Published on Oct 11, 2019 - 5 min read
Did you know frequent abdominal cramps, blood in the stool, loss of appetite, and diarrhea can be signs of inflammatory bowel disease (IBD)? Read the article to know more.
Inflammatory bowel disease (IBD) is a group of gastrointestinal disorders that result in chronic inflammation of the alimentary canal or the digestive tract. The digestive tract includes the mouth, esophagus, stomach, small and large intestines. This tract helps breakdown food, absorb nutrients, and in the excretion of waste products.
Inflammation anywhere in this tract can disrupt this natural process of digestion, absorption, and excretion. In some severe cases, IBD can be painful and disrupt normal life. It can also lead to life-threatening complications.
The two most common types of IBD are:
Ulcerative colitis - This condition causes inflammation of the large intestine and the rectum. Depending on the location and severity, the types are:
Ulcerative proctitis - It is the mildest form and causes inflammation of the rectum.
Pancolitis - Inflammation of the entire colon.
Proctosigmoiditis - Inflammation of the rectum and lower part of the colon.
Distal colitis - This affects the rectum up to the left colon.
Acute severe ulcerative colitis - It is a severe type, which affects the entire colon and causes pain.
Crohn’s disease - It can affect any part of the digestive tract, but commonly results in inflammation of the small intestine before the colon.
The other types include lymphocytic colitis and collagenous colitis. Indeterminate colitis is when the doctors are unable to differentiate between ulcerative colitis and Crohn’s disease.
Depending on the location, type, and severity of the disease, the symptoms vary. The common symptoms include:
Blood in stools.
Loss of appetite.
Painful bowel movements.
Feeling of incomplete defecation.
Mucus in stools.
Apart from gastrointestinal symptoms, IBD may also cause symptoms like:
Irregular menstrual periods.
The symptoms occur in periods of no symptoms (remission) and periods of severe symptoms (flares).
Genetics and immune system problems have been associated with IBD, but the exact cause is still not known.
Genetic - IBD is believed to be genetic because most patients have a positive family history. So if your sibling or parent has this condition, you are likely to develop IBD.
Autoimmune - Instead of the immune system attacking viruses and bacteria in the gut, but its tissue lining. This response is called an autoimmune response, which results in pain and inflammation.
When the body tries to fight off viruses and bacteria in the digestive tract, it results in inflammation of the lining of this tract. This inflammation normally goes away as soon as the infection gets cured. But in some cases, they may continue for months or even years, resulting in IBD.
The factors that increase the risk of IBD are:
Smoking - It mainly increases the risk of Crohn’s disease, and also aggravates the pain and other symptoms.
Age - The symptoms usually start before 35 years of age.
Family history - A positive family history increases the risk of IBD.
Sedentary lifestyle - People with a desktop job are more at risk.
Diet - Eating processed food increases risk.
Gender - Ulcerative colitis more commonly affects men, while Crohn’s disease affects women more.
Certain medications - Nonsteroidal anti-inflammatory medicines (NSAIDs) like Ibuprofen, Naproxen, and Diclofenac, increase the risk and worsen the symptoms of IBD.
Complications that are seen in both ulcerative colitis and Crohn’s disease are:
Eye inflammation (uveitis).
Joint inflammation (arthritis).
Primary sclerosing cholangitis (scars in the bile ducts).
Some of the complications only seen with Crohn's disease are:
Some of the complications only seen with ulcerative colitis are:
Toxic megacolon - (colon rapidly widens and swells).
Your doctor might suggest you get the following tests done to diagnose inflammatory bowel disease:
Blood tests - To check for anemia or infection.
Fecal occult blood test - To check for the presence of blood in the stool.
Colonoscopy - A thin, flexible tube (endoscope) is used to examine the entire colon. If needed, a small tissue sample of the tissue (biopsy) is taken for laboratory analysis.
Flexible sigmoidoscopy - Here, an endoscope is used to examine the rectum and sigmoid (last portion of the colon).
Upper endoscopy - This is done to examine the esophagus, stomach, and duodenum (upper part of the small intestine).
Capsule endoscopy - In this test, a capsule containing a camera is swallowed by the patient. The camera will click pictures as it passes through the gastrointestinal tract.
X-ray - X-ray of the abdomen is taken to rule out any perforation in the colon.
Barium enema - Here, an X-ray is taken after a solution containing barium is introduced in the rectum using an enema.
Computerized tomography (CT) scan or Magnetic resonance imaging (MRI) - MRI or CT scan is used to get detailed images of the bowel.
The aim of IBD treatment is to relieve symptoms and to keep the disease in remission. The treatment options include:
Anti-inflammatory drugs - Corticosteroids and Aminosalicylates like Mesalamine and Olsalazine.
Immunosuppressants - Azathioprine, Mercaptopurine, and Methotrexate.
Biologics - Infliximab, Adalimumab, and Natalizumab.
Antibiotics - Ciprofloxacin and Metronidazole.
Anti-diarrheal medications or laxatives - depending on the symptom.
For ulcerative colitis - A procedure called proctocolectomy is done, where the entire colon and rectum are surgically removed. After this, the doctor might construct a pouch with the end of the small intestine, which eliminates the need to wear a bag outside to collect stool. But in some cases, a small opening is made in the abdomen through which stool is collected in a bag attached outside the body. Surgery usually treats ulcerative colitis.
For Crohn's disease - Surgery only provides temporary benefits only and does not cure Crohn’s disease. Here, the damaged portion of the digestive tract is removed and reconnected to the healthy sections.
Drink plenty of fluid to prevent dehydration.
Avoid dairy products.
For more information on inflammatory bowel disease (IBD), consult a gastroenterologist now!
Query: Dear doctor, Is intestinal abscess a possibility? I need a second opinion. Medical history: On April 1st, I underwent sigmoidoscopy, and since then, a pain started on my left side. They also diagnosed C.difficile. We started Vancomycin. Then the pain stopped. At week-3 of treatment with Vancomycin,... Read Full »
Query: Hi doctor, I am 44 years old male. I have a good diet. I have been taking good care of my health for the past 20 years as my digestive tract is bad for many years. Can you review my medical records from July and compare it with my CT scan done yesterday? One thing which is confusing me is the promi... Read Full »
Query: Hello doctor, My son is 7 years old. He has diarrhea with a lot of blood in it. He goes to the washroom almost 20 times in day and night. The doctors say he has IBD. They are giving him steroid medicine to stop his blood in stool and inflammation in the intestine. What would you suggest to take, or... Read Full »
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