IBD Medical Terms

When you get diagnosed with Crohn’s Disease or Colitis it can be very daunting especially with all the medical terms that is used.  These medical terms can be very scary and put you off going to see your IBD team if you do not know what they are talking about.  Here are the most of the medical terms so it makes it less daunting for you when you go to speak to your IBD team:

 A

• Abdomen – the part of the body containing the digestive organs including the pancreas and gall bladder.
• Abscess – a pus filled are that becomes red, swollen and painful.  Abscesses may form in the abdomen or in the anal and rectal area.
• Acid reflux (heartburn) – the burning sensation usually felt in your chest when the stomach acid flows up the oesophagus.
• Acute (illness) – beginning suddenly and often severe but only lasts a short period of time.
• Adalimumab (Humira) – an anti-TNF drug used to treat IBD.
• Adhesions – bands of scar tissue (usually a result of surgery).
• Aetiology – the medical cause(s) of disease.
• Aminosalicylic acid (5-ASA) – a type of drug used to reduce inflammation in IBD.  Types include balsalazide, mesalazine, olsalazine and sulphasalazine.
• Anaemia – reduced numbers of red blood cells.  This results in tiredness and shortness of breath.  Anaemia may be due to blood loss and/or poor intake or absorption of vitamins or iron.
• Anal fissure – a crack or split in the skin area the anus, which is often extremely painful and may cause bleeding.
• Anal sphincter – the ring of muscle surrounding the anal canal which controls the opening and closing of the anus.
• Analgesic – a type of drug used for pain relief e.g. paracetamol.
• Anastomosis – the surgical joining two ends of bowel together after cutting out a diseased part.
• Ankylosing spondylitis – a chronic inflammatory disease of the spine and adjacent joints.  It causes stiffness in the spine, neck, hips and ribcage.  This can occur in anyone with an IBD.
• Antibiotics – drugs used to fight bacterial infections such as, abscesses and fistulas.
• Antibodies – proteins in the blood that destroy or neutralise antigens.
• Anti-diarrhoeas’ – medicine to slow down the contractions in the gut and allows more water to be absorbed so the stools become firmer.
• Antigen – a substance such as a virus or bacterium which the immune system recognises as ‘foreign’.
• Anti-spasmodic – a drug used to reduce painful spasms in the gut such as, colofac and buscopan.
• Anti-TNF drugs – a type of drug used to treat IBD.  Also known as biologics.  They work by blocking the effects of TNF-alpha which is an inflammatory substance in the blood produced in excessive amounts in people with an IBD.
• Anus – the opening at the lower end of the gastrointestinal tract at the end of the rectum.
• Appendix – a narrow tube like pouch attached to the caecum.
• Arthritis – inflammation of a joint causing pain, swelling and stiffness.
• Azathioprine (Imuran) – an immunosuppressant drug used to treat IBD.

    B

• Bacteria – minute organisms that exist in the environment and in our body.  Some are harmless and others can cause infection.  There are also some that can be helpful and aid digestion and destroy harmful organisms.
• Balsalazine (Colazide) – a 5-ASA drug used to treat IBD specifically in the colon.
• Barium enema- a type of investigation used to examine the colon.  A white liquid is inserted in the anus to coat the bowel lining and this helps give a clear x-ray image of the bowel.
• Barium meal and follow through – a test in which liquid barium is in a drink.  It is used to help clarify the outline of the oesophagus, stomach and small intestine in an x-ray.
• Beclomethasone dipropionate [BDP] (Clipper) – a steroid used often used for a short period of time in a combination with a 5-ASA drug to treat UC.
• Bile – a thick, bitter, greenish-yellow/brown fluid produced by the liver and stored in the gall bladder.  It helps digest fats in the small intestine.
• Biologic – also known as anti-TNF drugs.
• Biopsy – a small piece of tissue taken from the body for examination.
• Bowels – also known as the intestines.
• Breath tests – a simple breath test that measure chemicals in the breath.  It helps to find abnormalities in the intestines such as lactose intolerance.
• Budesonide (Entocort/Budenofalk) – a corticosteroid which is used to reduce the inflammation in the intestine.
• Bulking agents – these help to absorb water and swell up inside the bowel to soften hard stools or thicken liquid stools.
• Bypass – a surgery to re-route the intestine.
  C
• Caecum – the first section of the colon which is located in the lower right abdomen.
• Capsule endoscopy – a small capsule containing a tiny camera which is swallowed.  As it passes through the intestinal tract it takes photographs which are transmitted to a data recorder worn by the patient.  The capsule should pass out of the body naturally in a bowel movement.
• Colestyramine (Questran) – a drug used to treat certain types of diarrhoea in Crohn’s disease.  It absorbs the bile acids produced by the liver which can cause diarrhoea.  This is most likely to happen if the ileum is affected or removed due to Crohn’s Disease.
• Chromoendoscopy – a type of endoscopy with a special dye spray to improve the detection of abnormal cells in people who have longstanding IBD.
• Chronic (illness) – an illness that is ongoing or continues for a long time usually months or years.
• Ciclosporin (Sandimmum/Neoral) – an immunosuppressant used to treat severe UC.
• Ciprofloxacin (Ciproxin) – and antibiotic drug sometimes used to treat Crohn’s Disease.
• Clinical (research) trial – a study to investigate a treatment or test which could lead to improvements in IBD management.
• Cobblestoning – the characteristic appearance of the bowel lining seen in Crohn’s Disease that looks like cobblestones.
• Codeine phosphate – a painkiller which is also used to help control diarrhoea.
• Colectomy – surgery to remove the colon.
• Colitis – inflammation of the colon.
• Collagenous colitis – a form of Microscopic colitis where the lining develops a thicker layer of collagen (protein) than normal.
• Colon – also known as the large intestine.  The main function of the colon is to absorb water from undigested food waste to form a stool.
• Colonoscopy – a narrow tube with a camera on the tip sometimes called a colonoscope which is inserted through the anus to look at the rectum, colon and terminal ileum.
• Colostomy – an operation in which a cut end of the colon and is brought through the abdominal wall to create an opening called a stoma.  The digestive waste is then collected in a bag which is fitted over the opening and attached to the skin.  This may be temporary or permanent.
• Constipation – the reduction in number of bowel movements.  The stools can be hard, dry and lumpy and can also be painful to pass.
• Continent ileostomy – an operation to create an internal pouch out of the ileum.  Food waste then collects in the pouch instead of passing through the colon.  The pouch is emptied regularly with a small tube which is inserted in an opening in the abdomen and there is no need for an external bag.
• Corticosteroids (steroids) – a group of hormones used as a drug treatment to control IBD.  These include prednisolone, budesonide and hydrocortisone.
• Crohn’s Colitis – Crohn’s disease of the colon.
• Crohn’s Disease – an inflammatory bowel disease which can affect any part of the digestive system from the mouth to the anus.  All the layers of the lining in the bowel may become sore and inflamed.
• CRP (C-reactive protein) – a blood test which measures a protein to check for active inflammation.
• CT (Computerised tomography) scan – a special x-ray test that uses a computer to produce pictures as slices or cross sections of the body.
  D
• Defecation – the act of passing stools.
• Dehydration – a condition caused by lack of water.  It occurs when you lose too much liquid from the body through vomiting, diarrhoea or not drinking enough fluids.
• DEXA (dual energy x-ray absorptiometry) scan – a special scan that measures the density of bones to assess bone thinning and the risk of possible fractures.
• Diarrhoea – frequent and urgent passing of loose stools.  It is usually defined as passing such stools 3 or more times in a day.
• Dietitian – someone who is specially trained and qualified to advised people about a healthy diet.
• Dilated – widened.
• Distal or left-sided colitis – inflammation that extends up the left side of the colon but not into the top or right side.
• Distension – an uncomfortable feeling in the abdomen which is often caused by excess gas or fluid in the intestine.
• Diverticular disease – a common condition which forms small bulges or pouches (diverticula) in the wall of the colon.  If these pouches become inflamed or infected this condition is called diverticulitis.
• Double balloon enteroscopy (DBE) – a special endoscope with two small balloons attached to the tip to help it reach further into the small intestine.
• Duodenum – the first part of the small intestine.
• Dysplasia – a change in the size, shape and pattern of cells in the lining of the gastrointestinal tract which may indicate the possible development of cancer.
  E
• Electrolytes – salts in the bloods such as, sodium; potassium and calcium.
• Endoscopy – an examination of the inside of the body using a tube with a camera on its tip which can be inserted through the mouth or the anus.
• Enema – a liquid or foam inserted into the large bowel through the anus for diagnosis or treatment.
• Enteral nutrition – a way of providing extra or total nutrition.  A special designed, easily digestible but highly nutritional liquid food is taken by mouth or passed into the stomach through a nasogastric (NG) tube.
• Enteritis – inflammation of the small intestine.
• Episcleritis – inflammation of the episclera (white part of the eye).
• Erythema nodosum – red, tender swellings occasionally seen on the shins and lower legs when the IBD is in a flare up.
• ESR (erythrocyte sedimentation rate) – a blood test to measure inflammation in the body.
• Exacerbation – worsening of symptoms or an increase in the activity of the disease.  Also known as relapse or flare up.
• Extra-intestinal manifestations – other symptoms outside of the digestive system which may appear as part of your IBD e.g. erythema nodosum.
  F
• Faecal calprotectin – specific proteins found in the stool. Increased levels can be signs of active inflammation.
• Faecal transplant – a procedure aimed at restoring a healthy balance of bacteria on the gut.  It is when a healthy donor’s faeces is put into the recipient’s gut.
• Faeces (stools or motions) – waste matter passed through the anus or stoma.
• Fatigue – persistent physical or mental exhaustion that is more than the normal sleepiness.
• FBC (full blood count) – a blood test used to measure red blood cells, white blood cells and platelet count.  Also used to detect inflammation and anaemia.
• Ferritin test – a blood test used to measure iron levels in the body.
• Fistula – an abnormal channel connecting 2 loops of intestine or the intestine to another organ or the skin.
• Flare up – a relapse or exacerbation of a medical condition.
• Flatus – gas from the stomach or bowls let out through the rectum or stoma.
• Folic acid (folate) – a vitamin that is essential for forming red blood cells especially during times of growth and cell division, such as infancy and pregnancy.  This lack of this vitamin is resulted from a poor diet or poor absorption in the small intestine.
• Fulminant colitis – a very intense and severe form of colitis which can happen suddenly.
  G
• Gastroenterologist – a doctor specially trained in the diagnosis and treatment of intestinal disorders.
• Gastroscopy – an examination using a tube with a camera on its tip of the stomach, duodenum and oesophagus.
• Genetics – a branch of science that examines how you inherit physical and behavioural characteristics from your parents including medical conditions.
• Generic medicine – a term referring to the active ingredient of the medicine rather than the brand name it is sold under e.g. mesalazine.
• Granuloma (granulomata) – a round mass of non-cancerous inflammatory cells that can be found in the wall of the intestine in patients with Crohn’s Disease.
• Gut – another name for the digestive system or gastrointestinal tract.
  H
• Haemoglobin – a substance in the red blood cells that carries oxygen around the body.
• Haemorrhoids – swollen veins in or around the anus which can bleed easily and become painful.  Also known as piles.
• Hepatic flexure – the part of the colon where the ascending and the transverse colon meet.
• Hydrocortisone – a corticosteroid drug used to reduce inflammation.
  I
• IBD – Inflammatory bowel disease.
• IBD nurse – a nurse of the IBD with specialist training and knowledge of IBD who can provide support for people with IBD.
• IBD unclassified (IBDU) – also known as indeterminate colitis, colitis of uncertain type or etiology (CUTE).  Can also be used if it is unclear whether you have UC or Crohn’s disease.
• IBS (irritable Bowel Syndrome) – sometimes confused with IBD but is a separate and different condition.  Has similar symptoms but IBS does not cause inflammation or bleeding of the bowel.
• Ileal pouch-anal anastomosis (IPAA) – an operation to create an internal pouch after the removal of the colon.  The pouch is made from the ileum and attached to the anus so you can pass stools the usual way.  Also known as restorative protocolectomy or j pouch.
• Ileocecal valve – a valve at the joining of the small and large intestines that prevents food residue flowing back into the ileum from the colon.
• Ileorectal anastomosis – an operation for IBD after the removal of the colon.  The end of the ileum is attached to the rectum.
• Ileostomy – an operation in which the cut end of the ileum is brought through the abdominal wall to create an opening called a stoma.  The stoma is then fitted with a bag which is attached to the skin to collect digestive waste.  This may be temporary or permanent.
• Ileum – the lower part of the small intestine which joins the colon at the ileocecal valve.  Inflammation here is known as ileitis.
• Immune system – the body’s defence system.  It is made up of different types of tissues and cells that is used to protect the body against infectious or other harmful organisms which may cause diseases.
• Immunology – this is the study of the body’s immune system.
• Immunosuppressants (immunomodulators) – drugs that reduce inflammation over long periods of time (years rather than months), such as azathioprine.
• Incontinence – unintentional passing or leaking of stools and/or urine.
• Inflammation – the way the body responds to irritation, infection or another injury.  Blood collects in the affected areas, causing reddening, swelling and pain.
• Infliximab – also known as Remicade.
• Infusion – a procedure to inject a liquid directly into the blood stream.  This could be blood or a liquid drug such as, infliximab.  The fluid flows from a sterile bag through a plastic tube through a small needle into a vein.
• Intramuscular – into a muscle.
• Intravenously (IV) – into a vein.
• Iritis – painful inflammation of the eyes which can be experienced by people with an IBD.
• -itis – means inflammation of a part of the body, e.g. colitis means inflammation of the colon.
  J
• Jejunum – a section of the small bowel between the duodenum and the ileum.
  L
• Lactose intolerance – a common digestive disorder in which lactose (a sugar found in milk) is not broken down because of the lack of or reduced lactase (an enzyme in the small intestine which digests lactose).  Lactose intolerance can cause abdominal discomfort, diarrhoea and gas after drinking or eating milk products.
• Laparoscopy – a procedure in which a lighted instrument called a laparoscope is passed through a small cut in the abdominal wall to examine internal organs or to carry out surgery.  Also known as key-hole surgery.
• Laxative – a substance that helps you to have a bowel movement.  Different types of laxatives act differently to clear the bowel.
• Lesion – damage or injury to tissue anywhere in the body.
• Leucocytes (leukocytes) – white cells in the blood which help to fight infection.
• Leucocytosis – an increased number of white cells in the blood.
• Leukopenia – a decrease in the number of white cells in the blood.
• LFTs (liver function tests) – blood tests that measure a specific group of proteins and enzymes found in the blood to show how well the liver is working.
• Liver – the largest gland in the body with many functions.  Its main function is to regulate chemicals in the blood.
• Lymphocytic colitis – a form of microscopic colitis where the number of white blood cells within the lining of the colon is increased.
  M
• Maintenance therapy – a treatment (usually one or more drugs) taken long-term to keep an illness in remission.
• Malabsorption – the failure to fully absorb nutrients in food through the intestines.  Malabsorption may result in malnutrition.
• MAP (mycobacterium avium subspecies paratuberculosis) – an organism that causes a disease in cattle similar to Crohn’s disease.
• 6-mercaptopurine (6-mp) (Purinethol) – an immunosuppressant drug closely related to azathioprine used to treat IBD.
• Mesalazine – the generic name for one of the 5-aminosalicylic acid (5 ASA) group of drugs.  Brand names include Asacol, Ipocol, Mesren, Mezavant XL, Pentasa, Octasa and Salofalk.
• Methotrexate – an immunosuppressant drug used to treat IBD when azathioprine or 6-mp cannot be tolerated.
• Metronidazole (Flagyl) – an antibiotic which may be used to treat inflammation in Crohn’s disease, especially if there is an infection in the anal area.
• Microscopic colitis – a form of IBD where the appearance of the bowel lining appears to be normal to the naked eye e.g. in an endoscopy.  The inflammation however is only seen when samples of bowel lining are looked at under a microscope.
• Motility – involuntary movement often used to describe the contraction of muscles in the intestinal tract.
• MRI (magnetic resonance imaging) scan – an examination of internal organs using strong magnets and radio waves rather than x-rays.  A computer converts signals from the scanner into detailed images.  There is no radiation involved in this test.
• MRI enteroclysis/enterography – types of MRI test used to assess the small and large bowel using gas or liquid to give clearer images.  In an enteroclysis test, gas or liquid is passed into the intestine through a tube.  In the enterography the liquid is drunk/
• Mucus – a white jelly-like fluid produced by the mucosa (the lining of the intestines).  People with UC may have a lot of mucus in their stools.
• Mycophenolate mofetil (cellcept) – an immunosuppressant drug occasionally used to treat IBD when azathioprine or 6-mp cannot be tolerated.
  N
• NICE (National Institute for Health and Care Excellence) – an organisation which provides national guidance and advice to improve health and social care.
• NSAIDs (non-steroidal anti-inflammatory drugs) – painkillers often used for arthritis, such as ibuprofen and diclofenac.  There is some evidence that they can make IBD worse.
• Nuclear scan – a scan in which a small amount of radioactive substance (known as a tracer) is taken into the body (usually by injection).  This radioactive substance gives out energy which can be detected by a special camera in order to produce an image.
  O
• Obstruction – a blockage of the intestine often due to a narrowing or stricture.
• Occult blood – blood in the stool which can only be detected by a laboratory test.
• Oedema – a swelling caused by the accumulation of fluid in the tissues.
• Oesophagus (gullet) – the part of the digestive system from the throat to the stomach which food passes.
• Olsalazine (dipentum) – a 5-ASA drug used to treat UC.
• Oral Crohn’s – Crohn’s disease in the mouth.
• Osteoporosis – thinning of the bones that may cause weakness and higher risk of fractures.  It is more commonly found in people with IBD than in the general population and may be caused by long-term use of corticosteroids, severe active disease or by low levels of oestrogen (female sex hormones).
• Osteopenia – mild weakness or thinning of the bones, which is not as severe as osteoporosis.
• Ostomy – an artificial opening of the intestine onto the wall of the abdomen.  Also known as stoma.
  P
• Paediatrician – a doctor who specialises in the care of children and young people.
• Pancolitis – inflammation of the entire colon.  Also known as total colitis.
• Parenteral nutrition – a method of giving a specially prepared liquid food into the vein when nutrients cannot be absorbed through the intestines.  Also known as total parenteral nutrition or TPN.
• Pathogen – a harmful organism such as a bacterium or virus that causes disease.
• Pathology – the study of disease, its causes and progression.
• Pathologist – a doctor who specialises in examining samples of tissue (biopsy, blood, stools or urine to detect disease.
• Perforation – an abdominal opening in the bowel wall which causes the contents of the bowel to leak into the normally sterile abdominal cavity.
• Perianal – the area round the anal opening that is, around the anus.
• Peristalsis – the wave-like muscle contractions that move food through the digestive system.
• Peritoneum – the membrane (thin layer of tissue) lining the inside of the abdominal cavity.
• Peritonitis – inflammation of the peritoneum, often due to a perforation of the wall of the intestine.
• PET (positron emission tomography) scan – a scanner scans the whole body to produce a 3D image.  The person having the scan is given a small amount of a radioactive substance by injection, in a tablet, or through an inhaler and the scanner uses the energy given off by that substance to produce a clear image of the inside of the body.
• Polyp – a fleshy growth that juts out from the lining of the intestines.
• Pouch (ileo-anal) – an internal pouch or reservoir made from the lower part of the intestine (ileum) which is attached to the anus. This allows you to pass stools in the usual way.
• Pouchitis – inflammation of an ileo-anal pouch.
• Prebiotic – a natural, non-digestible substance found in certain foods such as, bananas and leeks that stimulates the growth and activity of beneficial bacteria in the intestines.
• Prednisolone – a corticosteroid drug used to reduce inflammation in IBD.  It can be given in tablet form, by injection into a vein or by an enema or suppository through the rectum.
• Primary sclerosing cholangitis – a rare disease affecting people with IBD in which the bile ducts can become inflamed and the liver can eventually be damaged.
• Probiotics – bacteria found in supplements or food products such as, some yoghurts that may benefit health by improving the balance of bacteria in the gut.
• Proctitis – inflammation in the rectum.
• Proctocolectomy – the removal of the colon and rectum by operation.  Also known as total colectomy.
• Proctosigmoiditis – inflammation of the rectum and lower colon.
• Prognosis – a prediction of what might happen in the future, the likely progress of the disease.
• Prophylactic therapy – preventive treatment.
• Pus – a thick, white, yellow or greenish fluid, made up of dead white blood cells, found in abscesses, on ulcers and on inflamed or discharging surfaces.
• Pyoderma gangrenosum – a chronic skin condition with painful ulcers mainly found on the legs.
  R
• Radiologist – a doctor who specialises in interpreting x-ray, ultrasound and other types of imaging or scanning examinations.
• Rectal bleeding – any blood that passed out through the anus.
• Rectum – the last part of the colon.
• Red blood cells or erythrocytes – blood cells containing haemoglobin, which carries oxygen from the lungs around the body to the tissues and returns with carbon dioxide.
• Relapse – return of the disease activity after it had been inactive.  Also known as flare-up
• Remission – a period of good health, free of active disease with few or no symptoms.
• Resection – the removal of a part of the intestine by operation.
• Rheumatologist – a doctor with special training in the diagnosis and treating with diseases of the joints and muscles.
• Right hemicolectomy – an operation to remove the terminal ileum and caecum.
  S
• Sacroiliac joints – the joints in the lower back between the pelvis and spine.  These may become inflamed and painful in some people with IBD.  This condition is called sacro-ilitis.
• Septicaemia – a bacterial infection of the blood, more commonly known as blood poisoning.
• Seton – a loop of thread or rubber band passed through an anal fistula to allow pus to drain and to encourage healing.
• Short bowel syndrome – where the bowel does not have enough surface area to absorb nutrients.  This may occur if large sections of the small intestine have been removed.
• Sigmoid colon – the lower end of the colon connecting the descending colon to the rectum.
• Sigmoidoscopy – an examination of the rectum and the lower colon using a short tube with a camera on its tip, called a sigmoidoscope.
• Small bowel enema – a type of test or investigation in which the liquid barium and air are passed into the small intestine through a fine tube inserted into the nose or mouth.  This helps give clearer x-ray images.
• Small intestine – the section of the intestines that digests food and absorbs nutrients after they have passed through the stomach.  It is divided into three parts: the upper region (duodenum); the middle region (jejunum) and the lower region (ileum).
• Splenic flexure – the part of the colon where the transverse colon meets the descending colon (just below the spleen).
• Stoma – a surgically constructed opening of the intestine onto the abdominal wall which a bag is fitted over and sealed to the skin.
• Stools – motions, faeces, poo/
• Stricture – a narrowing of a section of the bowel due to bowel wall thickening, inflammation or scarring.
• Strictureplasty – widening a narrow section of the bowel by an operation to allow food matter or waste pass through more easily.
• Sulphasalazine (salazopyrin) – a drug that combines 5-ASA with sulphapyridine.  It is often used to treat UC or occasionally Crohn’s Colitis.
• Suppository – a bullet shaped capsule of drug preparation which is inserted into the body through the anus into the rectum.  This allows the drug to act directly on the affected area.
• Sutures – stitches.
• Symbiotic – a supplement which contains prebiotics and probiotics.
  T
• Tacrolimus (advagraf/prograf) – an immunosuppressant drug similar to ciclosporin, used to treat severe IBD.
• Tenesmus – a constant urge to empty the bowel.  Usually caused by inflammation in the rectum.
• Terminal ileum – the last part of the small intestine before it joins the large intestine.
• Topical treatment – a drug treatment applied directly to an affected area of the body.  In IBD this refers to the use of suppositories and enemas to treat inflammation in the rectum or the lower section of the colon.
• Toxic megacolon – the widening or swelling of the colon which may cause perforation, sometimes seen in a very severe attack of UC or Crohn’s colitis.
• TPMT (thiopurine methyltransferase) – an enzyme in the blood which can be measured in a test to help predict the possibility of side effects from thiopurine drugs such as, azathioprine and 6-mp.
• Transition – the stage at which a young person moves from paediatric health care to adult health care.  This usually happens between the ages of 14-18.
• Tumour – an abnormal growth which may be benign (non-cancerous) or malignant (cancerous).
  U
• U&E (urea and electrolytes) – a blood test which mainly checks kidney function.
• Ulcer – an open sore on external or internal tissues of the body.
• Ulcerative colitis (UC) – an IBD in which the inner lining of the colon and/or rectum becomes inflamed and ulcerated.
• Ultrasound scan – a painless test using high-pitched sound waves to produce pictures of organs in the body.  In IBD it may show inflamed parts of the intestine or an abscess in the abdomen.
• Uveitis – inflammation of the eyes which causes redness and soreness.
  V
• Vedolizumab – a biologic drug used to treat IBD which works differently to other biologics by blocking white blood cells, rather than by binding to TNF-alpha.
• Viruses – very small infectious agents which can only multiply within other cells.  They are different from bacteria and this is why we cannot use antibiotics as treatment as it is not effective against viral infections.
• Vitamin D – it is produced by the action of sunlight on our skin and is essential for bone health.
  X
• X-ray – an electromagnetic ray that passes through the body and produces pictures of the inside of the body on photographic film.  Bones, muscles and organs absorb different amounts of radiation, so the picture shows different body parts in varying shades of light and dark.