What Is Inflammatory Bowel Disease?
Inflammatory bowel disease (IBD) is a chronic, immune-mediated condition causing persistent inflammation of the gastrointestinal tract. The two main forms are Crohn's disease, which can affect any part of the GI tract from mouth to anus, and ulcerative colitis (UC), which is confined to the colon and rectum. IBD is a lifelong condition requiring expert management to control inflammation, prevent complications, and maintain quality of life. While historically more prevalent in Western countries, IBD incidence is rising rapidly across Asia, including China. Ruijin Hospital's gastroenterology department is one of China's leading IBD centers.
Symptoms
Crohn's Disease:
- Persistent diarrhea, often with blood or mucus
- Abdominal pain and cramping, typically in the lower right abdomen
- Fatigue and unexplained weight loss
- Fever during flares
- Perianal disease — fistulas, abscesses, skin tags
- Mouth sores (aphthous ulcers)
- Extraintestinal manifestations — joint pain, eye inflammation, skin lesions
Ulcerative Colitis:
- Bloody diarrhea — the hallmark symptom
- Urgent need to defecate and tenesmus (feeling of incomplete evacuation)
- Abdominal cramping and pain
- Fatigue and anemia
- Weight loss during active disease
- Extraintestinal manifestations — primary sclerosing cholangitis, arthritis, uveitis
Causes & Risk Factors
- Immune dysregulation — an abnormal immune response to gut bacteria in genetically susceptible individuals
- Genetic predisposition — over 200 genetic loci associated with IBD risk
- Gut microbiome imbalance (dysbiosis)
- Environmental triggers — Westernized diet, antibiotic use, smoking (Crohn's), urban lifestyle
- Family history of IBD
- Prior GI infections
Diagnosis
IBD diagnosis requires a combination of clinical, endoscopic, histological, and imaging assessments:
- Colonoscopy with biopsy — the cornerstone of IBD diagnosis; allows direct visualization and tissue sampling
- Upper GI endoscopy — for Crohn's disease affecting the upper GI tract
- MRI enterography (MRE) — gold standard for assessing small bowel Crohn's disease and perianal fistulas
- CT enterography — for rapid assessment of complications such as obstruction or abscess
- Fecal calprotectin — a non-invasive biomarker of intestinal inflammation
- CRP and ESR — systemic inflammatory markers
- Capsule endoscopy — for small bowel Crohn's not visible on standard endoscopy
- Therapeutic drug monitoring (TDM) — to optimize biologic therapy dosing
Treatment Options
Ruijin Hospital's IBD center offers a comprehensive, multidisciplinary approach to IBD management:
- Aminosalicylates (5-ASA) — Mesalazine for mild-to-moderate ulcerative colitis
- Corticosteroids — for induction of remission during acute flares
- Immunomodulators — Azathioprine, 6-mercaptopurine, Methotrexate for maintenance therapy
- Anti-TNF biologics — Infliximab (Remicade), Adalimumab (Humira) for moderate-to-severe IBD; highly effective for both Crohn's and UC
- Anti-integrin therapy — Vedolizumab (Entyvio) for gut-selective immunosuppression
- Anti-IL-12/23 therapy — Ustekinumab (Stelara) for Crohn's disease
- JAK inhibitors — Tofacitinib, Upadacitinib for ulcerative colitis
- Exclusive enteral nutrition (EEN) — particularly effective for pediatric Crohn's disease
- Surgery — colectomy for refractory UC or dysplasia; bowel resection, strictureplasty, or fistula repair for Crohn's complications
- Fecal microbiota transplantation (FMT) — emerging therapy being studied in IBD
Why Treat IBD in Shanghai?
- Ruijin Hospital has one of China's most experienced dedicated IBD centers, with multidisciplinary teams including gastroenterologists, colorectal surgeons, radiologists, and nutritionists
- Access to the full range of biologic therapies at significantly lower cost than in Western countries — often 50–70% less expensive
- Expertise in complex perianal Crohn's disease management, combining medical and surgical approaches
- Therapeutic drug monitoring to optimize biologic dosing and prevent treatment failure
- Participation in international IBD clinical trials for novel therapies
Our Specialist
Professor Yuan Yaozong (袁耀宗) — Chief of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Professor Yuan is one of China's foremost gastroenterologists, with particular expertise in inflammatory bowel disease, pancreatic disease, and advanced endoscopy. He leads a nationally recognized IBD program and has contributed extensively to Chinese IBD clinical guidelines.
How CMCS Can Help
Managing IBD in a foreign country can be challenging, especially when navigating complex biologic therapies and specialist care. China Medical Concierge Shanghai (CMCS) provides comprehensive support — from reviewing your medical records and endoscopy reports, to arranging specialist consultations at Ruijin Hospital, coordinating diagnostic workup, facilitating biologic therapy access, providing medical interpretation, and supporting long-term disease management and follow-up.
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