Lower GI Tract Disorders

Inflammatory Bowel Diseases (UC & Crohn’s)

 Ulcerative Colitis    

Ulcerative Colitis (UC) causes inflammation and ulcers in both the large intestine and rectum. The mucosal layer of the intestine becomes inflammed leading to ulcers and bleeding. Damage to the large intestine can cause problems absorbing water, electrolytes, vitamins and minerals leading to vitamin deficiencies. UC can also lead to dysbiosis of the gut microbiota and increase risk of colon cancer. Rectal bleeding and diarrhea are common symptoms of UC and can lead to anemia, iron deficiency and malnutrition.

Crohn’s Disease

Crohn’s disease is a chronic disease that may affect any part of the GI tract but usually is found in the distal ileum and colon. Characterized by transmural inflammation, this disease can cause the mucosal layer of the intestinal wall to thicken and may lead to abscesses, fistulas, strictures and narrowed bowel segments resulting in obstructions. Crohn’s disease can lead to trouble digesting food properly due to the damage to the intestines. Malabsorption of nutrients can occur as a result of improper digestion.

Celiac Disease

Celiac disease is different from gluten intolerance and sensitivity. After ingesting gluten, for example: wheat, grains, cereal and rye, a person with Celiac disease will have a damaging autoimmune response. This response results in damage to the villi located on the lining of the small intestine. Villi on the lining of the small intestine start to atrophy or wither away. These villi are responsible for absorbing vitamins, minerals and macronutrient molecules such as protein, fat and carbohydrates. When these villi wither away, they have less surface area to absorb, which will result in malabsorption of nutrients and vitamins and may lead to deficiencies.  

 Common Symptoms

• Ulcerative Colitis

  • Abdominal cramps

  • Diarrhea

  • Fever

  • Weight loss

  • Anemia

  • Food intolerance

  • Malnutrition

  • Growth failure

  • Bloody stool

• Crohn's Disease

  • Abdominal cramps

  • Diarrhea

  • Fever

  • Weight loss

  • Anemia

  • Food intolerance

  • Malnutrition

  • Growth failure

  • Fistulas

  • Bowel strictures

• Celiac Disease

  • Anemia

  • Anxiety/depression

  • Diarrhea

  • Steatorrhea (fat in stool)

  • Malodorous stools (smell bad)

  • Bloating

  • Fatigue

  • Poor weight gain

  • Dermatitis herpetiformis (itchy skin rash)

  • Mouth Sores

  • Softening of bones

  • Osteoporosis

References:

1. Raymond, J. & Morrow K. Krause and Mahan's Food & the Nutrition Care Process.16th ed. Elsevier; 2023.

2. Caio, G., Volta, U., Sapone, A. et al. Celiac disease: a comprehensive current review. BMC Med 17, 142 (2019). https://doi.org/10.1186/s12916-019-1380-z

3. Ranasinghe IR, Hsu R. Crohn Disease. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK436021/

4. Lynch WD, Hsu R. Ulcerative Colitis. [Updated 2023 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459282/