young woman holding her stomach due to abdominal pain

7 Myths about Inflammatory Bowel Disease

Private: Joshua R. Korzenik, MD
Contributor Joshua R. Korzenik, MD

Inflammatory bowel disease (IBD) includes two types of diseases: ulcerative colitis and Crohn’s disease. As the name suggests, these diseases involve inflammation in the upper (esophagus, stomach and small intestine) or lower (colon) gastrointestinal tract. IBD may be confused with irritable bowel syndrome (IBS), which shares similar symptoms but is a completely different disorder. Patients with IBS do not have inflammation in the intestines. There is no cure for IBD, but proper care and treatment can help patients minimize the symptoms and prevent complications.

1. IBD is caused by nerves.

Fact: There is no evidence that emotions or stress can cause either Crohn’s disease or ulcerative colitis. Some people confuse IBD with IBS, once known as spastic colitis, which can be triggered by stress. Though the symptoms are similar, IBD is a completely different disease, characterized by inflammation in the intestines.

2. Certain personalities are prone to IBD.

Fact: The underlying cause of IBD is biological, not emotional. About 50 years ago, it was believed that IBD was part of a group of medical disorders that were characteristic of certain personality traits and a specific biological predisposition. The latest research does not show this to be true. In fact, earlier studies have concluded that psychoanalysis actually worsened the cases of ulcerative colitis because no other treatment was offered.

3. There is nothing that can be done for IBD.

Fact: While there is no cure for IBD, a gastroenterologist who specializes in IBD can work with you to find treatments that will minimize IBD symptoms and prevent complications. Treatments may include medication, dietary changes, and/or surgery – depending on the severity of your condition.

man experiencing IBS
While there is no cure for IBD, a gastroenterologist who specializes in IBD can work with you to find treatments that will minimize symptoms and prevent complications.

4. I have both Crohn’s disease and ulcerative colitis.

Fact: You either have Crohn’s disease or ulcerative colitis. While these diseases are similar in many ways, you cannot have both at the same time. Both conditions cause inflammation of the intestines and may cause similar symptoms.

5. Surgery should be avoided.

Fact: Many IBD patients can manage their symptoms with medication and diet. For patients who cannot find relief through medication, surgery can be an effective approach. A patient with ulcerative colitis who continues to have active symptoms despite the use of medication may benefit from a surgical procedure, such as a bowel resection. Temporary diversion (temporary ostomy) is a surgical option for patients with severe, refractory perianal disease or rectal Crohn’s that may only benefit from complete bowel rest.

7. You must stop taking your medications while you are pregnant.

Fact: Caution must always be exercised when taking medication during pregnancy. However, experiencing a flare of IBD symptoms during pregnancy also can pose risks to a mother and her baby. There are limited, controlled data on the safety of drugs used to treat IBD during pregnancy; however, recently published studies suggest that there may be no increased harm in their use. Furthermore, by managing the timing of when medications are administered, exposure and risk to the fetus can be minimized. Your doctor can help you evaluate the benefits and risks of taking IBD medication during your pregnancy. If you are taking methotrexate, you must stop the medication before you become pregnant.

8. You can stop taking your medications once you feel well.

Fact: Crohn’s disease and ulcerative colitis are chronic inflammatory diseases. Symptoms typically resolve with medication. If you stop taking your medication, even if you have been in remission for several years, you will experience a disease flare again. The long-term natural course of IBD has shown high recurrence rates in those patients who stopped their medication. Even if you feel well, keep taking your medicine!

Private: Joshua R. Korzenik, MD
Joshua R. Korzenik, MD

Joshua R. Korzenik, MD, is the Director of the Crohn’s and Colitis Center at Brigham and Women’s Hospital.

Before you go,

The microbiome, nutrition and screening tests, like colonoscopies, are an important part of your overall wellness. Read more articles about digestive health.