Inflammatory Bowel Diseases (IBD)

What is inflammatory bowel disease?

Inflammatory bowel disease is a medical term that encompasses disorders that cause chronic inflammation of the gut. Types of inflammatory bowel disease include:

Ulcerative colitis, which causes long-term infections and abscesses (ulcers) in the deeper lining of the large intestine (colon) and rectum.
Crohn’s disease, which causes inflammation in the lining of the gut that often spreads deep into affected tissues.
Inflammatory bowel disease can make you feel weak and sometimes lead to life-threatening complications.

What are the causes of inflammatory bowel disease?

The exact cause of inflammatory bowel is yet to be known. Previously, doctors suspected diet and stress to be the main culprits, but they now know these factors may exacerbate the condition, not cause it.

What are the risk factors of inflammatory bowel disease?

• Age. Most people with IBD are diagnosed before they are 30 years old. However, some people do not develop the disease until they are 50 or 60 years old.
• Family history. You are at greater risk of infection if a close relative – such as a parent, sibling, or child – has the disease.
• Smoking is the most prominent risk factor that can be controlled to prevent developing Crohn’s disease.
• Non-steroidal anti-inflammatory drugs. These include ibuprofen, naproxen sodium, and diclofenac sodium, among others. These drugs may increase the risk of developing IBD or worsen the disease in people with inflammatory bowel disease (IBD).
• Environment. If you reside in an industrialized country, you are at a higher risk of developing IBD.

What complications can inflammatory bowel disease cause?

Crohn’s disease and ulcerative colitis have some common complications and some other symptoms that distinguish one from the other. Common complications may include:

Colon Cancer.

Inflammation of the skin, eyes, and joints, which causes arthritis, skin lesions, and eye inflammation (uveitis).
Side effects of medications. Some inflammatory bowel disease medications are associated with a lower risk of certain types of cancer.
Primary sclerosing cholangitis. In this condition, the inflammation causes scarring in the bile ducts, which gradually narrows them, causing liver damage.
Blood clots. IBD increases the risk of developing blood clots in the veins and arteries.

Crohn’s disease complications may include:

• Bowel obstruction. Crohn’s disease affects the full thickness of the intestinal wall. Over time, parts of the intestine may thicken and narrow. This may block the flow of digestive contents. You may need surgery to remove the affected portion of your intestine.
• Malnutrition. Diarrhea, abdominal pain, and cramps may make it difficult for you to eat or for your gut to absorb enough nutrients to provide you with nutrition. It is also common to develop anemia due to a deficiency of iron or vitamin B12 caused by the disease.
• Stomach ulcers. Chronic inflammation can lead to open sores anywhere in your digestive system, including your mouth and anus, and in the genital area (perineum).
• Fistulas. The ulcers can sometimes extend completely through the intestinal wall, forming a fistula – an abnormal connection between different parts of the body. A fistula that develops near or around the anal area (perianal) is the most common type. In some cases, the fistula may become infected, forming an abscess.
• Anal fissure. This is a small tear in the tissue that lines the anus or the skin around the anus where infection can occur. It is often associated with painful bowel movements and can lead to a perianal fistula.

Ulcerative colitis complications may include:

Toxic megacolon. Ulcerative colitis may cause the colon to expand and swell rapidly, a serious condition known as toxic megacolon.
Perforation of the colon. Toxic megacolon is the most common cause of colon perforation, although the latter may also happen on its own.
Severe dehydration. Excessive diarrhea can cause dehydration.

How to diagnose inflammatory bowel disease?

Your doctor will only diagnose inflammatory bowel disease after ruling out other possible triggers of your signs and symptoms. To help diagnose IBD, you may need one or more of the following tests and procedures:

• Blood tests, which include tests for anemia and infection and fecal occult blood test.
• Endoscopic procedures. these include colonoscopy, flexible sigmoidoscopy, upper endoscopy, capsule endoscopy, and balloon-assisted enteroscopy.
• Imaging procedures, which include X-rays, CT scan, and MRI

How is inflammatory bowel syndrome treated?

Treatment for IBD aims to reduce the inflammation causing the signs and symptoms. In the best cases, this may not only relieve symptoms but also provide long-term relief and reduce the risk of complications. Treatment for IBD usually includes diet and lifestyle changes, drug therapy, or surgery.

Medical treatments

• Anti-inflammatory drugs. Anti-inflammatory drugs are often the first step in IBD treatment.
• Immune system suppressants. These medications work in different ways to suppress the immune response that releases inflammatory chemicals into the lining of the intestine.
• Antibiotics. Antibiotics may be used in combination with other medicines or in cases where there is a fear of infection.
• Other medications and supplements. In addition to controlling your infection, some medications may help relieve your signs and symptoms but always talk to your doctor before taking any over-the-counter medications.

Surgical treatments

If diet and lifestyle changes, medication, or other treatment methods failed to relieve inflammatory bowel disease (IBD) signs and symptoms, your doctor may recommend surgery.

Surgery for ulcerative colitis. Often, surgery can clear up ulcerative colitis. But usually, this means removing the entire colon and rectum (proctocolectomy).

In most cases, this includes a procedure called an ileoanal sinus anastomosis. This process eliminates the need to wear a bag to collect stool. The doctor creates a pocket at the end of the small intestine. This pocket is then attached directly to the anus, which allows you to pass stools relatively naturally.

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

During surgery, the surgeon removes a damaged section of the gut and then reconnects the healthy sections. Surgery may also be used to close fistulas and drain abscesses.

The benefits of surgery for Crohn’s disease are usually temporary. The disease often recurs near the reconnected tissue. The best approach is to follow surgery with medications to reduce the risk of recurrence.