Inflammatory Bowel Diseases

Inflammatory Bowel Diseases ( IBD )

Inflammatory bowel disease (IBD) represents a group of intestinal disorders that cause prolonged inflammation of the digestive tract.

Overview

The human digestive tract comprises the mouth, esophagus, stomach, small intestine, and large intestine. It’s responsible for breaking down food, extracting the nutrients, and removing any unusable material and waste products. Inflammation anywhere along the digestive tract disrupts this normal process. IBD can be very painful and disruptive, and in some cases, it may even be life-threatening.

Symptoms

Symptoms vary according to the location and severity of the disease, as well as the type of disease. The following symptoms are common to both types of IBD:

Blood in the stool.
Diarrhea.
Fatigue.
Fever.
Appetite loss.
Nausea.
Painful bowel movements.
Pus or mucus in the stool.
Stomach pain and cramps.
Vomiting.
Night sweats.
Weight loss.

Causes

It is not known what causes IBD exactly, but many experts believe several factors may play a role:

Immune function: IBD may result when an abnormal immune system response to bacteria, viruses, or food particles, triggers an inflammatory reaction in the gut.
Genetics: Links have been discovered between IBD and certain gene mutations. Upto 20 percent of those with ulcerative colitis have a close relative with IBD, but no specific pattern to heredity has been established.
Bacteria or viruses: Research has linked both E.coli and enteroviruses to Crohn's disease.
Environmental: Factors such as smoking, oral contraceptives, diet, breastfeeding, vaccinations, antibiotics, and others have been investigated as potential causes..

Diagnosis

In order to diagnose IBD, a doctor will take a full medical history before ordering one or more diagnostic tests. Types of tests include:

Stool samples.
Blood tests to test for anemia or infection.
X-rays, if a serious complication is suspected.
CT scan.
MRI scans, to detect fistulas in the small intestine or anal area.
Endoscopic procedures may also be used. A flexible probe with a camera attached is inserted through the anus. These procedures help uncover intestinal damage and allow the doctor to take a small sample of tissue to examine.

Types of endoscopic procedures typically used include:

Colonoscopy - to examine the entire colon.
Flexible sigmoidoscopy - to examine the last section of the colon.
Upper endoscopy - to examine the food pipe, stomach, and the anterior part of the small intestine.
Capsule endoscopy is another option. This procedure requires a person to swallow a capsule that has a camera inside, enabling the doctor to examine the small intestine.

Treatment

Anti-inflammatory drugs are the first step in IBD treatment. These drugs decrease inflammation of the digestive tract. However, they have many side effects.
Lifestyle choices are important when you have IBD. Drinking plenty of fluids helps to compensate for those lost in your stool. Avoiding dairy products and stressful situations also improves symptoms. Exercising and quitting smoking can further improve your health.
Vitamin and mineral supplements can help with nutritional deficiencies. For example, iron supplements can treat anemia.

Surgery can sometimes be necessary for people with IBD. 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.
Removal of the entire colon and rectum, for severe cases of ulcerative colitis.
Routine colonoscopy is used to monitor for colon cancer, since those with IBD are at a higher risk.

Medication

Anti-inflammatory drugs used for IBD include standard-dose mesalamine, sulfasalazine and its byproducts, and corticosteroids.
Immunosuppressants (or immunomodulators) prevent the immune system from attacking the bowel and causing inflammation. This group includes drugs that block TNF. TNF is a chemical produced by the immune system that causes inflammation. Excess TNF in the blood is normally blocked, but in people with IBD, higher levels of TNF can lead to more inflammation.
Another medication, tofacitinib (Xeljanz), is a newer option that works in a unique way to reduce inflammation.
Antibiotics are used to kill bacteria that may trigger or aggravate IBD symptoms.
Antidiarrheal drugs and laxatives can also be used to treat IBD symptoms.

Inflammatory Bowel Diseases