WHAT IS INFLAMMATORY BOWEL DISEASE (IBD): SYMPTOMS, CAUSES, DIAGNOSIS, AND MORE

Photo from discovermagazine.com

Inflammatory bowel disease (IBD) is a catch-all term for conditions characterized by chronic inflammation of the digestive tract. The following are examples of IBD:

Ulcerative colitis: This disorder causes inflammation and sores (ulcers) on the surface of your large intestine (colon) and rectum.

Crohn's disease: This kind of IBD is distinguished by inflammation of the digestive tract lining, which frequently involves the deeper layers of the digestive tract.

Diarrhea, rectal bleeding, stomach pain, exhaustion, and weight loss are common symptoms of ulcerative colitis and Crohn's disease.

IBD is a severe condition that can sometimes lead to life-threatening consequences.

WHAT ARE THE SYMPTOMS OF INFLAMMATORY BOWEL DISEASE?

The symptoms of inflammatory bowel disease vary depending on the intensity of the inflammation and where it occurs. The severity of the symptoms might range from minor to severe. You will most likely experience active sickness followed by periods of remission.

The following signs and symptoms are shared by Crohn's disease and ulcerative colitis:

Diarrhea

Fatigue

Cramping and pain in the abdomen

Your stool contains blood.

Reduced appetite

Unintentional weight loss

WHAT ARE THE CAUSES OF INFLAMMATORY BOWEL DISEASE?

Inflammatory bowel disease's specific cause is uncertain. Diet and stress were formerly suspected, but doctors now know that these factors may aggravate but are not the cause of IBD.

An immune system malfunction is one probable cause. When your immune system attempts to fight off an invading virus or bacterium, an aberrant immunological response causes the immune system to attack digestive tract cells as well. IBD appears to be more common among persons who have family members with the disease, which may be due to heredity. Most persons with IBD, however, do not have this family history.

WHAT ARE THE RISK FACTORS OF INFLAMMATORY BOWEL DISEASE?

Age: The majority of persons with IBD are diagnosed before the age of 30. However, some people do not get the condition until they are in their 50s or 60s.

Ethnicity or race: Although whites are at the largest risk of contracting the disease, it can affect people of any race.

Family history: If you have a close relative with the condition, such as a parent, sibling, or kid, you are at a higher risk.

Smoking cigarettes: Cigarette smoking is the most significant modifiable risk factor for Crohn's disease.

Tobacco use may help prevent ulcerative colitis. However, the harm to overall health outweighs any gain, and quitting smoking can enhance the overall health of your digestive tract while also providing numerous other health benefits.

Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen (Advil, Motrin IB, and others), naproxen sodium (Aleve), diclofenac sodium, and others are examples. These drugs may raise the likelihood of developing IBD or aggravate the condition in persons who already have it.

WHAT ARE COMPLICATIONS OF INFLAMMATORY BOWEL DISEASE?

Some problems are shared by ulcerative colitis and Crohn's disease, while others are unique to each ailment. Complications associated with both illnesses include:

Colon cancer: If you have ulcerative colitis or Crohn's disease that affects the majority of your colon, you are more likely to develop colon cancer. Cancer screening usually begins eight to ten years following the diagnosis. Inquire with your doctor about when and how frequently you should have this test performed.

Inflammation of the skin, eyes, and joints: During IBD flare-ups, some illnesses such as arthritis, skin rashes, and eye inflammation (uveitis) may arise.

Side effects of medication: Specific IBD treatments are linked to a low risk of getting certain malignancies. Corticosteroids have been linked to an increased risk of osteoporosis, high blood pressure, and other diseases.

Primary sclerosing cholangitis: Inflammation within the bile ducts promotes scarring in this disorder, eventually narrowing them and causing liver damage.

Blood clots: IBD increases the likelihood of blood clots forming in veins and arteries.

Crohn's disease complications may include:

Obstruction of the bowel: Crohn's disease affects the entire gut wall thickness. Parts of the colon might thicken and narrow over time, obstructing the movement of digestive materials. The unhealthy piece of your colon may require surgery to be removed.

Malnutrition: Diarrhea, gastrointestinal pain, and cramping can make it difficult to eat or absorb enough nutrition to keep you nourished. Anemia is also frequent as a result of the disease's low iron or vitamin B-12 levels.

Fistulas: Inflammation can sometimes go all the way through the intestinal wall, resulting in a fistula – an unnatural connection between distinct body organs. The most common type of fistula is one near or around the anal area (perianal). A fistula can become infected and create an abscess in some situations.

Anal fissure: This is a small rip in the tissue that lines the anus or in the skin surrounding the anus, which can lead to infection. It is frequently associated with painful bowel motions and might result in a perianal fistula.

Ulcerative colitis complications may include:

Toxic megacolon: Ulcerative colitis can cause the colon to rapidly enlarge and swell, resulting in toxic megacolon.

A perforated colon (hole in the colon): A toxic megacolon is the most prevalent cause of a perforated colon, but it can also occur on its own.

Severe dehydration: Dehydration can occur as a result of excessive diarrhea.

HOW IS INFLAMMATORY BOWEL DISEASE DIAGNOSED?

After ruling out other probable explanations of your signs and symptoms, your doctor will most likely diagnosis inflammatory bowel disease. A combination of tests and procedures will be required to help confirm an IBD diagnosis:

Lab tests

Anemia and infection tests: Blood tests may be recommended by your doctor to check for anemia (a disease in which there aren't enough red blood cells to provide enough oxygen to your tissues) or to look for symptoms of infection from bacteria or viruses.

Stool study: You may be asked to produce a stool sample so that your doctor may test for concealed (occult) blood or organisms in your feces, such as parasites.

Endoscopic procedures

Colonoscopy: Using a tiny, flexible, illuminated tube with a camera at the end, your doctor may view your whole colon. During the process, your doctor may collect small tissue samples (biopsies) for laboratory investigation. A biopsy is used to differentiate IBD from other types of inflammation.

Balloon-assisted enteroscopy: A scope is used in conjunction with a device known as an overtube for this test. This allows the clinician to see further into the small bowel than ordinary endoscopes can. This procedure is effective when a capsule endoscopy reveals abnormalities but the diagnosis remains unclear.

Flexible sigmoidoscopy: Your doctor examines the rectum and sigmoid, the last section of your colon, with a thin, flexible, lighted tube. If your colon is inflamed excessively, your doctor may order this test instead of a full colonoscopy.

Upper endoscopy: In this operation, your doctor examines the esophagus, stomach, and first section of the small intestine with a thin, flexible, lighted tube (duodenum). While these areas are rarely affected by Crohn's disease, this test may be recommended if you are experiencing nausea and vomiting, difficulty eating, or upper abdominal pain.

Capsule endoscopy: This test is sometimes used to assist in the diagnosis of Crohn's disease involving the small intestine. You take a capsule containing a camera. The photographs are sent to a recorder that you wear on your belt, and the capsule then exits your body painlessly in your feces. An endoscopy with biopsy may still be required to confirm a Crohn's disease diagnosis. If there is a bowel obstruction, capsule endoscopy should not be conducted.

Imaging procedures

X-ray: If your symptoms are severe, your doctor may perform a conventional X-ray of your abdomen to rule out significant consequences such as a ruptured colon.

Computerized tomography (CT) scan: You might undergo a CT scan, which is a type of X-ray that shows greater detail than a regular X-ray. This exam examines the entire colon as well as tissues outside of the bowel. CT enterography is a type of CT scan that produces more detailed images of the small bowel. In many medical centers, this test has taken the place of barium X-rays.

Magnetic resonance imaging (MRI): An MRI scanner creates comprehensive images of organs and tissues by using a magnetic field and radio waves. An MRI is very helpful in assessing a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). MRI, unlike CT, does not expose the patient to radiation.

WHAT ARE THE TREATMENTS FOR INFLAMMATORY BOWEL DISEASE?

The goal of treating inflammatory bowel disease is to minimize the inflammation that causes your signs and symptoms. In the best-case scenario, this may result in not just symptom relief but also long-term remission and reduced consequences. IBD treatment usually consists of either medication or surgery.

Anti-inflammatory medications

Anti-inflammatory medications are frequently used as the first line of treatment for inflammatory bowel disease. Corticosteroids and aminosalicylates, such as mesalamine (Asacol HD, Delzicol, and others), balsalazide (Colazal), and olsalazine, are anti-inflammatories (Dipentum). The medication you take is determined by the area of your colon that is affected.

Immune system suppressors

These medications act in a variety of ways to suppress the immunological response, which causes the body to generate inflammatory chemicals. When these substances are released, they can harm the lining of the digestive tract.

Immunosuppressive medications include azathioprine (Azasan, Imuran), mercaptopurine (Purinethol, Purixan), and methotrexate (Trexall).

Biologics

Biologics are a newer type of therapy in which the goal is to neutralize proteins in the body that cause inflammation. Some are given via intravenous (IV) infusions, while others are given as self-injections. Infliximab (Remicade), adalimumab (Humira), golimumab (Simponi), certolizumab (Cimzia), vedolizumab (Entyvio), and ustekinumab are among examples (Stelara).

Antibiotics

Antibiotics may be used in conjunction with other treatments or when infection is a risk, such as in cases of perianal Crohn's disease. Ciprofloxacin (Cipro) and metronidazole are two often given antibiotics (Flagyl).

Other drugs and supplements

Some drugs, in addition to managing inflammation, may help reduce your signs and symptoms; nevertheless, always see your doctor before using any over-the-counter treatments. Your doctor may recommend one or more of the following treatments depending on the severity of your IBD:

Anti-diarrheal medications: By adding weight to your stool, fiber supplements such as psyllium powder (Metamucil) or methylcellulose (Citrucel) can help treat mild to moderate diarrhea. Loperamide (Imodium A-D) may be beneficial for more severe diarrhea.

Pain killers: Acetaminophen may be prescribed by your doctor for minor pain (Tylenol, others). However, ibuprofen (Advil, Motrin IB, and others), naproxen sodium (Aleve), and diclofenac sodium are likely to aggravate your symptoms and can worsen your disease.

Supplements and vitamins: If you aren't getting enough nutrients, your doctor may advise you to take vitamins and nutritional supplements.

Nutritional assistance

To treat your IBD, your doctor may propose a specific diet administered through a feeding tube (enteral nutrition) or nutrients injected into a vein (parenteral nutrition). This can increase your overall nutrition while also allowing your bowel to relax. In the near term, bowel rest can help reduce inflammation.

If you have intestinal stenosis or stricture, your doctor may advise you to follow a low-residue diet. This will assist to reduce the likelihood of undigested food becoming lodged in the restricted section of the intestine and causing a blockage.

Surgery

If food and lifestyle modifications, medication, or other treatments do not alleviate your IBD symptoms, your doctor may consider surgery.

Ulcerative colitis surgery: The whole colon and rectum are removed during surgery, and an internal pouch linked to the anus is created to allow bowel movements without the use of a bag.

A pouch is not always possible. Instead, surgeons make a permanent incision in your belly (ileal stoma) through which excrement is transmitted and collected in a bag linked to the aperture.

Crohn's disease surgery: Up to two-thirds of Crohn's disease patients will require at least one operation during their lifespan. Surgery, however, does not cure Crohn's disease.

During surgery, the surgeon will remove a segment of your digestive tract that is diseased and then reconnect the healthy sections. Fistulas and abscesses can also be closed surgically.

The benefits of Crohn's disease surgery are usually just transitory. The disease typically recurs, usually near the rejoined tissue. To reduce the likelihood of recurrence, surgery should be followed with medication.

HOME REMEDIES AND LIFESTYLE CHANGES

When dealing with inflammatory bowel illness, you may feel helpless at times. Changes in your food and lifestyle, on the other hand, may help reduce your symptoms and extend the period between flare-ups.

Diet

There is no conclusive proof that what you eat promotes inflammatory bowel disease. Certain meals and beverages, however, can increase your signs and symptoms, particularly during a flare-up.

Keeping a food journal can help you keep track of what you eat as well as how you feel. If you realize that certain foods are exacerbating your symptoms, you might try avoiding them.

Here are some general dietary recommendations that may assist you in managing your condition:

Limit your dairy consumption: Many persons with inflammatory bowel disease find that limiting or eliminating dairy products improves symptoms such as diarrhea, stomach pain, and gas. You may be lactose intolerant, which means your body is unable to digest the milk sugar (lactose) found in dairy products. Lactaid, an enzyme product, may also be beneficial.

Consume small meals: You may find that eating five or six modest meals a day, rather than two or three larger ones, makes you feel better.

Drink plenty of water: Drink enough of drinks on a daily basis. Water is the finest option. Caffeine-containing beverages and alcohol stimulate your intestines and can aggravate diarrhea, while fizzy drinks frequently cause gas.

Consider multivitamins: Because Crohn's disease might impair your ability to absorb nutrients and your diet may be limited, multivitamin and mineral supplements are frequently beneficial.

Before using any vitamins or supplements, consult your doctor: Consult a dietician. Consult a certified dietitian if you begin to lose weight or if your diet has been severely restricted.

Smoking

Smoking raises your chances of getting Crohn's disease, and it can make it worse if you already have it. Smokers with Crohn's disease are more prone to relapse and require drugs and repeat procedures.

Tobacco use may aid in the prevention of ulcerative colitis. However, the harm to overall health outweighs any gain, and quitting smoking can enhance the overall health of your digestive tract while also providing numerous other health benefits.

Stress

Although the link between stress and Crohn's disease is debatable, many persons with the condition report symptom flares during times of high stress. If you're having problems dealing with stress, try one of these methods:

Exercise: Even light exercise can help reduce stress, alleviate sadness, and restore regular bowel function. Consult your doctor about the best workout program for you.

Biofeedback: With the help of a feedback gadget, this stress-reduction technique may learn you to lower muscular tension and slow your heart rate. The idea is to help you relax so that you can cope with stress more readily.

Regular breathing and relaxing exercises: One strategy to deal with stress is to practice relaxation techniques such as deep, steady breathing. Yoga and meditation classes are available, as are books, CDs, and DVDs.