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Definition
Inflammatory Bowel Disease (IBD) is a chronic inflammation of the gastrointestinal (GI) tract . There are two types of IBD:
- Ulcerative colitis: Chronic inflammation of the colon and rectum
- Crohn’s disease: Chronic inflammation of the lining of the gastrointestinal tract. It mostly affects the small intestine, and may also affect the large intestine and the upper GI tract.
IBD can be characterized by mild symptoms for some patients, while others may experience moderate to severe symptoms.
Risk Factors
The exact causes of IBD are not fully understood; however, there are genetic and environmental risk factors that may lead to IBD. The following are the risk factors of IBD:
- Genetic Factors: Gene mutations increase the possibility of IBD, which is why it is more common in people with a family history of IBD.
- Environmental Factors: include unhealthy diet, smoking, and pollution. Smoking is particularly linked to Crohn’s disease.
- Immune System: An abnormal immune response to GI bacteria may lead to IBD.
- Age: IBD is more common in people under 30 years old, however, some people develop IBD in their 50s or 60s.
- Race: Some studies suggest that IBD is more common in white people; however, other ethnicities may still develop it.
- Medications: Some drugs may increase the risk or worsen the symptoms of IBD, such as Non-steroidal anti-inflammatory drugs (NSAIDs).
Symptoms
Symptoms of inflammatory bowel disease vary depending on the site and severity of the inflammation and may be intermittent. They include:
- General fatigue
- Diarrhea lasting longer than 4 weeks
- Abdominal pain and cramps
- Rectal bleeding
- Loss of appetite
- Unexplained weight loss
- Severe symptoms: strictures, fistulas, abscesses, and an increased risk of colon cancer.
Diagnosis
Diagnosis of irritable bowel disease can be challenging due to symptom overlap with other digestive disorders and infections. Physicians perform several tests, such as the following:
- Clinical examination and thorough family history.
- Laboratory tests, including blood tests for anemia and inflammation markers, and stool tests to rule out other causes.
- Imaging techniques (e.g., X-rays, CT scan, or MRI)
- Endoscopic procedures and biopsies of the inflamed areas.
Treatment
Unfortunately, irritable bowel disease is incurable, but it’s possible to manage symptoms, reduce inflammation, and hopefully limit exacerbation and complications. The management of IBD depends on the site and severity of the inflammation. It includes:
- Lifestyle Modifications: Certain foods can trigger the symptoms of IBD, so it is crucial to follow a healthy diet to help reduce the symptoms, such as diarrhea and abdominal pain.
- IBD patients should avoid dairy products because they cause bloating and diarrhea.
- Eat food rich in omega-3 fatty acids to help ease inflammation, and avoid food rich in omega-6, such as red meats, due to their effect on worsening IBD symptoms.
- A low-fiber diet may be beneficial for IBD patients who cannot tolerate fiber in foods, such as fruits and vegetables, due to having narrowed bowels caused by IBD, causing undigested matter to become stuck and worsen symptoms.
However, fruits and vegetables are recommended for those who can tolerate fiber.
- Patients can consult a physician or a nutritionist and follow a diet low in undigested carbohydrates, called FODMAP. It may ease symptoms.
- Avoid sweeteners, caffeine, and smoking.
- Medications:
- Aminosalicylates are the first-line treatment for mild to moderate cases.
- Corticosteroids can relieve symptoms briefly but may cause significant adverse effects with long-term use.
- Immunomodulators and biologics are used in moderate to severe conditions by affecting the immune system.
- Surgery: In specific severe and complicated IBD cases, the damaged areas of the GI can be removed surgically.
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