Luckily, after getting on treatment, I was able to get back to running. I actually ran the Boston Marathon in 2014. I had to stop six times on the course, but since I prepared myself for it, I was mostly just happy to be there. I’ve since gone on to further improve as a runner, even setting a personal best of 3 hours and 5 minutes at the 2021 California International Marathon last December.IBD doesn’t keep me from running—I’ve just learned to adapt. For example, if I’m having any kind of flare-up, I know I’m going to have to plan my route and communicate with my friends. Now that my friends all know, I can just say “We need to stop. I need to find a spot to go.” Now, it’s just something I’m used to dealing with.My doctors have always said, “Do what you can. The healthier you keep the rest of your body, the better it’s probably going to be.” They also encourage me to live my life as close to “normal” as I can. Continuing to run has helped me feel like myself and keep me doing something I love in a community I love, despite IBD.I plan the bathroom situation ahead of time.I try to always keep tabs on bathroom locations and come up with a strategy when I first go somewhere new. On that note: If you hear someone has Crohn’s or ulcerative colitis, always show them where the bathroom is. You don’t have to do it in front of everyone or make it obvious, but it means a lot to people dealing with this to have that intel. Being able to plan helped me become more comfortable with leaving the house, and could help provide peace of mind to someone who might feel inclined to turn down an invitation if they don’t have a bathroom plan in place. It can also help people be more open to being social despite the embarrassing nature of the disease.I have, unfortunately, run into situations where I’ve needed to go into a business and ask to use a bathroom and have been denied. Most of the time people are very accommodating, and I think they can see the look in my eye that it’s urgent. But sometimes, I’m still told no. In addition to deciding not to frequent those businesses in the future, it’s made me wary about running in an unfamiliar spot if I’m flaring.I connect with a community online.Reaching out to other people with Crohn’s was another thing that has been helpful for me, especially when I was flaring really bad. The Crohn’s and Colitis Foundation has a huge community of people going through the same thing as you. After sharing publicly (on social media) that I have Crohn’s, I’ve had a lot of people—be it friends of mine or people I don’t even know very well—reach out if they or their loved ones are experiencing something similar, and I love that. I’m happy to be that person for other people learning to navigate the disease.If what you’re experiencing feels isolating, the best thing you can do is reach out to someone you know, even if it’s just someone you know of, who is also dealing with it. Talking openly to people who “get it” made me feel way less isolated and, in fact, like I suddenly had a community around me of people who could relate.This interview has been edited and condensed for clarity.
The smell of poop isn’t exactly the most pleasant scent. It’s not supposed to smell good. But if the stench of your stool suddenly becomes so out-of-this-world, you may wonder, “Why does my poop smell so bad?” First, don’t panic. A stench that overpowers what’s already considered pungent must signal something is wrong, right? Not exactly.“The way poop smells can indicate a wide variety of things,” Christine Lee, MD, a gastroenterologist at Cleveland Clinic, tells SELF. Most of the time, a foul scent alone isn’t indicative of anything worrisome. But if there is an acute change in the smell of your number two that coincides with one or more symptoms like diarrhea, fever, chills, or unexplained weight loss, it could signal something more serious, Dr. Lee says.Below is everything you need to know about what can change the smell of your poop, and when a wince-worthy sniff may signal something is off.What causes foul-smelling poop?Becoming acquainted with the scent of your poop sounds less than appealing, but establishing what’s abnormal from your baseline can help determine when your bowel movements are especially rancid, Dr. Lee says. Here are some of the main causes of particularly bad-smelling poop:1. Sulfur-rich foods“The first thing you might want to do is think back to what you ate,” Dr. Lee says. “Whether it was eggs, Brussels sprouts, or tuna fish, those kinds of things can change the smell of the stool.” Foods high in sulfur (think: meats, eggs, dairy, garlic, and cruciferous veggies like broccoli)1 are more difficult to digest, according to the Cleveland Clinic. When these foods move undigested into the large intestine, sulfur-metabolizing bacteria try to break it all down. This process creates odorless hydrogen and carbon dioxide gas (and sometimes methane) as well as odorous hydrogen sulfide—which mix into your poop and add an extra stench.2. Medications, supplements, and vitaminsLike food consumption, taking some daily medications, supplements, and vitamins can cause your poop to smell particularly off, Dr. Lee says. Antibiotics, for example, strip your colon of good and bad bacteria and open up the possibility of infections like C. diff, Nipaporn Pichetshote, MD, a board-certified gastroenterologist at UCLA Health, tells SELF. This can cause uniquely foul-smelling stool. Some supplements and vitamins, like fish oil, can also result in a smellier-than-usual bowel movement, adds Dr. Lee. This is because vitamins can attach to undigested fat in your stool, causing it to stink2.3. InfectionThe next thing you want to consider is whether you might have a viral, bacterial, or parasitic infection. While a telltale sign is the accompaniment of other symptoms such as diarrhea, chills, fever, or unexpected weight loss, each infection can be identified by the unique scent of its chemical makeup of gasses. A few examples include:Giardia, which is a parasitic infection that can be acquired from swallowing contaminated water and is known for its particularly pungent odor that’s hard to describe, Dr. Lee says.Bacterial infections like Clostridium difficile, or C. diff, which can be contracted via hospital contamination and antibiotic usage, according to the Mayo Clinic. As a result, you may have sweet-smelling poop—but not in a good way. Viral infections like rotavirus, which can make poop smell foul, can be transmitted through contaminated food or if you touch a contaminated object and don’t wash your hands3.4. Dehydration“Being dehydrated increases your propensity to be constipated,” Dr. Lee says. Feces consists of about 75 percent water and 25 percent organic matter (we’re talking undigested carbohydrate, fiber, protein, and fat)4. When you’re properly hydrated, that fluid helps your poop move more easily through the digestive tract and facilitates a healthy bowel movement. When you’re in a state of dehydration, the fluids that usually help digested food pass through the intestines are absorbed by your stool instead5. “Constipated stool tends to have a different smell because it’s been in your colon for so long,” Dr. Lee says.5. Lack of fiberBy now, you may have realized that the characteristics of your poop are largely dependent on what you consume. That said, some foods better aid in digestion than others. “Fiber can work in two ways: as a bulking agent in patients who have looser stools and as an osmotic laxative in those who are constipated,” Dr. Pichetshote says. If you lack the necessary fiber to aid in bowel regulation, there’s a chance you could become constipated or experience stool that’s looser than usual.With the former, which causes your stool to sit in your colon for longer, stool can begin to further ferment or break down6 and continue to yield gas such as hydrogen, methane, and carbon dioxide that lead to greater flatulence and more foul-smelling poop7.6. MalabsorptionThe job of your small intestine is to absorb food’s nutrients (vitamins, minerals, carbs, fats, and proteins) as it makes its way through your digestive tract. In certain medical conditions like Crohn’s disease, where the small intestine lining is inflamed and sometimes damaged, nutrients may not be easily digested. Similarly, if you can’t easily absorb lactose, a sugar found in milk products, then it can remain undigested and end up in the stool, where it ferments and gets stinky, Dr. Pichetshote says.7. Inflammatory bowel diseaseInflammatory bowel disease (IBD) includes Crohn’s disease and ulcerative colitis, which are disorders that involve chronic inflammation of the digestive tract. When the digestive tract lining is inflamed (like in Crohn’s disease) and the large intestine and rectum inflame and line with sores (like in ulcerative colitis), diarrhea, rectal bleeding, abdominal pain, fatigue, and weight loss can occur, per the Mayo Clinic. These symptoms can make it difficult to eat or for your intestines to properly absorb nutrients, leading to excess fat in the stool. Poop that contains excess fat produces more gas, which makes it especially foul-smelling.8. Metabolic disordersYour metabolism serves to convert food into energy and remove toxins from the body. A metabolic disorder is when the process of either becomes disrupted and leads to a series of chain reactions. For example, in cystic fibrosis, the disruption comes in the form of thick mucus that blocks the digestive enzymes in the pancreas from reaching the small intestine, according to the Mayo Clinic. Chronic pancreatitis is another metabolic disorder that decreases the number of digestive enzymes produced, which are key in the breakdown of sugars, fats, and starches, according to Johns Hopkins Medicine. The result is malabsorption and foul-smelling stool.9. Blood in the stoolPoop that smells like metal is usually a result of blood in the stool, according to Dr. Pichetshote, who adds that the scent is often accompanied by black stool or apparent blood. If your stool is black, you’re likely having issues in your upper digestive tract, she says. If it’s bright red, the problem is probably in the lower portion, particularly the colon or rectum.
Certain aspects of having a period are talked about more frequently than others, like dealing with menstural cramps, sore boobs, and bloating. But there’s one common symptom that, for whatever reason, gets less buzz: period poop.Yup, it’s not just you—pooping habits can get weird during your period. “Many people do get bowel changes just before or during their period,” Kyle Staller, MD, a gastroenterologist at Massachusetts General Hospital, tells SELF. That includes a whole potential host of things, from period constipation to period diarrhea, with some people just pooping more than usual during that time of the month.Maybe you just happened to notice that period poop is a thing for you and are simply curious about what, exactly, is going on down there. Or maybe period poop is a problem for you and you need a solution ASAP. Either way, getting to the bottom of this (no pun intended) can go a long way toward helping you understand your body and figuring out a solution if your period poops start to interfere with your life. Here’s what you need to know about this totally normal phenomenon.What are period poops?Some people refer to changes in bowel movement that happen around their menstrual cycle as period poops. As with most other period wonkiness, you can thank hormonal fluctuations for this phenomenon. “The reason that this happens is largely due to hormones,” Dr. Staller says. That includes constipation that starts before your period and subsequent diarrhea or excessive pooping that happens once aunt Flo has actually come to town.Preperiod constipation could be a result of an increase in the hormone progesterone, which starts to increase in the time between ovulation and when you get your period.1 Progesterone can cause food to move more slowly through your intestines, backing you up in the process.But levels of progesterone plummet around the same time that your period starts.1 Simultaneously, there’s an increase in hormone-like compounds in your body called prostaglandins. The cells that make up the lining of your uterus (known as endometrial cells), produce these prostaglandins, which get released as the lining of your uterus breaks down right before and during menstruation. These chemicals cause the blood vessels and muscles in the uterus to contract. If your body has high levels of prostaglandins, they can make their way into the muscle that lines your bowels.There, they can cause your intestines to contract just like your uterus and push out fecal matter quickly, Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center, tells SELF. (Fun fact: These prostaglandins are also responsible for those painful menstrual cramps you might get every month.) This explains why you might have diarrhea or poop so much more often during your period.Of course this can all vary for different people. But if you notice you experience constipation or diarrhea right around your period like clockwork, this may be why.Back to topCan health conditions cause period poop changes?Certain health conditions like endometriosis, Crohn’s disease, irritable bowel syndrome, or ulcerative colitis, can flare up during menstruation, leading to bowel changes. For example, if you struggle with Crohn’s disease, which can often cause diarrhea, or IBS-D (a form of IBS that causes people to have diarrhea), your body’s release of prostaglandins during your period may exacerbate your condition, worsening your diarrhea. But if you suffer from IBS-C (IBS that causes people to have constipation), you may find yourself struggling even more to have a bowel movement on your period as progesterone further slows your bowels’ activity. Since ulcerative colitis can lead to both diarrhea and constipation, you might experience an uptick in either during your period.Back to topWhat does it mean if it hurts to poop during my period?There are a few potential reasons why it might hurt to poop on your period. If it’s something you notice here and there—especially if you’re dealing with a lot of diarrhea—it could be a side effect of diarrhea itself, like cramping in your stomach or even irritation around your anus from going so often, Dr. Farhadi says.
As for what causes IBD, both ulcerative colitis and Crohn’s disease happen when a person’s immune system accidentally attacks their G.I. tract, according to the NIDDK. Ulcerative colitis and Crohn’s disease are separate conditions, but they do share a few risk factors. Both diseases tend to run in families, so researchers are working to understand the connection, according to the Mayo Clinic. Both also usually start causing symptoms before a person turns 30 and are more likely to affect those of Eastern European Jewish descent.There’s also a question of how a person’s environment or lifestyle factors, like medications and diet, may cause or exacerbate both IBD and IBS.Back to topHow do you get an IBS diagnosis or an IBD diagnosis?There’s no definitive test for IBS, so doctors typically diagnose it after excluding most other potential causes. In addition to evaluating your symptoms, they may perform a host of exams to identify the problem.For example, they may order a colonoscopy or a flexible sigmoidoscopy (using a thin tube to examine your rectum and only part of your colon) to see if your gut shows signs of inflammation. IBS symptoms can also mimic an overgrowth of bacteria in your gut or parasites, so your provider might want to conduct a stool sample to check your poop for germs, according to the Mayo Clinic.Because celiac disease, an immune response to eating gluten, can cause similar symptoms, doctors may want to take a blood test to rule it out before diagnosing you with IBS, says Jill Deutsch, MD, a gastroenterologist at Yale Medicine and an assistant professor at Yale School of Medicine. Once celiac and any other conditions your doctor wants to explore are ruled out, IBS can usually be diagnosed based on your symptoms.Diagnosing IBD can be similarly time-consuming. Your doctor will likely order a range of tests to pick up on any abnormalities that could signal these conditions, including blood tests, a colonoscopy, a flexible sigmoidoscopy, or an x-ray or CT scan. They may also test your poop to see if any blood is present. According to Dr. Hanauer, doctors often look for white blood cells—which may signal inflammation in the gut—in your stool if they’re testing for inflammatory bowel disease.If your doctor suspects Crohn’s disease has affected your small intestine, they may also have you do exams like a capsule endoscopy, which involves swallowing a capsule that has a camera in it to view your intestines. An external recorder captures the images, and you’ll later poop the capsule out.Back to topWhat does IBS treatment look like vs. IBD treatment?Although IBS and IBD share commonalities, they aren’t managed in the same way. “The treatment of IBD is focused on controlling inflammation. IBS treatment is about controlling the heightened sensitivity to what’s going on in the gut,” Dr. Hanauer says.If you’re diagnosed with IBS, your doctor may recommend a range of treatment options depending on your exact symptoms, and it can take some trial and error to get it right. According to the Mayo Clinic, if you have IBS-C (which causes constipation), your doctor might suggest adding more fiber to your diet since it soaks up water as it moves through your digestive system, making your poop softer and easier to expel. They may also recommend laxatives or prescription medications that boost the amount of fluid that gets into your poop.
If anyone in your family has had colon cancer, or if you’re nearing the age of 45, you’ve probably already been told about the importance of scheduling a colonoscopy. You may even have grown tired of your doctor telling you that it’s something you need to consider.But the prospect of having your bowels explored on camera doesn’t exactly have most people running to book an appointment. According to the Centers for Disease Control and Prevention (CDC), less than half of adults in their early 50s have had a colonoscopy or any type of colorectal cancer screening.This is bad news because colorectal cancer is the second most common cause of cancer death in the United States. A colonoscopy—a procedure doctors use as a tool to diagnose and screen conditions of the colon—is particularly useful for its early diagnosis. When colon cancer is found in its early stages, the five-year survival rate is 90%, according to the American Cancer Society.Unfortunately, four out of 10 cases of colon cancer are found when cancer has already spread to other areas of the body. Rates of colon cancer are also rising significantly in younger people, according to 2020 statistics published in CA: A Cancer Journal for Clinicians.1 That’s why, beginning in 2016, the American Cancer Society recommends anyone with average risk to start screening for colon cancer at age 45, or sometimes earlier depending on personal health history.Colon cancer isn’t the only condition that a colonoscopy can catch, though. Ulcerative colitis and Crohn’s disease, both autoimmune conditions that fall under the umbrella of inflammatory bowel disease (IBD), can be detected with this test. If you’ve already been diagnosed with one of these conditions, you do have an increased risk of colon cancer, so getting regular screenings is especially important, according to a 2018 study published in the journal Clinics of Colon and Rectal Surgery.2SELF spoke with doctors who perform colonoscopies to give us the details on what they wish people knew about this potentially life-saving screening procedure.What is a colonoscopy, exactly?A colonoscopy basically is what it sounds like: a camera (scope) on a flexible rod explores your large and small intestine, looking for inflammation and pre-cancerous lesions called polyps that can grow on your intestinal walls, Matthew Bechtold, MD, a practicing gastroenterologist and professor of clinical medicine at the University of Missouri, tells SELF.“The whole idea of screening is to prevent colon cancer from forming,” Dr. Bechtold says. “With screening, you can go in and take out these polyps or growths. Those polyps would otherwise likely grow into colon cancer over five to 15 years. So that’s why we want to go in there, find them, and take them out before they even have a chance of becoming colon cancer.”If a polyp is spotted during the course of a colonoscopy, it gets removed and retrieved for further testing. If you do have one (or a few) removed, don’t worry. Polyps are common, and many found during a colonoscopy are later determined to be benign, according to a 2016 study published in the World Journal of Gastroenterology.3Colonoscopies are also the go-to diagnostic test for conditions that affect your lower bowel, including Crohn’s disease, ulcerative colitis, and others. Your doctor might take a biopsy—remove a small piece of tissue—in your colon, which will then be looked at closely in a lab. They’ll check for signs of inflammation or changes associated with IBD.Back to topWhen should you get a colonoscopy?The answer varies, but in general, if you are considered “average” risk of colon cancer—that is, you don’t have a history of bowel disease, a family history, or symptoms of concern, such as abdominal pain—it is advised that you get your first colonoscopy at or around age 45, says Keri Pinnock, MD, a gastroenterologist at Austin Regional Clinic in Texas.Dr. Pinnock adds that if you have a history of colon cancer in your immediate family—that means a parent or sibling—you may be recommended to start getting screened earlier. “If your family member was diagnosed before 60, the guidelines are that you are recommended to have a colonoscopy at age 40 or ten years prior to the age that that family member was diagnosed with colon cancer, whichever is sooner,” she says.
If you’re a fan of linguistics, you might know that the word “colitis” can refer to any type of inflammatory reaction that happens in your colon. “Pan” is simply a descriptor used to refer to an organ in its entirety. When you put it all together, “pancolitis” is chronic inflammation that impacts your entire colon, or large intestine. One of the main causes of pancolitis is ulcerative colitis (U.C.). Sometimes you’ll see this term used to describe advanced U.C. that affects—you guessed it—the entire colon, but U.C. isn’t the only condition that can lead to pancolitis.Ulcerative colitis is a type of inflammatory bowel disease (IBD), along with Crohn’s disease, that causes inflammation in the lining of your colon. It’s autoimmune-related (meaning your immune system attacks cells in your colon) and can cause tough-to-deal-with symptoms like bloody diarrhea, abdominal cramps, and unintentional weight loss.When ulcerative colitis does affect your entire colon, pain and other symptoms can be quite severe—you may even run a fever. If the inflammation isn’t managed, it can even increase your chances of developing complications. Non-ulcerative colitis causes of pancolitis include bacterial infection, medications, and other problems with blood supply to the colon (more on this later).If you’ve been recently diagnosed with pancolitis or if you’re concerned that you may have this condition, you probably have a lot of questions. We spoke with two gastroenterologists to get answers about pancolitis diagnosis, symptoms, treatment options, and more.First, let’s talk about the digestive system.Because pancolitis is a term that involves where inflammation is happening in the digestive tract, it’s pretty important to understand what that means in terms of anatomy. Here’s a quick refresher: First up is your mouth, throat, esophagus, and stomach, all of which enable you to eat, swallow, and begin to break down your food. (You’re probably pretty familiar with these).Next comes the small intestine, which further digests your food, and helps absorb nutrients and vitamins into your bloodstream. The small intestine then delivers what remains of your food into your large intestine, also called your bowel or colon. When a stool is ready to be released, it makes its descent into the sigmoid colon (the lowest, S-shaped portion of your bowel) and makes its exit through your rectum, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).The colon is where people with ulcerative colitis can run into some digestive trouble. The colon’s lining is called its epithelium, and it regenerates and repairs itself constantly. The colon’s epithelium absorbs nutrients as it creates the waste product we know as stool, feces, or its most popular name “poop.” When the epithelium becomes inflamed (whether due to IBD, bacterial infection, or other issues), the colon can’t complete the absorption process normally (cue the diarrhea).1Back to topHow is pancolitis connected to ulcerative colitis?To understand pancolitis as it relates to ulcerative colitis, we have to see where it lands on the “spectrum of disease,” David Schwimmer, MD, a gastroenterologist in Sarasota, Florida, tells SELF. Ulcerative colitis is a general diagnostic term for chronic, inflammatory bowel disease affecting your colon. Here’s a quick breakdown of the different types, according to the Mayo Clinic:Ulcerative proctitis: This is the mildest form of ulcerative colitis, which Dr. Schwimmer explains is inflammation that only affects your rectum, the few inches closest to your anus. Rectal bleeding may be the only symptom you experience.Proctosigmoiditis: This is inflammation that affects both the rectum and the sigmoid colon, which is the lower end of the colon. This is where you may start to get those classic symptoms of ulcerative colitis, like bloody diarrhea, abdominal cramps, and an urge that you have to go now.Left-sided colitis: In this scenario, the inflammation affects everything from the rectum to the descending colon on the left side of your body. In addition to the previously mentioned symptoms, you may feel pain specifically on the left side of your abdomen.Pancolitis: This is where the inflammation impacts your entire colon lining, and in addition to having more severe symptoms, you may also have fatigue and unintentional weight loss.
Digestive troubles, for many people, top the list of symptoms that are straight-up miserable to live with. After all, who wants to feel constantly gassy or bloated while running to the bathroom left and right? Not only can these symptoms feel uncomfortable (or even downright painful), they can seriously impact how you feel about yourself and the way you live your daily life. If you’re not sure what’s going on, don’t fret. Oftentimes, there is a simple explanation for gastrointestinal (GI) issues. But if they’re starting to feel constant, it’s worth exploring whether something more complicated could be lingering under the surface. Take this quiz to find out what might be causing your stomach problems, and when you should consider seeing a doctor about them—because you deserve to feel good in your body.
Pooping is a natural and essential bodily function. Everybody poops—no matter your location, socioeconomic status, or delicate sensibilities. Unfortunately, something that is supposed to be second nature can also sometimes be super difficult. So if you’ve ever found yourself straining to poop, you are definitely not alone.“Almost everyone experiences the feeling of having a hard time having a bowel movement,” Alex Sherman, MD, board-certified gastroenterologist at Vanguard Gastroenterology and a clinical professor at NYU Grossman School of Medicine, tells SELF.While that piece of information won’t exactly make you feel better when you’re stuck on the toilet, it should reassure you that straining to poop isn’t necessarily concerning. In fact, if it happens every once in a while, you’re likely okay and things can often be resolved with something as simple as increasing the fiber intake in your diet.But if you find yourself straining to poop frequently, that could potentially signal an underlying issue that needs your attention, Dr. Sherman says. Want to find out why it hurts to poop—and what to do about it? We turned to top docs for the answers to all your poop questions.First, let’s talk about why you’re straining to poop.“Someone sits down and they are trying to push, push, push—that’s really what straining is,” Felice Schnoll-Sussman, MD, professor of clinical medicine and director of the Jay Monahan Center for Gastrointestinal Health at Weill Cornell Medicine, tells SELF. People can strain to poop for all sorts of reasons, but constipation is really the main cause of this. By definition, constipation symptoms include passing hard, dry stools, having fewer than three bowel movements a week, or feeling like you haven’t really gotten everything out (if you know what we mean), according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).It’s important to understand that people poop at different frequencies, so pooping less than three times a week doesn’t always mean you’re constipated. For example, one person may poop twice a week for as long as they can remember and feel completely fine. “There is no rulebook for how often someone should go to the bathroom,” Dr. Schnoll-Sussman says. “The only time we are concerned is when there is a significant change for you.” If you’re frustrated because it feels impossible to poop and nothing comes out, then that’s also a problem. So, then, what causes constipation? A number of things, but dietary habits are a big contributor to this particular problem, Shilpa Ravella, MD, assistant professor of medicine at Columbia University Medical Center, tells SELF. “I see a lot of patients coming in who have way too little fiber in their diets. That can lead to hard stools and constipation that can cause people to strain a lot when they go to the bathroom,” Dr. Ravella says.That’s why constipation treatment typically includes eating more fiber-rich food, which adds weight to your stool and helps it stay soft, making it easier to pass. Drinking more fluids than you’re currently getting and increasing your physical activity can also help move stool through your digestive tract, according to Johns Hopkins Medicine.Some medications, including things like blood pressure drugs, opioids, antacids, and antidepressants, can also cause constipation, according to Dr. Ravella. And finally, constipation can be a symptom of certain medical conditions like irritable bowel syndrome (IBS) and celiac disease.Your body mechanics might also explain why you’re straining to poop. There are two sphincter muscles in the rectum (the inner and the outer sphincter) that assist with bowel movements.1 The inner sphincter is controlled involuntarily, meaning your brain tells that muscle it’s time to relax (so you can poop) when your rectum is full. Your outer sphincter is a muscle that you knowingly control. And some people may not have good control over the outer sphincter, so they tense their muscles, holding poop in when they should really be relaxing that muscle to let poop out.2 This can make you feel like you’ve never really emptied everything in your bowels.
Back to topWhat are the differences between ulcerative colitis symptoms and Crohn’s symptoms?Another way these sister diseases like to mimic each other is in their symptoms. According to the Centers for Disease Control and Prevention (CDC), both ulcerative colitis symptoms and Crohn’s disease symptoms include:Bloody diarrheaRectal bleedingsBowel movement urgencyAbdominal painUnintended weight lossFatigueThe severity of these symptoms varies widely, but none of them are exactly pleasant. The good thing about bloody diarrhea (never thought we’d say that phrase, but here we are) is that it can be alarming enough that it forces a trip to the doctor. And it should, says Dr. Balzora. “Blood in the stool is never normal,” she warns. “That really should prompt a visit and discussion with your physician.”It might also help to open dialogue with your family, she says. “You’ll need to assess your medical history with your family. That’s a very taboo topic for certain cultures, but it can prompt earlier, more aggressive treatment that would otherwise be missed.”Back to topHow are ulcerative colitis and Crohn’s disease diagnosed?If you’re looking for one easy test that will definitively tell you whether you have ulcerative colitis or Crohn’s, you might be disappointed. Getting an ulcerative colitis diagnosis or a Crohn’s disease diagnosis is a process that involves multiple tests and factoring in your unique symptoms. “There’s not that one signature test,” says Dr. Balzora. “So when we meet somebody and there’s a suspicion for the disease, it’s really just a matter of the story they tell us, their age, and their family history because it does run in families. There are other things that might be ruled out right like an infection or cancer with a colonoscopy (a procedure in which a doctor looks in your colon with a scope),” she explains.Other ulcerative colitis and Crohn’s disease tests can include an upper endoscopy, where a doctor will use a scope to look inside your stomach and the first part of the small intestine. They may also take a biopsy (a small piece of tissue) from one of these tests that they will then study in the lab for signs of inflammation or cancer. Imaging tests, like MRIs and CT scans, can also help give your doctor information about what’s going on in your digestive tract.“Sometimes we do something called a video capsule which is basically a pill that you swallow that has a camera inside and allows us to look at the small intestine,” says Dr. Balzora. Finally, blood tests may be able to show whether certain inflammatory markers that are consistent with IBD are present in your blood.Basically, getting a Crohn’s disease or ulcerative colitis diagnosis can be challenging, but it’s an important first step to finding the right treatment, and one that could put you on the road to remission (a period of time when your symptoms disappear).Back to topUlcerative colitis treatments vs. Crohn’s disease treatmentsWhile there is no cure for ulcerative colitis or Crohn’s disease at the moment, don’t despair, research is moving quickly. “There has been such a rapid advancement in the different options that are available now compared to 10 or 20 years ago,” says Dr. Blazora.Those advancements include things like anti-inflammatory medications, immunosuppressants (to calm down the immune activity in the body), and biologics—these are injected or received via infusion—which are the newest class of medications that work to neutralize certain proteins that activate inflammation, according to the Mayo Clinic.
Immunomodulators can take up to three months to start working, however, so your doctor might recommend a steroid alongside one while you wait for it to take effect. These are most commonly taken as a pill.BiologicsBiologics are a class of drugs that target the specific proteins in the immune system that are involved with creating inflammation, according to the NIDDK. Biologics are a newer type of medication and are recommended for people with moderate to severe Crohn’s disease. Further, there are numerous types of biologics available and they all target different proteins, so if one doesn’t work for you, then there are others you can try. “Generally, biologics are the most effective treatment,” Dr. Higgins says. Some biologics can be self-injected at home, while others are given as an intravenous infusion at an outpatient treatment center.AntibioticsAntibiotics, which are usually available in tablet or liquid form, aren’t used to reduce bodily inflammation, but they may be given alongside other medications to help treat or prevent specific complications. For example, Crohn’s disease inflammation can cause pockets of pus called abscesses, and antibiotics can help these heal, according to the Mayo Clinic.SupplementsMalnutrition is a potential side effect of Crohn’s disease and more than half of people with IBD wind up with a nutrient deficiency5, as damage to your digestive tract can impact how well your body absorbs essential vitamins and minerals. Plus, many people with Crohn’s disease may have trouble eating regularly, possibly leading to both unintentional weight loss and nutrient gaps.People with Crohn’s disease most commonly deal with low levels of iron, vitamins B1, B6, or B12, vitamin D, vitamin K, folic acid, selenium, or zinc. To diagnose you with a deficiency, your doctor will take a close look at your symptoms and order blood tests to see exactly what you’re not getting enough of and the best way to go about supplementing your diet. For example, iron-deficiency anemia is extremely common in people with Crohn’s disease, so your doctor might suggest an IV iron treatment,6 which can take effect more quickly than iron tablets.It’s crucial to talk to your doctor before taking any supplements, because some oral supplements may irritate your stomach and worsen your symptoms7. Plus, you want to make sure you aren’t getting too much (or not enough) of a particular nutrient.Back to topWhat is bowel rest treatment?If your symptoms become especially difficult to manage, you might opt for bowel rest, and it is exactly what it sounds like: letting your bowel rest so that it’s encouraged to heal, according to the NIDDK. “Bowel rest is sometimes recommended for hospitalized individuals with severe Crohn’s disease,” Dr. Lebwohl says.Typically, bowel rest is done in preparation for surgery, or as a way to reign in severe symptoms when medications aren’t helping. During bowel rest, you will not be able to consume regular foods or drinks in a medically supervised setting—meaning you should never attempt to do this on your own. You’ll receive nutrition one of three ways: by drinking a special liquid, through a feeding tube (enteral nutrition), or through an IV (parenteral nutrition). This can last for anywhere from a few days to a few weeks.