Common symptoms
- Diarrhoea lasting more than a few weeks, sometimes with blood or mucus
- Urgency and needing to go at night
- Abdominal pain or cramping
- Tiredness and fatigue
- Weight loss or reduced appetite
- Anaemia
- Mouth ulcers, joint pain, skin or eye problems
- Pain or swelling around the back passage
Conditions diagnosed and managed
- Crohn’s disease
- Ulcerative colitis
- Microscopic colitis
- Persistent intestinal inflammation
- IBD flare-ups
- Ongoing monitoring and colonoscopic surveillance
What is inflammatory bowel disease?
Inflammatory bowel disease (IBD) is the name for long-term conditions in which the immune system causes inflammation in the gut. The two main types are Crohn’s disease and ulcerative colitis. IBD is different from IBS: in IBD there is visible inflammation which, if untreated, can damage the bowel.
Crohn’s disease
Crohn’s disease can affect any part of the gut from mouth to anus, most often the end of the small bowel and the colon. Inflammation can be patchy and can involve the full thickness of the bowel wall. Symptoms vary widely depending on where it occurs.
Ulcerative colitis
Ulcerative colitis affects the lining of the large bowel (colon) and rectum, starting at the rectum and extending a variable distance upwards. Bloody diarrhoea and urgency are typical symptoms during a flare.
Microscopic colitis
Microscopic colitis causes persistent watery diarrhoea, most often in people over 50. The bowel looks normal at colonoscopy, so it can only be diagnosed by taking biopsies — which is one reason why an experienced endoscopist matters. It usually responds well to treatment.
What causes inflammatory bowel disease?
The exact cause isn’t fully understood. It is thought to involve a combination of genetic susceptibility, the immune system, the gut microbiome and environmental factors such as smoking (for Crohn’s disease). IBD often starts in young adulthood, but it can begin at any age.
How Dr Khalid investigates the problem
Diagnosing IBD, and understanding how extensive and active it is, usually involves:
- Blood tests for inflammation, anaemia and nutritional deficiencies
- Faecal calprotectin, a stool test that measures inflammation in the bowel
- A colonoscopy with biopsies — the key test for diagnosing and assessing IBD
- A gastroscopy where the upper gut may be involved
- Imaging such as MRI of the small bowel where Crohn’s disease is suspected
Treatment and management
The aim of treatment is to settle inflammation, keep the disease in remission and protect the bowel over the long term. Dr Khalid will discuss the options suited to your condition, which may include anti-inflammatory medicines, steroids for flares, immunosuppressants and, where needed, referral for advanced (biologic) therapies or surgical opinion. Long-standing colitis also needs regular surveillance colonoscopy, which is a core part of Dr Khalid’s endoscopic practice.
If you already have a diagnosis, a private consultation can also be used for a second opinion, a review of treatment that isn’t working, or a timely surveillance colonoscopy.
When should you see a gastroenterologist?
See a specialist if you have diarrhoea lasting more than four weeks, blood or mucus in your stool, or if you have IBD and your symptoms are flaring or not well controlled.
Book a private consultation at Spire Cheshire in Warrington or The Highfield Hospital in Rochdale.
When to seek urgent help
Don’t wait for a routine appointment. Call 999 or go to A&E if you have:
- Vomiting blood or material that looks like coffee grounds
- Black, tarry stools or heavy rectal bleeding
- Severe or worsening abdominal pain
- Food stuck and being unable to swallow
- Yellowing of the skin or eyes with fever or pain
Frequently asked questions
What is the difference between IBD and IBS?
IBD (Crohn’s disease and ulcerative colitis) involves visible inflammation of the bowel that can be seen at colonoscopy and measured in blood and stool tests. IBS is a functional condition affecting how the gut works, without inflammation or damage.
Can I have a private second opinion about my IBD?
Yes. Many patients seek a private consultation to review their diagnosis, discuss treatment options or arrange a timely surveillance colonoscopy.
How often do I need a colonoscopy if I have colitis?
People with long-standing ulcerative colitis or Crohn’s colitis are usually offered surveillance colonoscopy every one to five years, depending on how extensive and active their disease has been and other risk factors.
Medically reviewed by Dr Sal Khalid, Consultant Gastroenterologist. Last reviewed November 2026. This page is general information and does not replace a personal medical consultation.