Inflammatory bowel disease (IBD) is a chronic condition that causes inflammation of the digestive tract. Your digestive tract performs the function of breaking down food, extracting the nutrients, and disposing any waste product. IBD is used as an umbrella term to describe a group of intestinal disorders that are responsible for the severe inflammation of the digestive tract or gut.
Inflammation of the digestive tract, which includes your mouth, esophagus, stomach, small intestine, and large intestine causes disruption of its normal function, which can lead to sores and narrowing of the intestines.
India has an estimated 1.5 million patients affected by Inflammatory bowel disease, putting the country only second to the U.S. with 1.6 million patients. These numbers are only rising at a high single-digit rate, as Indians have a greater than average risk of getting IBD.
There are mainly two types of inflammatory bowel diseases- Ulcerative Colitis (UC) and Crohn’s Disease (CD).
Ulcerative Colitis
Ulcerative colitis involves inflammation of the large intestine, or colon. The inflammation in ulcerative colitis (US) occurs only in the innermost lining of the intestinal lining.
There are different classes of ulcerative colitis, depending on location and severity- Ulcerative proctitis, Universal colitis, or pancolitis, Proctosigmoiditis, Distal colitis, and Acute severe ulcerative colitis.
Crohn’s Disease
This type of IBD causes inflammation of any part of the digestive tract but mostly affects the end of the small intestine and the beginning of the large intestine.
Symptoms
The symptoms for IBD can vary from person to person, depending on the type, severity and location of the inflammation.
The most common signs and symptoms for IBD include
- Frequent and/or urgent bowel movements
- Diarrhea
- Abdominal pain and cramping
- Bloody stool
People with IBD may also report symptoms of
- Fatigue
- Lack of appetite
- Weight loss
Along with these, people have also experienced symptoms outside the digestive system like fever, joint pain, eye inflammation, and skin conditions.
Causes
The exact cause of inflammatory bowel disease is still unknown. However, research believes that a combination of several factors can contribute to the development of IBD. Genetic component(s), an environmental trigger, an imbalance of intestinal bacteria and immune system malfunction can lead to IBD.
In people with inflammatory bowel disease, an abnormal immune response causes the immune system to attack the cells in the digestive tract, resulting in inflammation. This is called an autoimmune response. IBD can also occur in people even when there’s no infection. The inflammation may last for months or even years and sometimes leads to life-threatening complications.
Who is at risk of getting IBD?
IBD can occur at any age, but often people receive a diagnosis at around 15–35 years of age or after 60 years of age. Gender and your ethnicity also come in play to recognise a person’s risk of developing the condition. It is observed that IBD affects men and women equally, with Ulcerative colitis (UC) being more common among men, and Crohn’s disease (CD) being more common among women.
Ethnicity wise, IBD more commonly affects Caucasians. Ashkenazi Jews are also at a higher risk. But the condition can occur in any race or population.
Family history, geographical region, and lifestyle choices like smoking are also considered to be potential factors of IBD.
Diagnostic procedure and Treatment
To diagnose the condition, your full medical history will be taken before performing other diagnostic tests like a physical exam, laboratory tests, and a variety of endoscopic procedures.
To help confirm the diagnosis, tests like blood tests (for anemia or infection), Stool tests (to look for signs of inflammation in the digestive tract as well as infection), External imaging procedures like CT scans and MRI’s (to generate images of the digestive organs), and Endoscopic procedures are conducted.
These procedures help reveal any intestinal damage.
Treatment
There is currently no cure for inflammatory bowel disease. The treatment options available are meant to help reduce inflammation and to provide relief from the symptoms.
Anti-inflammatory drugs
Your doctor may prescribe anti-inflammatory drugs as the first step in the treatment of IBD. Anti-inflammatories help decrease inflammation of the digestive tract.
Medication used to treat IBD includes corticosteroids and aminosalicylates, such as mesalamine (Asacol HD, Delzicol, others), balsalazide (Colazal) and olsalazine (Dipentum).
Antibiotics
Antibiotics may be used in addition to other medications to kill bacteria that may trigger or aggravate IBD symptoms. Prescribed antibiotics for IBD include ciprofloxacin (Cipro) and metronidazole (Flagyl).
Immune system suppressors
Immune suppressors work by preventing or “suppressing” the immune system from attacking the bowel cells. Immune suppressants (or immunomodulators) suppress the immune response that releases inflammation-inducing chemicals in the intestinal lining, thus reducing inflammation.
Some immunosuppressant drugs include azathioprine (Azasan, Imuran), mercaptopurine (Purinethol, Purixan), cyclosporine (Gengraf, Neoral, Sandimmune) and methotrexate (Trexall).
Immune suppressants, can however, cause cause a number of side effects such as such as rashes and increased risk of infection.
Supplements
Vitamin and mineral supplements and some over-the-counter medications can also help relieve your signs. But it’s better to consult with your doctor before taking any such medication.
Lifestyle choices and Nutritional support
A healthy diet can improve your overall nutrition and help better manage your signs and symptoms, reduce flares, and even maintain remission.
It is also important to note that dietary recommendations must be individualized, depending on the disease and the part of the intestine that is affected. The key is to strive for a well-balanced, healthy diet. People suffering from IBD should also be mindful of their fluid intake. Drinking plenty of fluids will help compensate for the dehydration caused due to chronic diarrhea.
Engaging in physical exercises and quitting habits like smoking can further improve your health and provide relief from IBD in the long run.
Surgery
In some cases of IBD, surgery can be considered as the last resort. Some IBD surgeries include strictureplasty to widen a narrowed bowel, closure or removal of fistulas, removal of affected portions of the intestines, for people with Crohn’s disease, and removal of the entire colon and rectum, for severe cases of ulcerative colitis.
According to the Crohn’s & Colitis Foundation, with effective treatment, “around 50% of people with Crohn’s disease will be in remission or have only mild symptoms within the next 5 years”. With medical interventions and making lifestyle changes, it is possible for you to manage your condition.
If you experience any warning signs or symptoms, seek consultation with your medical health professional.
