Inflammatory Bowel Disease

Table of Contents

Overview

Inflammatory bowel disease (IBD) is an all-encompassing term that refers to disorders that involve chronic digestive tract inflammation. When left untreated, IBD can lead to gastrointestinal (GI) damage.

People who struggle with IBD experience pain and inflammation regularly. It is a condition that affects up to 3 million people in the United States, according to the Cleveland Clinic. It most commonly occurs in people aged 15 to 30 years old.

Types

Crohn’s Disease

Crohn’s disease causes digestive tract inflammation. It is a chronic disease that can impact any part of the GI system, but it typically affects the small intestine and the beginning portion of the large intestine.

The following call all increase a person’s risk for Crohn’s disease:

  • Smoking
  • Taking some medications, such as antibiotics, NSAIDs, and birth control pills
  • Eating a high-fat diet
  • Having a family history of Crohn’s disease

Ulcerative Colitis

Ulcerative colitis is a form of IBD that causes ulcers (sores) and inflammation in the colon and in the lining of the rectum. Around half of the people with UC experience mild symptoms.

Anyone can get UC, but it most commonly occurs in people between the ages of 15 and 30 years old. This condition tends to run in families.

Microscopic Colitis

Microscopic colitis is a medical condition that causes inflammation in the large intestine. It can be a hard disease to diagnose, and colonoscopies may appear to be normal in people with this condition. An accurate diagnosis involves examining tissue from the colon under a microscope.

There are three subtypes of microscopic colitis, and they are:

  • Lymphocytic colitis
  • Collagenous colitis
  • Incomplete microscopic colitis

Causes

Researchers do not know the exact cause of inflammatory bowel disease. At one time, diet and stress levels were thought to be the culprits. Today, doctors believe that while these factors may play a role, they are not the root causes.

Immune system problems may lead to IBD diagnoses in some people. The theory is that when the immune system attempts to fight off a virus or bacteria, it also attacks the cells in the GI system.

These conditions may be hereditary, but most people with IBD do not have a family history of it.

Symptoms

The symptoms of inflammatory bowel disease vary depending on the severity of the condition and the source of the inflammation. Some common symptoms may include:

  • Having bleeding ulcers, which is evidenced by blood in the stool
  • Pain, cramping, and bloating in the stomach, which could be a sign of a bowel obstruction
  • Weight loss
  • Anemia
  • Diarrhea
  • Fatigue
  • A reduced appetite

With all forms of inflammatory bowel disease, it is common for people to experience periods of active symptoms followed by periods of no symptoms at all. This is called being in remission.

Testing

The first step in treating IBD is to determine what type of condition the patient has. Tests are necessary because so many symptoms are common with all of the above types of inflammatory bowel disease.

The following tests may be ordered:

  • Blood work to check for infections or anemia.
  • Stool studies to check for blood or parasites.
  • Upper endoscopy to check the esophagus, stomach, and beginning of the small intestine.
  • A capsule endoscopy to examine the small intestine.
  • A colonoscopy to examine the colon and take samples for biopsies.
  • A balloon-assisted enteroscopy to check the small bowel.

Additional tests may include x-rays, an MRI, and a CT scan.

Treatment

Treating inflammatory bowel disease involves reducing the inflammation that is causing the patient to have symptoms. Proper treatment can provide relief, reduce the risk of any complications, and possibly lead to long-term remission.

Treatment is patient-specific and may include the following approaches.

Medications

Doctors may prescribe a combination of medications to treat IBD, including:

  • Anti-inflammatory medications
  • Biologics
  • Antibiotics
  • Immune system suppressors
  • Pain relievers
  • OTC anti-diarrhea medications, such as Imodium A-D

Supplements

Supplements offer a more natural way to treat IBD. Psyllium powder or methylcellulose can provide relief from mild to moderate symptoms of diarrhea. They work by adding bulk to the stool.

Other vitamins or supplements may be recommended if there is a concern that the patient is not absorbing enough nutrients through their diet.

Surgery

Dietary and lifestyle changes, medications, and other treatments may not always work. In cases like these, surgery may be an option to consider.

Surgery for ulcerative colitis involves removing the colon and rectum and is called Ileal Pouch Anal Anastomosis. A pouch is attached to the anus, and patients who get this surgery will not need an external bag to have bowel movements.

Surgery for Crohn’s disease is quite common, but it will not cure the condition. A portion of the digestive tract is removed and the healthy sections are reconnected. Medications may be used to avoid the recurrence of symptoms.

Nutritional Changes and Support

For patients experiencing dramatic weight loss, a special diet delivered through a feeding tube may be needed.

Medications

There are several medications that may be recommended to treat IBD, depending on the patient’s diagnosis. They include:

Sources

  1. Mayo Clinic. Inflammatory bowel disease (IBD) symptoms & causes. November 7, 2020. Available at MayoClinic.org.
  2. Cleveland Clinic. Inflammatory Bowel Disease (Overview). May 3, 2021. Available at My.ClevelandClinic.org.
  3. MedlinePlus. Crohn’s Disease. June 8, 2016. Available at MedlinePlus.gov.
  4. MedlinePlus. Ulcerative Colitis. June 14, 2016. Available at MedlinePlus.gov.
  5. Mayo Clinic. Microscopic colitis. January 20, 2021. Available at MayoClinic.org.
  6. CDC. Inflammatory bowel disease (IBD). March 22, 2018. Available at CDC.gov.
  7. Mayo Clinic. Inflammatory bowel disease (IBD) diagnosis & treatment. November 7, 2020. Available at MayoClinic.org.
  8. Baylor Medicine. Healthcare: Gastroenterology & Digestive Health. 2021. Available at BCM.edu.
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  14. Humira. Humira Adalimumab. 2012. Available at Humira.com.
  15. Cimzia. Cimzia (certolizumab pegol). 2021. Available at Cimzia.com.
  16. Tysabri. Tysabri (natalizumab). 2022. Available at Tysabri.com.

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