disease. Diagnostic features include ileal strictures and cobblestone mucosa seen on imaging and colonoscopy, and granulomas on pathology. Treatment aims to improve quality of life and induce remission, using surgical interventions (bowel resection, fistulectomy) and medical therapies such as antibiotics, aminosalicylates, corticosteroids, immunomodulators, biologics (anti-TNF, anti-integrins, anti-IL12/23), and small molecule inhibitors.<br /><br />Ulcerative Colitis is a chronic, relapsing inflammatory disease confined to the colon with continuous involvement starting at the rectum. Symptoms include bloody diarrhea, abdominal pain, anemia, and tenesmus. Diagnosis is made via colonoscopy showing ulcerations and pseudopolyps. Treatments range from aminosalicylates and corticosteroids to biologics and surgery, depending on severity. Serious complications include toxic megacolon necessitating surgical intervention.<br /><br />Microscopic colitis is an inflammatory colon condition presenting with chronic watery diarrhea but normal colonoscopy, diagnosed by biopsy showing collagenous or lymphocytic infiltration. Treatments include anti-diarrheals, budesonide, and sometimes biologics.<br /><br />IBS is a functional GI disorder affecting about 15% of Americans, more commonly women. It manifests as abdominal pain linked to defecation and altered bowel habits, classified into diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), or mixed types. Causes include psychosocial factors, infections, motility changes, visceral hypersensitivity, and neurotransmitter imbalances. Diagnosis is clinical, excluding alarm symptoms. Management involves lifestyle modifications, symptom-targeted drugs (antispasmodics, laxatives, antidepressants), and alternative therapies such as hypnotherapy and stress management.<br /><br />Overall, these diseases differ in pathology, clinical presentation, diagnosis, and treatment approaches but significantly impact patient quality of life.

Asset Subtitle

Ayokunle Abegunde, MBBC, MSc, FASGE

Keywords

Inflammatory Bowel Disease

Irritable Bowel Syndrome

Crohn's Disease

Ulcerative Colitis

Microscopic Colitis

Colon Inflammation

Abdominal Pain

Diarrhea

Biologic Therapies

Gastrointestinal Disorders