Inflammatory bowel disease (IBD)

IBD

Inflammatory bowel disease (IBD) is a term used to describe disorders that involve chronic inflammation of your digestive tract. Types of IBD include:

• Ulcerative colitis – This condition causes long-lasting inflammation and sores (ulcers) in the innermost lining of your large intestine (colon) and rectum.
• Crohn’s disease – This type of IBD is characterized by inflammation of the lining of your digestive tract, which often spreads deep into affected tissues.

Both ulcerative colitis and Crohn’s disease usually involve severe diarrhea with or without blood in stools, abdominal pain, fatigue, and weight loss.

Symptoms

Signs and symptoms that are common to both Crohn’s disease and ulcerative colitis include:

• Diarrhea
• Abdominal pain and cramping
• Blood in your stool
• Reduced appetite
• Weight loss

Causes

The exact cause of inflammatory bowel disease remains unknown. Previously, diet and stress were suspected, but now doctors know that these factors may aggravate but don’t cause IBD.

One possible cause is an immune system malfunction. When your immune system tries to fight off an invading virus or bacterium, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too. Heredity also seems to play a role in that IBD is more common in people who have family members with the disease. However, most people with IBD don’t have this family history.

Complications

• Colon cancer – Having IBD increases your risk of colon cancer. General colon cancer screening guidelines for people without IBD call for a colonoscopy every 10 years beginning at age 50. Ask your doctor whether you need to have this test done sooner and more frequently.
• Skin, eye, and joint inflammation – Certain disorders, including arthritis, skin lesions, and eye inflammation (uveitis), may occur during IBD flare-ups.
• Liver and bile ducts – The patient can develop primary sclerosing cholangitis. In this condition, inflammation causes scars within the bile ducts, eventually making them narrow and gradually causing liver damage.
• IBD increases the risk of blood clots in veins and arteries.
• Bowel obstruction.
• Nutrition problems
• Fistulas and anal fissure. 

Diagnosis

• Blood tests
• Endoscopic procedures
  1. Colonoscopy and Upper endoscopy.
  2. Capsule endoscopy and Balloon-assisted enteroscopy.
  3. Imaging procedures include X-ray CT scan and MRI.

Treatment

IBD treatment aims to quell the gut inflammation causing your symptoms. Ideally, this not only brings relief but also ushers in long-term remission and lowers complication risks. The two main weapons in this fight are medications and, in some cases, surgery.

Calming the Fire:

• Anti-inflammatory Drugs: These medications act like firefighters, directly extinguishing the inflammation in your intestines.

• Immune System Regulation: Sometimes, the body’s own immune system fuels the inflammation. These drugs, like azathioprine, mercaptopurine, cyclosporine, and methotrexate, work by strategically calming the overactive immune response.

One class of drugs called tumor necrosis factor (TNF)-alpha inhibitors, or biologics works by neutralizing a protein produced by your immune system. Examples include infliximab and adalimumab. Antibiotics may be used in addition to other medications or when the infection is a concern.

Nutritional support

This can improve your overall nutrition and allow the bowel to rest. Bowel rest can reduce inflammation in the short term.

If you have stenosis or stricture in the bowel, your doctor may recommend a low-residue diet. This will help to minimize the chance that undigested food will get stuck in the narrowed part of the bowel and lead to a blockage.

Surgery

If diet and lifestyle changes, drug therapy, or other treatments don’t relieve your IBD signs and symptoms, your doctor may recommend surgery.

Smoking

Smoking increases your risk of developing Crohn’s disease, and once you have it, smoking can make it worse. People with Crohn’s disease who smoke are more likely to have relapses and need medications and repeat surgeries.

Stress

The association of stress with Crohn’s disease is controversial, but many people who have the disease report symptom flares during high-stress periods.