What is Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease IBD Crohns disease Colitis ulcerosa

Inflammatory bowel disease (IBD) is a general term used to define diseases that include chronic swelling of your digestive region. Types of IBD include:

Ulcerative colitis. This condition causes extensive- swelling and sores (ulcers) in the deep inner lining of your larger intestine (colon) and rectum.
Crohn’s disease. This kind of IBD 2is distinguished by inflammation of the lining of your digestive tract, which often reaches deep into damaged tissues.
Both ulcerative colitis and Crohn’s disease normally involve severe abdominal pain, diarrhea, weight loss and fatigue.

IBD can be draining and sometimes leads to life-threatening health complications.

Symptoms

Inflammatory bowel disease symptoms differ based on the seriousness and severity of inflammation and the region it occurs. Signs may extend from mild to severe. You tend to have phases of progressive illness accompanied by stages of remission.

Signs and symptoms that are prevalent in both Crohn’s disease and ulcerative colitis encompass:

  • Fever and fatigue
  • Diarrhea
  • Abdominal pain and cramping
  • Reduced appetite
  • Blood in your stool
  • Unintended weight loss

When Should You See A Physician 

Make an appointment with your physician if you encounter a consistent difference in your bowel movements or if you have any of the symptoms of inflammatory bowel disease. However, inflammatory bowel disease is typically not fatal; it’s a severe disease that, in some situations, may produce life-threatening issues.

Causes

The exact reason for inflammatory bowel disease remains unclear. Historically, stress and diet were presumed, but now physicians understand that these circumstances may aggravate IBD but don’t cause it.

One plausible explanation is an immune system defect or failure. When your immune system attempts to combat an inundated virus or bacterium, an irregular immune response produces the immune system to engage cells within the digestive tract, as well. Heredity also appears to play a part in the development of IBD. It tends to be more prevalent in those who have family members with the condition. Though, most people with IBD do not have this family history.

Risk factors

  • Age. Most individuals who acquire IBD are diagnosed with the condition before they turn 30 years old. However, some people don’t form the disease until their 50s or 60s.
  • Race or ethnic background. Even though people of Caucasian descent have the highest risk of developing IBD, it can happen in any race. Researchers have found that the risk for people of Ashkenazi Jewish descent is even higher.
  • Family Health History. If you have a close relative — such as a child, parent, or sibling — with IBD, you are also at higher risk.
  • Cigarette Smokers. Cigarette smoking is the most critical controllable and preventable risk factor for forming Crohn’s disease. Although studies have found smoking may provide some slight protection against ulcerative colitis, the overall health benefits of not smoking make it essential to quit as soon as possible.
  • Nonsteroidal anti-inflammatory drugs. These medications comprise naproxen sodium (Aleve), ibuprofen (Motrin IB, Advil, others), and diclofenac sodium.
  • (Voltaren) and others. These medicines can raise the risk of contracting IBD or worsen the condition’s impact in those with IBD.
  • The area you live in. If you live in an advanced or industrialized country, you have a higher likelihood of developing IBD. Accordingly, the environmental factors may play a role, including food such as a high-fat diet, refined foods, refined sugars, and processed foods. People in northern and colder climates also appear to be at greater risk.
  • Complications
  • Ulcerative colitis and Crohn’s disease have similar complications, while others are unique to each condition. Complications found in both conditions can include:
  • Colon cancer. Having IBD heightens your risk of colon cancer. Universal colon cancer screening guidelines for individuals without IBD recommend a colonoscopy every ten years starting at age 50. Ask your physician if you need this test done earlier and more regularly.
  • Eye, skin, and joint swelling. Some disorders, including skin lesions, arthritis, and eye inflammation (uveitis), can occur during IBD.
  • Drug side effects. Particular medications for IBD are linked with a small risk of incurring certain cancers. Corticosteroids are also linked with a risk of high blood pressure – hypertension, osteoporosis, and other conditions.
  • Blood clots. IBD raises the risk of blood clots in veins and arteries.
  • Primary sclerosing cholangitis. In this condition, inflammation produces scars within the bile ducts, ultimately making them too narrow and slowly causing liver damage.
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Complications Caused by Crohn’s disease Can include:

Bowel obstruction. Crohn’s disease impacts the full circumference and stiffness of the intestinal wall. As time passes, a portion of the bowel can narrow due to the increased diameter, which can obstruct the flow of digestive contents. You may need surgery to extract the diseased part of your bowel.

Malnutrition. Abdominal pain, di, and cramping may cause difficulty eating foods or for your intestine to absorb enough of the vital nutrients you require to stay nourished. Often people develop anemia due to the low iron or vitamin B12 that can be absorbed.

Fistulas. Occasionally ulcers can spread completely through the intestinal wall, creating a fistula — abnormal contact between intestines and different body parts. Fistulas around or near the anal (perianal) are the most common. In some circumstances, a fistula may grow infected and develop an abscess.

Ulcers. Chronic inflammation can initiate open sores (ulcers) anywhere along your digestive tract, anus, genital area (perineum), and even your mouth.

Anal Fissure. This is a little tear in the tissue that pads the anus lining or in the skin surrounding the anus where infections can transpire. It’s often combined with painful bowel movements and may lead to a perianal fistula.

Complications of ulcerative colitis may include:

Toxic megacolon. Ulcerative colitis may cause the colon to widen and swell rapidly, a severe condition known as the toxic megacolon.

A hole in the colon (perforated colon). A perforated colon most commonly is triggered by toxic megacolon, but it may also happen on its own.

Serious dehydration. Extreme diarrhea can occur in dehydration.

Diagnosis

Your physician will likely determine inflammatory bowel disease ultimately after excluding other possible causes for your symptoms. To help verify a diagnosis of IBD, you may have one or more of the rear tests and procedures:

Blood tests

For infection or anemia. Your physician may recommend blood tests to monitor for anemia — a condition in which there are not sufficient red blood cells to carry enough oxygen to your tissues — or to check for signs of contamination from viruses or bacteria.

Fecal occult blood test. You may need to produce a stool sample so your doctor can test for hidden blood in your stool.

Endoscopic procedures

Colonoscopy. This exam lets your physician view your complete colon using a thin, flexible, lighted tube with a connected camera. During the procedure, your physician can also take tiny tissue samples (biopsy) for laboratory analysis. Sometimes a tissue specimen can help verify a diagnosis.

Flexible sigmoidoscopy. Your physician uses a slender, flexible, lighted tube to check the rectum and sigmoid, the last part of your colon. If your colon is severely inflamed, your surgeon may administer this test rather than a full colonoscopy.

Upper endoscopy. In this procedure, your physician uses a slender, flexible, lighted tube to check the esophagus, stomach, and initial part of the small intestine (duodenum). While it is uncommon for these regions to be associated with Crohn’s disease, this test may be suggested if you have vomiting and nausea, trouble eating food, or upper abdominal pain.

Capsule Endoscopy. This exam is occasionally utilized to help diagnose Crohn’s disease affecting your small intestine. You take a capsule that has an optical lens in it. The photos are transferred to a recorder you wear on your belt, after which the capsule leaves your body without pain in your stool. You may still require an endoscopy with a biopsy to validate a diagnosis of Crohn’s disease.

Balloon-assisted enteroscopy. For this examination, a scope is used in conjunction with a device referred an overture. This enables the physician to look further into the small bowel where conventional endoscopes don’t reach. This technique is helpful when capsule endoscopy shows abnormalities, but the determination is still in question.

Imaging Procedures and Test.

X-ray. If you have severe symptoms, your doctors may use a standard X-ray of your gastric area to exclude serious complications, such as a perforated colon.

Computerized tomography (CT) scan. You may have a CT scan — a particular X-ray technique that provides more detail than a conventional X-ray. This test studies the entire bowel as well as tissues outside the intestine. CT enterography is a special CT scan that produces better images of the small bowel. This test has substituted barium X-rays in many medical centers.

Magnetic resonance imaging (MRI). An MRI scanner utilizes a magnetic field and radio waves to produce detailed images of organs and tissues. An MRI is especially useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). Unlike a CT, there is no radiation susceptibility with an MRI.

Treatment

The goal of inflammatory bowel disease therapy is to reduce the inflammation contributing to your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission and reduced risks of complications. IBD treatment usually involves either drug therapy or surgery.

Anti-inflammatory drugs

Anti-inflammatory medications are often the initial step in treating inflammatory bowel disease. Anti-inflammatories include corticosteroids and aminosalicylates, such as balsalazide (Colazal), mesalamine (Asacol HD, Delzicol, others), and olsalazine (Dipentum). Which drugs you take depends on the area of your colon that’s impacted.

Immune system suppressors

These drugs work in several ways to suppress the immune response that releases inflammation-inducing chemicals in the intestinal lining. For some individuals, a combination of these medications works better than one drug alone.

Some examples of immunosuppressant drugs include azathioprine (Azasan, Imuran), mercaptopurine (Purinethol, Purixan), cyclosporine (Gengraf, Neoral, Sandimmune), and methotrexate (Trexall).

One class of drugs called biologics, or tumor necrosis factor (TNF)-alpha inhibitors, works by offsetting a protein produced by your immune system. Instances include adalimumab (Humira), golimumab (Simponi). And infliximab (Remicade). Other biologic therapies that can be used are stekinumab (Stelara),edolizumab (Entyvio), natalizumab (Tysabri), and vedolizumab (Entyvio),

Antibiotics

Antibiotics may be utilized with other medications or when the infection is a concerning matter — in instances of perianal Crohn’s disease, for example. Frequently prescribed antibiotics comprise metronidazole (Flagyl). And ciprofloxacin (Cipro).

Other medications and supplements

In addition to controlling inflammation, some medications may help relieve your signs and symptoms but always talk to your physician before taking any over-the-counter medications. Based on the severity of your IBD, your physician may suggest one or more of the following:

Anti-diarrheal drugs. A fiber supplement — such as methylcellulose (Citrucel) or psyllium powder (Metamucil) — can assist in relieving mild to moderate diarrhea by giving mass to your stool. For more serious diarrhea, loperamide (Imodium A-D) may be useful.

Pain relievers. Your physician may suggest acetaminophen (Tylenol, others) for mild pain. Nevertheless, ibuprofen (Advil, Motrin IB, others), diclofenac sodium (Voltaren), and naproxen sodium (Aleve) likely will cause your symptoms to worsen as well as make your disease worse as well.

Iron supplements. You may develop iron deficiency anemia and need to take iron supplements if you have chronic intestinal bleeding.

Calcium and vitamin D supplements. Crohn’s disease and steroids utilized to treat it can raise your risk of osteoporosis, so you may require to take a calcium supplement combined with vitamin D.

Nutritional support

Your doctor may prescribe a special diet via a feeding tube (enteral nutrition) or nutrients inserted into a vein (parenteral nutrition) to manage your IBD. This can improve your complete nutrition and allow the bowel to rest. Bowel rest can limit inflammation in the short term.

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

Surgery

Your physician may recommend surgery if diet and lifestyle adjustments, drug therapy, or other treatments don’t relieve your IBD signs and symptoms.

Surgery for ulcerative colitis. Surgery can often eliminate ulcerative colitis. But that usually means removing your whole colon and rectum (proctocolectomy).

In most cases, this entails a procedure called an ileal pouch-anal anastomosis. This procedure removes the need to wear a bag to collect stool. Your surgeon creates a pouch from the end of your small intestine. The pouch is then connected directly to your anus, allowing you to depose waste normally.

In some instances, a pouch is not possible. Instead, surgeons create a lasting opening in your abdomen (ileal stoma) through which stool is passed for collection in an attached medical bag.

Surgery for Crohn’s disease. Up to one-half of individuals with Crohn’s disease will need at least one surgery. However, surgery does not cure Crohn’s disease.

During surgery, your surgeon removes a damaged portion of your digestive tract and then reattaches the healthy sections. Surgery may also be utilized to close fistulas and drain abscesses.

The perquisites of surgery for Crohn’s disease are normally temporary. The disease frequently recurs, often close to the reconnected tissue. The best proposal is to follow surgery with medicine to reduce the risk of recurrence.

Lifestyle and home remedies

Occasionally you may feel incapable of achieving recovery when dealing with inflammatory bowel disease. But adjustments in your diet and lifestyle may help manage your symptoms and prolong the time between flare-ups.

Diet

There’s no solid proof that what you eat causes inflammatory bowel disease. But specific foods and beverages can exacerbate your signs and symptoms, especially during a flare-up.

It can be helpful to maintain a food diary to keep a record of what you’re eating, as well as how you feel. If you discover some foods are creating your symptoms to flare, you can try to stop eating those foods. Here are some suggestions that may help:

Reduce dairy product consumption. Many individuals with inflammatory bowel disease find that difficulties such as diarrhea, abdominal pain, and gas improve by limiting or reducing dairy foods. You may be lactose intolerant — that is, your body can not ingest the milk sugar (lactose) in dairy foods. Utilizing an enzyme product such as Lactaid may help as well.

Try low-fat foods. If you have Crohn’s disease of the small intestine, you may not be capable of absorbing or digesting fat normally. Instead, fat passes through your intestine, making your diarrhea worse. Try avoiding butter, margarine, cream sauces, and fried foods.

Employ a high-fiber diet: If you have inflammatory bowel disease, high-fiber foods, such as vegetables, fresh fruits, and whole grains, can worsen your symptoms. If raw fruits and vegetables bother you, try steaming, baking, or stewing them.

Overall, you may have more issues with foods in the cabbage family, such as cauliflower and broccoli cauliflower, nuts, corn, seeds, and popcorn.

Avoid other problem foods. Spicy foods, alcohol, and caffeine may make your signs and symptoms worse.

Other dietary measures

Eat smaller meals. You may notice you respond better by eating five or six small meals daily rather than two or three large meals.

Drink plenty of liquids. Try to drink plenty of fluids daily. Water is the best option. Beverages containing caffeine and alcohol incite your intestines and can make diarrhea severer, while carbonated drinks frequently produce gas.

Caffeine as well as alcohol incite your intestines and can make diarrhea severer, while carbonated drinks frequently produce gas.

https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315