Inflammatory bowel disease

Understanding Inflammatory Bowel Disease

It’s estimated that more than 3 million Americans suffer from some form of inflammatory bowel disease (IBD). While many learn to live with it, others have to contend with symptoms that can have a huge impact on their quality of life. 

Here we look at what inflammatory bowel disease is, who it affects, the common symptoms associated with the condition and how it can be diagnosed and treated.

What Is Inflammatory Bowel Disease?

Part of the digestive system, the bowel is made up of the small intestine, colon (large intestine) and rectum. When there is chronic inflammation in these areas, it causes damage to the digestive tract. There are two main types of IBD – Crohn’s disease and ulcerative colitis

  • Crohn’s disease causes damage in any part of the digestive tract from the mouth to the anus but it is normally found in the small intestine and the first part of the colon. 
  • Ulcerative colitis is found in the large intestine and is characterized by swelling and sores.
Man suffering from abdominal pain

Inflammatory Bowel Disease Causes and Risk Factors

The exact cause of IBD is not understood. Diet and stress were thought to be contributory factors but research now tells us that these exacerbate the condition rather than cause it to occur in the first place. 

There is evidence to suggest that the development of this disease may be related to a problem with the immune system. Our immune system helps the body to fight infection and may see food as an invading virus or bacteria. 

Other possible causes could be environmental triggers such as smoking or taking certain medications.

Several risk factors have been identified: 

  • If IBD is going to develop, it tends to do so before the age of 30. 
  • Although it can occur in any ethnicity, IBD tends to affect white individuals more. 
  • A family history of IBD raises the risk of developing the condition. 

Controllable risk factors include quitting smoking which can increase the likelihood of developing Crohn’s disease and not taking certain pain killing medications such as Ibuprofen. 

People who have IBD are also at risk of developing other diseases, including colorectal cancer and osteoporosis.

Inflammatory Bowel Disease Symptoms

The symptoms of IBD can vary depending on the location and how severe the inflammation is. They can range from mild to severe and there can be periods of remission where the individual feels perfectly fine. 

The most common symptoms include abdominal pain and diarrhea. Individuals may also experience fatigue, reduced appetite and weight loss and notice blood in their stool on occasion.

Inflammatory Bowel Disease Diagnosis

Both Crohn’s disease and ulcerative colitis can cause similar symptoms and there isn’t a single set test that can reveal what the problem is. The doctor will first look at the patient’s symptoms and conduct some blood and stool tests to check for signs of inflammation. 

There are a variety of diagnostic tools that can enable the doctor to see inside the bowel and find out if there is any sign of IBD. These include a colonoscopy, endoscopic ultrasound and capsule endoscopy. More detailed images of the bowel can be obtained with CT or MRI scans.

Inflammatory Bowel Disease Treatment

There are many different approaches to treating IBD and a lot will depend on the individual case. In many cases, the disease can be controlled or suppressed through lifestyle choices. These could include: 

  • Drinking plenty of water.
  • Keeping a food diary to learn which foods spark their inflammation.
  • Taking a variety of supplements to help with nutritional deficiencies.
  • Quitting smoking and undertaking more exercise. 

There are also a variety of medical treatments for IBD. Surgery used to be a common solution (removing the affected area) in the past, but recent advances in medication have made this less likely to be considered, unless the condition is severe. 

Medicinal approaches include:

  • Corticosteroids help reduce inflammation and are often used in the short term to deal with IBD flare ups. 
  • Aminosalicylates reduce inflammation in the lower end of the small intestine and the colon.
  • In more severe cases, where corticosteroids and aminosalicylates don’t work, immunomodulators are often useful though they are not approved for use with IBD by the FDA. 
  • Those with moderate to severe IBD may also benefit from using biologics that block tumor necrosis factor or TNF as this can reduce inflammation. 

Patients will often try a combination of interventions. For many, lifestyle changes can make a huge difference. For others, some drugs may help reduce inflammation and keep their condition under control.