What is Gastroenterology?
Gastroenterology is a subspecialty of internal medicine concerned with the structure, functions, diseases, and pathology of the digestive system.
There are many organizations that provide helpful info and resources related to your digestive health. Below we have included links to some of the resources that we find most useful for patients.
- American Gastroenterology Association
- American College of Gastroenterology
- American Society for Gastrointestinal Endoscopy
- American Association for Study of Liver Diseases
- American Dietetic Association
- International Foundation for Functional Gastrointestinal Disorders
About Colorectal Cancer
Learn more about colorectal cancer and help raise awareness for the disease. Below find some of our top rated articles, brochures, and fact sheets on the subject.
- Colon Cancer Alliance
- American Cancer Society
- Colorectal Cancer Network
- Visit CDC’s Colorectal Cancer Web site
- Stop Colon Cancer Now
In many instances, just getting to see what you should expect is a helpful educational process. Below you will find educational videos that describe expectations of gastroenterological procedures, as well as helpful videos to better understand GI conditions.
Associates in Gastroenterology provides healthcare for a variety of gastrointestinal conditions that may ail you. To learn more about some of the GI conditions for which we provide care, click on the links below.
- Acid Reflux Disease
- Colon Cancer
- Colonic Polyps
- Crohn's Disease
- Esophageal Spasms
- Hepatitis B
- Hepatitis C
- Irritable Bowel
- Regional Enteritis
- Ulcerative Colitis
Acid Reflux Disease
Acid reflux disease is the backward flow or regurgitation of stomach acid, contents, and occasionally bile, up into the esophagus. The most common symptom is a burning sensation behind the breastbone in the chest, also called heartburn or acid reflux. This reflux causes the lining of the esophagus to become irritated, which produces the burning discomfort. Although occasional heartburn and acid reflux are common to the majority of people (the American College of Gastroenterology estimates that over 60 million Americans experience this once per month), when it happens more frequently than twice per week or begins to disrupt daily life, then acid reflux disease may be the cause. Other symptoms include difficulty swallowing (dysphagia) and hoarseness or sore throat. This condition is also commonly called gastroesophageal reflux disease, or GERD.
Acid reflux disease is caused by frequent acid reflux, which can be the result of a number of triggers. Heartburn is common in pregnant women, although it generally resolves itself post-pregnancy. Certain types of food and drinks (tomato sauces, chocolate, peppermint, alcohol and carbonated beverages) can cause heartburn and acid reflux. Eating large, particularly fatty meals, lying down after eating, and excess weight can also be causes. Finally, certain types of medications can contribute to the condition as well.
Frequent heartburn alone can often be enough evidence to diagnose acid reflux disease. There are also tests which can be performed by your gastroenterologist in order to determine whether you are suffering from acid reflux disease. Esophageal pH monitoring measures the level of acid in your esophagus. It can also be used to determine the effectiveness of various treatment options. An upper GI X-ray, also called a barium swallow, similar to a barium enema, can be used by a gastroenterologist to view a silhouette of esophagus. An endoscopy is a more accurate means of studying the esophagus and will also allow for biopsy in order to perform tissue testing.
Certain lifestyle changes, such as eating smaller meals more frequently, avoiding certain foods which may contribute (see Overview above), exercise and maintaining a normal body weight, avoiding eating before bedtime, and even elevating the head of your bed slightly can be very helpful. Mild cases of GERD can be treated with medication and for many, over the counter antacids or acid-blocking medications will be sufficient, combined with these lifestyle changes. If heartburn persists, prescription medication may be necessary, and possibly surgery in severe cases. It is important to understand that acid reflux disease is not simply an inconvenience. Left undiagnosed and untreated, it can lead to more serious conditions such as esophageal ulcers, Barrett’s esophagus, and can greatly increase the risk of cancer.
Colon cancer, also called colorectal cancer, is a type of cancer that originates in the large intestine or the rectum. According to the American Society of Colon and Rectal Surgeons (ASCRS), 140,000 people per year in the United States are struck with colon cancer, 60,000 of whom will die from the disease. Although 90% of colon cancer patients are over the age of 40, it can occur at any age. After 40, however, the risk of getting colon cancer doubles every 10 years. Any family history of colorectal cancer or polyps, as well as a personal history of colonic polyps, ulcerative colitis, or any other type of cancer places an individual in a higher risk category. Despite all of these figures, colon cancer is potentially curable if diagnosed in its early stages, making regular screening essential.
In many cases, colon cancer will have no discernable symptoms, which is another reason that regular screening is so important in early diagnosis. Some symptoms which may indicate colorectal cancer are blood in stool, rectal bleeding, and changes in bowel habits (constipation or diarrhea). These can also indicate other gastrointestinal diseases, so a thorough screening is essential to determine the cause. Other symptoms which can indicate an advanced stage of colon cancer are abdominal pain and weight loss.
It is unclear what causes colon cancer, in most cases. As with colonic polyps, when healthy cells in the colon are altered, polyps, and ultimately, cancer can form. Nearly all colon cancer begins as benign (non-cancerous) colonic polyps, but which develop into cancer.
There are several methods for detecting colon cancer. As with colonic polyps, a barium enema can be used, as well as sigmoidoscopy and colonoscopy. Your gastroenterologist can also perform a chemical test on stool for blood. The most thorough method is the colonoscopy as it allows the entire bowel to be viewed.
There are several treatment options for colon cancer, although nearly all cases will require surgery. For the earliest stage, the cancer cells can be removed, often during a colonoscopy. Later stages will likely require more extensive surgery to remove the part of the colon that contains the cancer. Chemotherapy and radiation therapy are other treatment methods. Chemotherapy is generally recommended after surgical removal of Stage III colon cancer in order to increase the chance of complete cure. ASCRS estimates that 80%-90% of patients are restored to normal health when colon cancer is diagnosed and treated in its earliest stages.
Colonic Polyps found in the colon (also called colorectal polyps, or simply polyps) are abnormal growths found protruding from the lining of the large intestine. They can vary in size from smaller than the head of a pin, to the size of a golf ball or larger. They can be flat (sessile), or mushroom-shaped with a stalk (pedunculated). They are very common in the adult population, occurring in 15-20% of individuals, and are one of the most common conditions affecting the colon. Because these growths are generally so small, there are virtually no symptoms associated with colonic polyps. In certain instances though, bleeding, disruption in bowel function, mucous discharge, and abdominal pain may be symptoms. And although most instances are benign, certain types of colonic polyps can be directly linked to colon cancer. Generally speaking, the larger the polyp, the greater the likelihood it is cancerous.
Colonic Polyps are the result of abnormal cell growth, cell division that does not follow the orderly method of normal cell growth. If this growth occurs in the colon and rectum, colonic polyps will begin to form along the intestinal wall. The exact reason for these mutations in cell growth is unknown.
Because there are generally no symptoms, diagnosis can be made through an endoscopic exam, a virtual colonoscopy, or by x-ray of the bowel through barium enema. A colonoscopy, the endoscopic method, allows your gastroenterologist to directly examine, and remove, the colonic polyps. The virtual colonoscopy allows for accurate observation/diagnosis of colonic polyps, but removal cannot be completed at the same time. The x-ray through barium enema method is generally not as accurate in discovering abnormalities such as colonic polyps.
Because of colonic polyp’s ties to various types of colorectal cancer, the safest treatment is the removal of all discovered polyps. This ensures that the polyps can be studied to determine the nature (benign or malignant) of the polyp(s). This can be an important preventative measure for catching cancerous colonic polyps early, should the removed growths contain cancer cells.
Though never a pleasant discussion topic, constipation affects a large percentage of the population. According to the American Society of Colon and Rectal Surgeons (ASCRS), approximately 80 percent of people experience this condition at some point in their lives. Constipation can be defined as decreased frequency of bowel movements, straining in order to have a bowel movement or passing small, hard stools, the feeling that one’s bowels have not completely emptied after a movement, or the need for laxatives or enemas in order to have regular bowel movements.
Slow transit of stool (when waste from digested food moves too slowly through the digestive tract) is the most common reason for constipation. This can be caused by dehydration, a change in diet or activity and exercise levels, and certain medications can cause this slow transit. When this occurs, too much water is absorbed from the stool, causing it to dry and harden. More serious causes such as polyps, tumors, or other growths can also cause slow transit, as can areas of narrowing in the colon. For these reasons it is important to consult with a gastroenterologist in the event of constipation that is unresponsive to treatment.
There is no predetermined number of bowel movements per day or week that constitutes a constipated state, as anything ranging from three movements per day to three per week can be healthy, depending upon the individual. Knowing whether or not to see a physician can be difficult to determine. It is any lasting change in regularity, or a change in frequency of movements that indicates the need to visit a physician. While periodic episodes of constipation are not uncommon and can subside relatively quickly, persistent bouts can be indicative of more serious issues and can warrant seeking the assistance of a gastroenterologist. Alternating constipation and diarrhea can be a symptom of Irritable Bowel Syndrome (IBS). For more information on IBS, please visit here.
Treatment of constipation can be as simple as change in diet and increased exercise. This is also an important element of prevention as well, as these both play an important role in gastrointestinal health. In the event of impacted stool, laxatives or an enema may be introduced in order to remove the impaction. In certain situations, the need for further tests might be necessary to ensure that there is not an underlying gastrointestinal issue at work.
Crohn’s Disease is a type of inflammatory bowel disease (IBD) causing chronic inflammation of the lining of the bowel tract, most commonly affecting the ileum (last part of the small intestine, colon and rectum. Crohn’s is not limited to a particular age group or gender; the majority of individuals affected are between the ages of 16 and 40, both men and women equally. Symptoms of Crohn’s can be mild or severe, and may include abdominal pain (cramping), diarrhea, bloating, anal pain or drainage, fever, weight loss and reduced appetite. Other symptoms can include joint pain, skin lesions or ulcers, rectal abscess and fissure. It is estimated by the American Society of Colon and Rectal Surgeons that together, ulcerative colitis (another IBD) and Crohn’s afflict two million Americans. Another common name for Crohn’s is Regional Enteritis.
The exact cause of Crohn’s Disease is unknown, although it is believed that immune system malfunction and a bacterial infection may be at the root of its development. Studies suggest that the body’s response to particular bacteria may cause the lining of the digestive tract to become inflamed. It is also thought there is a slight genetic tendency which contributes to the likelihood that individuals who have a relative with history of Crohn’s or ulcerative colitis are more susceptible to developing it.
A diagnosis of Crohn’s Disease will generally be made after your gastroenterologist has ruled out other issues which present with similar symptoms, such as irritable bowel syndrome (IBS) and colon cancer. Procedures such as blood tests, a colonoscopy, a flexible sigmoidoscopy, barium enema, or various X-rays can be used, sometimes in combination, to diagnose Crohn’s.
Initial treatment for Crohn’s is nearly always with medication, diet, and lifestyle changes, as recommended by your gastroenterologist. The goal of any treatment is to reduce the inflammation which triggers the symptoms. Although there is no “cure” for Crohn’s, medical therapy can reduce these symptoms to bring relief and greater comfort, and often long-term remission. Corticosteroids can reduce this inflammation. In more advanced cases, surgery may be necessary. The persistence of Crohn’s symptoms and unresponsiveness to medication, abscess formation, and severe anal disease may all be indications that surgery is needed. In the event that the bowel becomes blocked, the intestine becomes perforated, or there is significant bleeding as a result of Crohn’s, emergency surgery may be needed.
Esophageal spasms are muscle contractions affecting the esophagus, often causing pain and in many cases, difficulty swallowing (dysphagia) and pain when swallowing (odynophagia). They can be characterized by sudden and severe chest pain that will generally subside after a few minutes, but is often mistaken for heart pain due to the location and squeezing sensation. Although most esophageal spasms are infrequent, some people experience them regularly, which can lead to chronic dysphagia and odynophagia. Other symptoms can be regurgitation and the feeling that something may be lodged in the throat.
Esophageal spasms generally occur one of two ways. Diffuse esophageal spasms are intermittent muscle contractions during which the regurgitation of foods or liquids also occur. The strong contractions which cause pain may be called nutcracker esophagus and most often is not accompanied by regurgitation. In either case, the cause is the involuntary contraction of the esophageal muscles.
Endoscopy and barium x-ray are two of the most effective means of diagnosing esophageal spasms. An esophageal manometry test is another method of diagnosis during which a thin tube is inserted through the nose or mouth and into the esophagus in order to assess the effectiveness of the esophageal swallowing muscles.
Treatment for esophageal spasms will depend upon severity. Occasional esophageal spasms, though they can be painful, most often dissipate relatively quickly (within a few minutes). Paying attention to activities which tend to trigger them can help to mitigate the instances of esophageal spasms. In more severe cases, however, especially when esophageal spasms interfere with eating and drinking, your doctor may prescribe medications which help to relax the swallowing muscles, pain medication, and other medications which may help control underlying causes of heartburn or GERD, as these can contribute to esophageal spasms. If none of these treatment methods help, surgery may be another option to explore with your gastroenterologist.
Gastritis is the general description given to a group of conditions which all involve inflammation of the stomach lining. It is most often associated with a bacterial infection and can be either acute, which occurs suddenly, or chronic, which will slowly develop over a period of time. The most common symptom is a persistent burning or aching pain in the upper abdominal area (indigestion). Eating may either make this pain worse or better. Other symptoms include nausea, vomiting, and a full feeling in the upper abdomen after eating. For most individuals, gastritis is not serious and can be cured easily, however, it can cause stomach ulcers and may ultimately lead to stomach cancer if more severe, or left untreated.
The weakening of the stomachs protective lining is the cause of gastritis. As this weakening worsens and the lining becomes damaged, the digestive acid in the stomach causes inflammation. There are diseases which contribute to this weakening of the stomach’s lining and may ultimately lead to gastritis. Ask your gastroenterologist about which diseases may cause this. Non-steroidal anti-inflammatory medications and alcohol have also been known to cause or contribute to gastritis.
Diagnosis of gastritis may be accomplished via endoscopy or barium x-ray in order to examine the stomach lining for inflammation, ulcers, or the early stages stomach cancer. Another test which may be performed is for the presence of Helicobacter Pylori (H. pylori), a type of bacteria present in the stomach and upper small intestine, which can cause serious stomach complications in some.
Gastritis treatment will vary based upon the cause. When caused by medication or alcohol, simply stopping usage of those substances can cause symptoms to subside. If H. pylori infection is the cause, medical treatment of the infection will be necessary through antibiotics. Gastritis treatment plans are most often accompanied by medications to help treat stomach acid as well, not only for symptomatic relief, but also to promote healing of the stomach and other damaged areas.
In general, the term hepatitis refers to inflammation or swelling of the liver. Hepatitis B is liver inflammation caused specifically by the hepatitis B virus, HBV. According to the World Health Organization, over two billion people have been infected with the hepatitis B virus, which includes an estimated 350 million individuals who are chronic carriers of the disease.
There may be no symptoms of Hepatitis B upon initial infection, however, acute viral Hepatitis B will generally present with a general feeling of sickness, loss of appetite, nausea/vomiting, body aches and mild fever, dark urine, and then may proceed to development of jaundice over the course of several weeks. Itchy skin has also been reported as a symptom, and some individuals may become very sick, which called fulminant hepatitis. This can lead to liver disease called fulminant hepatic failure, which can be fatal. If the body is able to fight the disease off symptoms should go away over a period of weeks or months.
Individuals whose bodies are unable to completely fight off the infection will have chronic Hepatitis B. They may neither display any symptoms nor appear sick in any way. Often they will not even know that they are infected. The danger is that they are able to infect others, and with chronic Hepatitis B, long term liver damage occurs, often resulting in cirrhosis of the liver. This dramatically increases incidences of liver cancer.
Hepatitis B is spread through either percutaneous (skin puncture) or mucosal contact with bodily fluids of infected individuals. These include blood, semen, vaginal fluids, or other bodily fluids. This can occur in a variety of ways, for example, direct contact with blood in a hospital or other healthcare environment, sexual contact with someone infected, infected needles (acupuncture, drug, or tattoo), the sharing of personal items like toothbrushes or razors, or birth to an infected mother.
Testing to diagnose Hepatitis B involves blood and serum tests, called assays, which detect the presence of viral antigens or antibodies. If the presence of either is detected, resulting in a positive diagnosis of Hepatitis B, a liver biopsy may be done in order to determine whether there the disease has caused liver damage.
In most cases, the body will fight off the Hepatitis B on its own (acute Hepatitis B). Ample bed rest, eating healthy foods, and drinking plenty of fluids is essential to helping the body do its work. It is also important to do blood testing during recovery to monitor and ensure that the liver is not sustaining damage.
For chronic Hepatitis B sufferers, treatment may be recommended depending upon whether or not the infection is worsening, and whether or not liver damage is occurring. Most chronic Hepatitis B patients are able to live full and active lives by monitoring their health (eating habits, exercise, etc…) and getting regular check-ups. Sufferers of acute and chronic Hepatitis B should both avoid alcohol and drugs, and in either case, liver failure may occur and a liver transplant may be necessary.
In general, the term hepatitis refers to inflammation or swelling of the liver. Hepatitis C is liver inflammation caused specifically by the hepatitis C virus, HCV. According to the Centers for Disease Control, it is the most common blood borne infection in the United States, chronically affecting approximately 3.2 million people. In time, it can lead to advanced liver scarring (cirrhosis), liver failure, or liver cancer.
Like Hepatitis B, Hepatitis C can be classified as either acute or chronic. Most Hepatitis C patients will develop chronic HCV infection, and most will neither display nor experience symptoms during the acute phase. In the instance that symptoms do appear, they are generally mild (as they are with Hepatitis B) and do not lead to a diagnosis. A general feeling of tiredness and fatigue, loss of appetite, nausea/vomiting, body aches and mild fever, dark urine, itching, joint pain and then may proceed to development of jaundice as other symptoms subside.
Individuals who develop chronic Hepatitis C (an estimated 75-85% of those infected, according to the CDC) will be asymptomatic, or exhibit no symptoms. Because of this, diagnosis often comes during blood donation screening or a routine check-up many years after the disease is contracted. This can be after severe liver damage has occurred, such as cirrhosis or liver cancer.
Hepatitis C is primarily contracted through repeated contact with infected blood. Intravenous drug use is still the most common cause in the United States. Anyone who received either blood transfusions or organ donation prior to 1992 (when advanced screening techniques were developed) may have contracted the disease this way. Inadvertent needle stick injuries in the health care setting and birth to an HCV-infected mother are common causes. Though much less frequent, it is possible to become infected through sex or the sharing of personal items like toothbrushes or razors with an HCV-infected partner.
Several blood tests are used to test for HCV infection, among them are several types of screening tests which search for antibodies to HCV, as well as qualitative tests to detect the presence of, absence of, or amount of the virus present in the blood. As with Hepatitis B, a positive diagnosis of Hepatitis C may warrant a liver biopsy in order to determine the presence of liver damage.
It is important for a specialist to evaluate and test Hepatitis C patients in order to test for chronic liver disease. The goal of any treatment for Hepatitis C is to eradicate the HCV virus from the body, stopping chronic Hepatitis C and limiting the chance of liver damage or cancer.
Many chronic Hepatitis C sufferers benefit from medical treatment with antiviral medication. Avoidance of toxic elements such as alcohol is crucial, as it is with Hepatitis B, and it is very important for Hepatitis C patients to consult their physicians prior to taking over the counter medications, vitamins, or nutritional supplements.
Irritable Bowel Syndrome is a much more common gastrointestinal disorder than many realize. It is estimated that 15-20% of the American population (approximately 55 million people) are affected by IBS. The most common symptoms are changes in bowel habits such as diarrhea, constipation, or alternating between the two. Abdominal pain, increased urgency of bowel movements, abdominal bloating, and excess gas are also common with IBS. Other names for IBS are Spastic Colon, nervous stomach, irritable colon, and Spastic Colitis.
While the general understanding is that abnormal communication between the nervous system and the muscles of the bowel is the trigger of IBS, the exact reason for this abnormal communication is not known. Sufferers of IBS tend to have heightened sensitivity in the bowel, which can manifest as irritation and create the pain, urgency, and feeling of incomplete evacuation. The miscommunication is what results in the bowel moving too quickly, causing diarrhea, or too slowly, causing constipation. While studies have shown that stress can contribute to IBS, is not a cause of the disorder. Irritable Bowel Syndrome is more often diagnosed in women, although it should be noted that it is common in men as well.
It is important to note that Irritable Bowel Syndrome (Spastic Colon) is not a life-threatening condition. It can, however, cause great pain and discomfort to its sufferers, and because there are a number of more serious disorders which affect the gastrointestinal region, IBS should be diagnosed by a board-certified gastroenterologist in order to ensure that a more serious disorder or disease is not at work.
Advances in treatment options for IBS have come a long way in recent years. As mentioned above, reduction of stress factors in one’s life can help to ease the severity of IBS. The assurance that a confirmed diagnosis of Irritable Bowel Syndrome can bring that it is not a more serious issue can help to relieve the stress brought on by the day-to-day symptoms. For mild to moderate cases, changes in diet can go a long way. Generally, meals which are high in fat, fried foods, caffeine, certain sugars, and alcohol can contribute to diarrhea, cramping, and discomfort with IBS. Keeping track of which foods bring on these symptoms and avoiding them will help. The addition of foods high in soluble fiber can help as well, although you should consult your physician on the best method of introduction of these foods to your diet. More severe cases can be managed with medication, which your gastroenterologist can prescribe.
Regional Enteritis (also known as Crohn’s Disease) is a type of inflammatory bowel disease (IBD) causing chronic inflammation of the lining of the bowel tract, most commonly affecting the ileum (last part of the small intestine, colon and rectum. Regional Enteritis is not limited to a particular age group or gender; the majority of individuals affected are between the ages of 16 and 40, both men and women equally. Symptoms can be mild or severe, and may include abdominal pain (cramping), diarrhea, bloating, anal pain or drainage, fever, weight loss and reduced appetite. Other symptoms can include joint pain, skin lesions or ulcers, rectal abscess and fissure. It is estimated by the American Society of Colon and Rectal Surgeons that together, Ulcerative Colitis (another IBD) and Regional Enteritis afflict two million Americans.
The exact cause of Regional Enteritis is unknown, although it is believed that immune system malfunction and a bacterial infection may be at the root of its development. Studies suggest that the body’s response to particular bacteria may cause the lining of the digestive tract to become inflamed. It is also thought there is a slight genetic tendency which contributes to the likelihood that individuals who have a relative with history of Regional Enteritis or ulcerative colitis are more susceptible to developing it.
A diagnosis of Regional Enteritis will generally be made after your gastroenterologist has ruled out other issues which present with similar symptoms, such as irritable bowel syndrome (IBS) and colon cancer. Procedures such as blood tests, a colonoscopy, a flexible sigmoidoscopy, barium enema, or various X-rays can be used, sometimes in combination, to diagnose Regional Enteritis.
Initial treatment for Regional Enteritis is nearly always with medication. The goal of any treatment is to reduce the inflammation which triggers the symptoms. Although there is no “cure” for Regional Enteritis, medical therapy can not only reduce these symptoms to bring relief and greater comfort, but often long-term remission. Corticosteroids can reduce this inflammation. In more advanced cases, surgery may be necessary. The persistence of Regional Enteritis symptoms and unresponsiveness to medication, abscess formation, and severe anal disease may all be indications that surgery is needed. In the event that the bowel becomes blocked, the intestine becomes perforated, or there is significant bleeding as a result of Regional Enteritis, emergency surgery may be needed.
Ulcerative colitis, along with Crohn’s Disease, is another inflammatory bowel disease (IBD). Colitis is swelling in the large intestine. Ulcerative colitis is a chronic inflammation of the digestive tract. Unlike Crohn’s disease, which can affect patches of the colon and run deep into the affected intestinal tissue, ulcerative colitis generally occurs in one continuous stretch, and only affects the innermost tissue of the colon and rectum. It appears to affect men and women equally, and can strike any age from young adulthood on. Symptoms of ulcerative colitis can include rectal bleeding, diarrhea, abdominal cramping, weight loss, and fever. As with many other gastrointestinal conditions and diseases, symptoms can range from mild to severe. Left untreated, complications can arise from ulcerative colitis, thus any of these symptoms warrant a visit to your gastroenterologist.
The exact cause of ulcerative colitis is unknown, but like Crohn’s Disease, it appears that the causes may be very similar. Although it was once thought that stress might be a main trigger, this is no longer believed to be the case. While stress may aggravate symptoms, researchers believe that causes may be due to the immune system’s attempt to fight off a virus or bacterium. Genetic predisposition is also thought to play a role.
Also like Crohn’s diagnosis for ulcerative colitis can involve various blood tests, a colonoscopy, a flexible sigmoidoscopy, barium enema, or various X-rays. Certain diagnosis can only be made after ruling out other similar gastrointestinal disorders. Upon diagnosis, your gastroenterologist may classify the ulcerative colitis based on its location within the bowel.
Another of the similarities between ulcerative colitis and Crohn’s is seen in treatment methods. Medical treatment through anti-inflammatory medications (sometimes coupled with antibiotics) is the first step in order to reduce the inflammation which triggers symptoms, with long term remission being the ultimate goal. Lifestyle and diet changes can also play a significant role in successful treatment. In more severe cases, surgery may be necessary to remove the affected portion of the bowel.