Inflammatory bowel disease (IBD)
IBD encompasses two separate conditions - ulcerative colitis and Crohn's disease. In both conditions, there is inflammation in the lining of the digestive tract, specifically the large intestines in ulcerative colitis, and mostly the small intestines in Crohn's. The inflammation causes swelling, redness, ulceration and bleeding.
What causes IBD?
Exact cause is not clear yet, but genetic factor plays a role. About 15-30% of people with IBD have a family member who also has the same problem. There are many changes in the immune system in IBD sufferers which are not fully understood.
Who are at risk?
IBD can affect any age, from young children to the elderly, but often affects young adults in their late teens or 20s. Women and men are equally affected.
What are the signs and symptoms?
Common signs and symptoms:
- Abdominal pain and cramping
- Bloating/distension
- Blood in the stool
- Loss of appetite
- Mucus in the stool
- Persistent diarrhea
- Ulceration in the digestive tract
What are the complications?
Poor nutrition, weight loss and anemia may result.
Crohn's disease can cause inflammation anywhere in the digestive tract from the mouth to the anus, and can lead to tunnels, called fistulas, forming between the bowel and the skin or surrounding structures such as the bladder. These can get infected and become abscesses.
Ulcerative can lead to joint, eye, liver and skin problems, although it is not clear why. There is an increased risk of bowel cancer.
How is it diagnosed?
Apart from medical examination, stool samples and blood tests may be necessary. The bowels may also be investigated with colonoscopy (a flexible scope is put through the anus to visualize the lining of the bowels) or X-ray techniques.
What are the treatments?
Treatment for IBD is highly individualized depending on the type and severity of the symptoms. It is aimed at improving the nutrition of the sufferer and keeping them as well as possible. Treatment options for IBD include dietary changes, medications and sometimes surgery.
Drugs include mesalamine agents, antibiotics, corticosteroids, azathioprine and infliximab. Surgery is reserved for people who are very unwell, for whom drug options have failed, and to relieve emergencies such as bowel obstruction. Surgery may result in a temporary or permanent 'stoma', or opening of the bowel onto the abdomen. A bag has to be placed over this opening to collect waste material.
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