Inflammatory bowel disease (IBD) is a broad term used to describe two types of inflammatory conditions of the gastrointestinal tract (GIT): Ulcerative colitis and Crohn’s disease.
Ulcerative colitis is a long-term inflammation in a part of the digestive tract, generally occurring in the colon (large intestine) and rectum. The inflammation is present in the inner lining in a continuous stretch that usually starts at the rectum, further spreading into the colon.
Crohn’s disease can occur in any part of the digestive tract (mouth to anus), but generally affects the small intestine before the large intestine. The inflammation can penetrate multiple layers of the GIT and the inflamed areas are seen in patches (next to the healthy tissue) rather than a continuous stretch.
Symptoms
The symptoms of IBD can come and go. There can be long periods when a person with IBD suffers from few or no symptoms at all (remission), to having severe symptoms at certain times (flare-ups). However, the main symptoms of both types of IBD are similar. These include:
- Pain or cramps in the abdomen
- Change in bowel habits like diarrhea or constipation
- Bleeding from rectum or bloody stool
- Weight loss
- Tiredness and fatigue
In extreme cases or flare-ups for a longer period, people may also show fever, nausea, vomiting and anemia.
Causes
The exact cause of IBD is unknown, but the leading theory is that it happens because the body’s immunity attacks itself. The immunity responds incorrectly to certain environmental triggers and causes inflammation of the GIT. People having a family history of IBD in close relations are more likely to develop the condition.
Diagnosis
A series of endoscopies, imaging and blood tests can help make a definite diagnosis of IBD. Some of the common methods used are:
- Endoscopy — often used to rule out Crohn’s disease by photographing the upper gastrointestinal tract using a camera fitted in a tube that is inserted from the mouth
- Colonoscopy — used to rule out ulcerative colitis by photographing the large intestine or rectum using a camera inserted from the rectum
- MRI/CT scans — can be used to identify the exact location and severity of the inflammation in the GIT. MRI produces a more accurate image helping establish the type of IBD
- Blood tests — can detect specific antibodies in the blood that can help to rule out the type of IBD. However, they are not a definite marker and should be collaborated with endoscopy to establish a definite diagnosis
- Stool tests — may be used to check if the cause is due to any other infection caused by bacteria, viruses, or parasites
Treatment
Medications may be used to treat IBD in many ways and can be used standalone or in combination. These include:
- Drugs such as mesalazine, aminosalicylates that reduce inflammation
- Immuno-suppressants such as steroids, azathioprine
- Biologics to target a specific part of the immune system to neutralize autoimmunity reaction
- Antibiotics to kill bacteria
Many people do not respond to medication and require surgical intervention to treat the damaged or inflamed part of GIT. Bowel resection, strictureplasty, colostomy or ileostomy are some surgical methods to remove the damaged part of the GIT.
