Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease also known as IBD is a group of inflammatory diseases that affect the large intestine and or the small intestine.

The majority of IBD patients experience periods during which the disease intensifies or subsides (remissions).

The main forms of IBD:

  • Crohn's disease
  • Ulcerative colitis

    The difference between the two is the location and nature of the inflammatory conditions in the gut.

    Crohn's disease affects any part of the gastrointestinal tract - from the mouth to the anus. However, a majority of the cases start in the terminal ileum.

    Ulcerative colitis affects the large intestines (colon). It is restricted to the mucosa (lining of the gut), while Crohn's disease affects the whole bowel wall.

    Crohn's disease and Ulcerative colitis manifest themselves outside the digestive system by causing liver problems, arthritis, skin problems and eye problems etc. in different proportions.

    In some rare cases, some patients have been diagnosed with a combination of both Crohn's disease and Ulcerative Colitis. Whether it was truly a combination or simply unidentifiable as one or another is uncertain.

    IBD Causes

    The exact causes of IBD are unknown. Causes may be germs or immune system problem. It is suspected that IBD may also be caused by a virus or bacteria interacting with the body's immune system.

    IBD is not contagious but does seem to be hereditary (runs in the family). Smoking may increase the chances of developing Crohn's disease.

    Inflammatory Bowel Disease Symptoms

    Both crohn's disease and ulcerative colitis may present the following symptoms:

  • Abdominal cramps and pain
  • Vomiting
  • Diarrhoea
  • Constipation
  • Weight loss over a short period
  • Bleeding from intestines

    Both may also present various associated complaints or diseases such as arthritis, pyoderma gangrenosum, and primary sclerosing cholangitis.

    IBD Diagnosis

    Diagnosis may be done using a sigmoidoscope or a colonoscope. During this procedure, the doctor uses a narrow flexible tube to look directly inside your intestines.

    Special x-rays may be helpful in diagnosing the illnesses. Biopsies may also be collected for examination under a microscope.

    Inflammatory Bowel Disease Treatment

    A healthy diet and adequate rest are essential for IBD treatment. You also need to learn to manage the stress in your life. If issues around you overly upset you, your intestinal problems can get worse.

    Both forms of Inflammatory bowel disease may require immunosuppression to control the symptoms.

    This initially consists of mesalazine and steroids. Later steroid-sparing agents such as azathioprine or methotrexate) or biologicals may be used.

    To treat the symptoms, your doctor may also recommend anti-diarrhoeal, laxatives, pain relievers or other over the counter drugs.

    Severe cases may require surgery. Surgery involves operations such as bowel resection, strictureplasty or a temporary or permanent colostomy or ileostomy. Despite IBD treatment, it can limit quality of life due to pain, vomiting, diarrhoea, and other socially unacceptable symptoms.

    IBD is rarely fatal on its own. Fatalities due to complications such as toxic megacolon, bowel perforation and surgical complications are rare.

    Patients of IBD have an increased risk of colorectal cancer. However, this is usually caught much earlier than in the general population during routine surveillance of the colon by colonoscopy. Patients are therefore much more likely to survive.

    Inflammatory Bowel Disease Diet

    To soothe the inflammation associated with IBD, taking fatty acids from fish oil, antioxidants, and short-chain fatty acids (SCFAs) produced during the fermentation of soluble fibre foods is vital.

    The dietary guidelines for Irritable Bowel Syndrome can also be helpful for symptoms of IBD such as diarrhoea and abdominal cramps. Dietary changes can considerably increase patient comfort.

    Having a dietary foundation of soluble fibre foods, substituting soy or rice products for dairy, being careful with fresh fruits and vegetables that are high in insoluble fibre and can contribute to bowel impactions, and eating regular small amounts can all help.

    Foods and beverages to be avoided or minimized as part of a good IBD diet include:

  • Red meat
  • Oily or fatty (and fried) products
  • Dairy (even when there is no lactose intolerance)
  • Solid chocolate
  • Coffee (regular and decaffeinated)
  • Alcohol
  • Carbonated beverages (especially those also containing sorbitol)
  • Artificial sweeteners (aspartame, splenda etc)

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