Inflammatory bowel disease (IBD) refers to several long-term medical conditions involving inflammation of the digestive tract. Inflammation occurs when the body’s immune system reacts to something it detects as harmful. This could be bacteria or a virus or an injury.
However, sometimes the immune system reacts like this to a threat that does not exist, in the process causing damage to body cells. Inflammation is often characterised by redness, pain hotness and swelling.
The most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease. Neither of these conditions have a cure but the symptoms associated with them can be managed.
Ulcerative colitis
Ulcerative colitis involves inflammation and sores commonly referred to as ulcers along the superficial lining of the large intestine and rectum. There are several types of ulcerative colitis depending on its location in the gut and severity.
Ulcerative proctitis occurs when inflammation stays within the rectum. It tends to be the mildest form of ulcerative colitis. Universal colitis or pancolitis occurs when inflammation spreads across the entire colon.
Proctosigmoiditis is another type that occurs when the rectum and lower end of the colon experience inflammation. Distal colitis occurs when inflammation extends from the rectum and up the left side of the colon.
Acute severe ulcerative colitis is a rare type that causes inflammation across the entire colon, leading to severe symptoms and pain.
Crohn’s disease
This type of IBD can affect any part of the digestive tract between the mouth and the anus. However, it most commonly develops in the final section of the small intestine and colon.
It often can involve the deeper layers of the digestive tract as well.
Symptoms
IBD can be unbearable and sometimes may lead to life-threatening complications. Both ulcerative colitis and Crohn’s disease have similar symptoms. These include diarrhoea, rectal bleeding and abdominal cramps as well as pain, fatigue and weight loss.
IBD symptoms also vary depending on the severity of inflammation and where it occurs. They may range from mild to severe, which will result in you experiencing periods of active illness followed by periods of remission.
Some researchers suggest that IBD in women may also lead to symptoms outside the digestive system that include fever, joint pain and skin conditions. IBD can make the effects of menstruation more severe.
They also say IBD symptoms may become worse during menstruation and can increase women’s risk of iron deficiency or anaemia.
Diagnosis
To diagnose IBD, a health professional or doctor will ask for your full medical history before requesting diagnostic tests be carried out. Some of the tests may include stool samples and blood tests to check for anaemia or infection.
X-rays are used if a serious complication is suspected. CT or MRI scans can be used to detect fistulas in the small intestine or anal region.
Some doctors may also request endoscopic procedures. This process involves inserting a flexible probe with a camera attached through the anus.
Common causes
The precise cause of inflammatory bowel disease is still unknown. Researchers in the past had concluded that diet and stress were most likely the cause but now doctors say these are factors that may aggravate the condition but are not the cause.
There are however several potential factors that can increase your risk of developing IBD. For example, it may occur because your immune system has an irregular response to bacteria, viruses or food particles. This can trigger an inflammatory reaction in the stomach.
This means 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 as well.
In some cases IBD seems to be a heredity disease especially if you have a close relative such as a parent, sibling or child with the disease. However, most people with it do not have any IBD family history.
The use of certain medications including nonsteroidal anti-inflammatory medications (NSAIDs), birth control pills and antibiotics may increase the risk of suffering from IBD. A diet that contains high levels of fat can increase the risk of Crohn’s disease. Some research says smoking can increase the risk and severity of Crohn’s Disease.
Complications
Ulcerative colitis and Crohn’s disease have some complications in common and others that are specific to each condition.
Complications of ulcerative Colitis disease include rectal bleeding which may lead to iron deficiency, dehydration, toxic mega colon, poor absorption of nutrients and reduced bone density that may possibly lead to osteopenia or osteoporosis.
Crohn’s disease may also cause complications such as bowel obstruction, colon cancer and fistulas, which are abnormal tunnels in the gut. Other possible problems are small tears in the anus or anal fissures and ulcers in the mouth, intestines, anus or the area between the genitals and anus.
Complications found in both conditions may include blood clots, colon cancer and skin, eye and joint inflammation.
Some medications used to treat IBD are associated with a small risk of developing certain cancers. Corticosteroids can be associated with a risk of osteoporosis, high blood pressure and other conditions.
Treatment
Since there is currently no cure for IBD, the goal of treatment is to reduce the symptoms, achieve and maintain a remission, and prevent complications.
The most common treatments are medications and surgery. Your doctor may prescribe certain drugs to treat IBD, starting off with milder ones and working up to more aggressive treatments later on.
These medications may include anti-inflammatory drugs, corticosteroids, immune suppressors and biologic therapies which target certain substances that cause inflammation in the body.
Other medications that can reduce IBD symptoms include antibiotics, antidiarrhoeal drugs, laxatives and vitamin and mineral supplements for cases of nutritional deficiency due to IBD.
In some cases surgery may be necessary to treat IBD or its complications. Your doctor may, for example, recommend surgery to widen a narrow bowel or close fistulas.
People with ulcerative colitis may need to undergo surgery to remove the colon and rectum. Those with Crohn’s Disease may need a procedure to remove certain portions of the intestines.
Lifestyle changes are also recommended. Certain dietary and lifestyle factors can make IBD symptoms worse. However, making positive changes to these habits can help you manage symptoms and even maintain a remission.
Many people with IBD say that they experience more severe symptoms during stressful periods so stress management may help reduce the frequency and severity of your symptoms.
