What is inflammatory bowel disease?
Inflammatory bowel disease is a general term that includes clinical manifestations in which parts of the large and small intestine, as well as other parts of the gastrointestinal tract, are inflamed. These inflammations are usually seen in recurrent attacks. The main symptoms are diarrhea and abdominal cramps. The main chronic inflammatory bowel diseases include Crohn’s disease and ulcerative colitis .
It is estimated that there are hundreds of thousands of people with Crohn’s disease and ulcerative colitis in the world. Experts estimate that one to two out of every ten people with chronic diarrhea have microscopic colitis .
It is not yet clear where intestinal diseases come from. Scientists think that a combination of genetic disposition and environmental factors is at play. Most affected first become ill between the ages of 20 and 35.
Who is it seen in?
Both classic bowel diseases usually break out between the ages of 20 and 35, but can also affect infants and children. The disease called microscopic colitis is found in women around the age of 65.
What causes inflammatory bowel disease?
The exact cause of inflammatory bowel disease is still unknown. Previously, eating habits and stress were suspected, but now doctors know that these factors can aggravate the disease, but not cause inflammatory bowel disease.
One possible cause is an immune system malfunction. Normally, your immune system tries to fight off an invading virus or bacteria. An abnormal immune response causes the immune system to also attack healthy cells in the digestive tract.
It appears to play a role in hereditary predisposition. Having any of these diseases in the family is also a risk factor for others. However, it should not be forgotten that; Most people with these diseases do not have a family member with the disease.
What are the symptoms of inflammatory bowel disease?
The classic chronic inflammatory bowel diseases, Crohn’s disease and ulcerative colitis, can cause a range of similar symptoms, making it difficult to distinguish between the two diseases.
These include a general feeling of sickness, a feeling of exhaustion, diarrhea associated with fever and nausea, abdominal pain, and blood in the stool. Both Crohn’s disease and ulcerative colitis can cause electrolyte, iron, and vitamin deficiencies and low weight. In addition, the levels of inflammation in the blood increase.
Both bowel diseases have symptoms beyond the gastrointestinal tract such as joint pain, skin changes, and eye infections. However, these symptoms are common in Crohn’s disease and extremely rare in ulcerative colitis.
In addition, there are a number of complaints that patients experience more often in one disease and less often in another. Ulcerative colitis, for example, has very frequent and bloody diarrhea, which rarely occurs in Crohn’s disease.
When to see a doctor?
You should consult your doctor if you experience a constant change in your toilet habits or if you suffer from any of the signs and symptoms of inflammatory bowel disease.
Although inflammatory bowel disease is not usually fatal, it is a serious disease that in some cases can cause complications that threaten the person involved.
How is inflammatory bowel disease diagnosed?
Your doctor will likely diagnose inflammatory bowel disease only after ruling out other possible causes for your signs and symptoms.
You may have one or more of the following tests and procedures to help confirm a diagnosis of IBD:
- Anemia or infection tests: Your doctor may recommend blood tests to check for signs of infection from bacteria or viruses, to check for anemia, a condition in which there is not enough red blood cells to carry enough oxygen to your tissues.
- Stool occult blood test: You may need to provide a stool sample so your doctor can test for occult blood in your stool.
- Colonoscopy: This exam allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, your doctor may take small tissue samples ( biopsies ) for laboratory analysis. Sometimes a tissue sample can help confirm the diagnosis.
- Flexible sigmoidoscopy: Your doctor uses a thin, flexible, lighted tube to examine the rectum and sigmoid, the last part of your colon. If your colon is severely inflamed, your doctor may do this test instead of a full colonoscopy.
- Upper endoscopy: In this procedure, your doctor uses a thin, flexible, lighted tube to examine the esophagus, stomach, and first part of the small intestine (duodenum).
- Capsule endoscopy: This test is sometimes used to help diagnose Crohn’s disease involving your small intestine. You swallow a capsule with a camera inside. The images are transmitted to a recording device that you attach to your belt area, then the capsule is painlessly removed with your stool. You may still need endoscopy with biopsy to confirm a diagnosis of Crohn’s disease.
- Balloon-assisted enteroscopy: This allows the doctor to look further into the small intestine where standard endoscopes do not reach. This technique is useful when a capsule endoscopy shows abnormalities.
- X-ray: If you have symptoms of severe inflammatory bowel disease, your doctor may examine your abdomen with a standard X-ray to rule out serious complications, such as a perforated colon .
- Computed tomography: This test looks at the entire intestine and tissues outside the intestine. This is a special computed tomography scan that provides better images of the small intestine . It has replaced barium x-rays in many medical centers.
- Magnetic resonance imaging: An MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. An MRI is particularly helpful in evaluating a fistula around the anal area or small intestine. Unlike a CT, you are not exposed to radiation with an MRI.
How is inflammatory bowel disease treated?
The goal of inflammatory bowel disease treatment is to reduce the inflammation that triggers your signs and symptoms. In the best cases, this can lead not only to symptom relief, but also to long-term remission and a reduced risk of complications.
IBD treatment usually includes medication or surgery.
In general, drug therapy includes:
- Anti-inflammatory drugs : Drugs in this class are often the first step in the treatment of inflammatory bowel disease.
- Immune system suppressors : These drugs work in several ways to suppress the immune response, which releases inflammation-causing chemicals in the intestinal lining.
- Antibiotics : Antibiotics, in addition to other medications or when infection is a concern; for example, it can be used in severe cases of Crohn’s disease.
- Other medications : In addition to controlling inflammation, some medications can help relieve your signs and symptoms. However, you should always talk to your doctor before taking any over-the-counter medication.
For the treatment of inflammatory bowel disease, your doctor may recommend a special diet given through a feeding tube ( enteral nutrition) or nutrients injected into a vein ( parenteral nutrition ). This can improve your overall nutrition and allow the gut to rest. Bowel rest can reduce inflammation in the short term.
If you have intestinal stenosis or stenosis, your doctor may recommend a suitable diet for you. This will help minimize the chance of undigested food sticking to the narrowed part of the intestine and causing a blockage.
If diet and lifestyle changes, medication, or other treatments don’t relieve your IBD signs and symptoms, your doctor may recommend surgery.
- Surgery for ulcerative colitis: Surgery can usually clear up ulcerative colitis. But that usually means removing your entire colon and rectum.
- Surgery for Crohn’s disease: Up to half of people with Crohn’s disease need at least one surgery. However, surgery does not cure the disease, and the benefits are usually temporary.