Inflammatory Bowel Disease

A patient with persistent diarrhea, rectal bleeding, weight loss, abdominal pain, or perianal drainage may have inflammatory bowel disease (IBD), but symptoms alone do not establish the diagnosis. Infection, irritable bowel syndrome, medication effects, and colorectal disease can look similar. The clinical task is to identify whether objective intestinal inflammation is present, determine whether the pattern fits Crohn disease (CD) or ulcerative colitis (UC), and look for complications that change urgency. The distinction is more than a label. Disease location and depth predict what the bowel can do: superficial continuous colonic inflammation produces a different risk profile from patchy, transmural inflammation that can narrow or penetrate the bowel wall. Treatment is then chosen according to phenotype, inflammatory burden, prognosis, previous therapy, and patient priorities.