IBD refers to a non-infectious inflammation of the gastrointestinal tract. There are two major types of IBD:

1. Ulcerative Colitis: This involves the inner lining (mucosa) of the colon only and begins in the rectum and spreads upwards in some cases to involve other areas in the colon. Thus there can be proctitis (rectal involvement only), left sided colitis and universal colitis (whole colon).
2. Crohn’s Disease: This involves any layer of the gut and can involve not only the colon but also the small bowel, stomach etc. Thus can be colitis (colon involvement), enteritis (small bowel involvement) or Ileo-colitis (both small bowel and colon)and gastro-duodenal Crohn’s.

Irritable Bowel Syndrome, or IBS, refers to a wide spectrum of symptoms caused by gastrointestinal dysmotility (abnormal contraction of the gut). The cause is not known and treatment is directed at control of symptoms. We now know this is true disease indeed and is not “just in the head” as was thought before and patients do suffer from symptoms and need the physician’s full attention.

The definition of constipation is variable but it generally implies the infrequent passage of hard stools. This is a very common problem especially among elderly patients with limited mobility. This problem also occurs in young patients especially females and in those taking Opiate type pain medications.

Diverticulosis refers to herniation (out pouching) of the inner lining of the colon through the muscle layers of the colon causing pouches or pockets. Over half of Americans over the age of 50 have diverticulosis.

What causes diverticular disease?

With advancing age, the colon wall weakens and the increased pressure within the colon causes herniation of the inner lining. Normally the colon contracts in a wave like manner to expel feces; when the stools are hard and less bulky, greater pressure is required to move the stools resulting in high intracolonic pressure and thus diverticulosis. With high fiber intake, the stools are bulkier and soft and easy to expel.

Colon cancer is a malignancy arising from the inner lining (mucosa) of the colon and rectum. Colon cancer in the third leading cause of cancer behind breast and lung cancer and is second leading cause of cancer deaths in the US. African-Americans have a higher incidence of colon cancer. Men have a slightly increased incidence of developing colon cancer than women. The disease is more common in developed countries. Most colon cancers begin as a small precancerous growth called a polyp. The time taken for a polyp to become a cancer is very variable but is in the order of 3-5 years. Remember not all polyps have the potential to grow in to cancer.