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Idiopathic inflammatory bowel disease is a set of chronic inflammatory conditions resulting from in appropriate and persistent activation of the mucosal immune system, driven by the presence of normal intra luminal flora. The two disorders known as inflammatory bowel disease are Crohn's disease and Ulcerative colitis. Crohn's disease: is an idiopathic chronic IBD, characterized by transmural, non-caseating granulomatous inflammation, affecting most commonly the segment of terminal ileum and/or colon, though any part of the gastrointestinal tract may be involved. Its annual incidence in the United States is around 3 per 100,000 reported in great Britain and Scandinavia. It occurs at any age, but peak ages of detection are the second and third decades of life and a minor peak in the sixth and seventh decades. Males and females equally affected. Whites appear to develop the disease two to five times more than nonwhites. In the United States, CD occurs 3 to 5 times more often among Jews than among non-Jews. Ulcerative colitis is an ulceroinflammatory disease limited to the colon and affecting only the mucosa and submucosa except in the most severe cases. Unlike CD, UC extends in a continuous fashion proximally from the rectum. In the United States, Great Britain, and Scandinavia the incidence is about 4 to 12 per 100,000 populations, which is slightly greater than CD. As with CD, the incidence of this condition has risen in recent decades. In the United States it is more common among whites than among blacks. Incidence in Jews more than Caucasians more than African Americans, and females are affected more often than male. Most common in 20 -25 years of life, with second peak at about age of 70 years . From the current understanding, it is likely that chronic intestinal and extraintestinal inflammation in IBD is due to overly aggressive cellular immune responses to a subset of luminal bacteria, which are most likely commensal bacteria. Susceptibility to disease is thereby determined by genes encoding immune responses and a barrier triggered by environmental stimuli. In most instances, these two disorders may be readily distinguished from each other pathologically, particularly when each exhibits classic histological features. However, some patients with IBD show overlapping pathological features of UC and CD, which makes definite distinction between these two disorders difficult and often results in an diagnosis of ‘indeterminate colitis’ (IC). IBD is a systemic disease, since its clinical manifestations can affect not only the bowel but also practically any other organ (extra intestinal manifestation) includes: skin, eyes, liver, osteoarticular system, kidneys, lung and other organ. Some intestinal complications of IBD occur in both ulcerative colitis and Crohn’s disease, although they may occur more commonly in one than in the other. The most important complication is Increase risk of colorectal carcinoma in patients with long-standing IBD.
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