Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease

What is Inflammatory bowel disease (IBD), Symptoms and Treatment?

Inflammatory bowel disease (IBD) defines as a group of disorders in which the intestines become inflamed/swollen. It has often been believed to as an “Autoimmune disease“, The Research recommends that the chronic inflammation may not be due to the immune system attacking the body. It is an outcome of the immune system attacking a harmless virus, bacteria, or food in the gut, causing inflammation that creates to bowel injury.

What are the symptoms of Inflammatory bowel disease?

 Some common symptoms are:

  • Persistent diarrhea
  • Abdominal pain
  • Rectal bleeding/bloody stools
  • Weight loss
  • Fatigue

IBD may also be linked with problems other than of the digestive system, such as:

  • Eye inflammation
  • Skin disorders
  • Arthritis

What are the Types of Inflammatory bowel disease?

   The two most common ones are:

  • Ulcerative colitis (UC): it involves inflammation of the large intestine, but only in the digestive tract. It can lead to other non-digestive problems.
  • Crohn’s disease: it can cause inflammation in any part of the digestive tract. Majorly, on the tail end of the small intestine.

Also includes,

  • Microscopic colitis:  It causes intestinal inflammation only detectable on microscope.

What are the Risk Factors associated with IBD?

  • Age: Patients are diagnosed before they’re 30 years old. But it may be developed until their 50s or 60s.
  • Race or ethnicity: No evidence of research done but it might be possible occur in any race.
  • Family history.
  • Cigarette smoking.
  • Nonsteroidal anti-inflammatory (NSAIDs) medications. 

Example: ibuprofen , naproxen sodium, diclofenac sodium and others. They could increase the risk of developing IBD or worsen the disease in people who have IBD.

What are the Complications associated with IBD and Crohn’s Disorder?

 Problems found in both Crohn’s Disease and IBD conditions :

  • Colon cancer: Ulcerative colitis or Crohn’s disease that creates an effect on the colon may increase your risk of colon cancer.
  • Skin, eye & joint inflammation.
  • Medication side effects: As a side effect of medications used for IBD are linked with a small risk of developing certain cancers. Corticosteroids have a risk of osteoporosis, high blood pressure & other conditions.
  • Primary sclerosing cholangitis: This is a condition associated with bile ducts. Inflammation causes scarring within the bile ducts, ultimately making them narrow and slowly causing liver damage.
  • Blood clots. 

Complications of Crohn’s disease may include:

  • Bowel obstruction. 
  • Malnutrition: Diarrhea, abdominal pain and cramping may make it difficult for to absorb enough nutrients/food to keep you nourished. This may lead to lack in nutrition.
  • Fistulas

Anal fissure: It is a condition where small tears in the moist tissue of the anus or in the skin around the anus are infected. It’s often related to painful bowel movements and may lead to a “Perianal fistula” (Hindi: भगन्दर).

Complications of Ulcerative colitis may include:

  • Toxic Megacolon: Ulcerative colitis could lead to the colon rapidly widening and swelling, a serious condition known as “Toxic Megacolon”.
  • A hole in the colon (perforated colon). 
  • Severe dehydration. 

What’s the difference between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS)?

Inflammatory Bowel Disease (IBD)Irritable Bowel Syndrome (IBS)
It is a syndrome or group of symptomsIt is a functional gastrointestinal disease
It is Autoimmune deficiency.It can affect the bowels function process.
Risk of colon cancerIBS is also known as spastic colon or nervous stomach.
IBD can cause IBS symptomsIt doesn’t inflame or damage the intestines like IBD
May lead surgeryNo need for hospitalization or surgery

How is inflammatory bowel disease diagnosed?

Crohn’s disease and ulcerative colitis cause some how similar symptoms. No solitary test can diagnose either disorder.

The test starts with a complete blood count (CBC) and stool test for intestinal inflammation.

Other diagnostic tests:

  • Colonoscopy to observe the large and small intestines.
  • EUS (endoscopic ultrasound) to check the digestive tract for swelling and ulcers.
  • Flexible sigmoidoscopy to inspect the inside of the rectum and anus.
  • Imaging scan, i.e a CT scan or MRI, to check for signs of inflammation or an abscess.
  • Upper endoscopy to study the digestive tract from the mouth to the start of the small intestine.
  • Capsule endoscopy : It is a small camera device that is being swallow. The camera captures images as it travels over the digestive system.
  • Barium enema

Treatment for Inflammatory bowel disease (IBD) :

Numbers of different treatments for IBD available as listed,

A. Medications for IBD:

  1. Corticosteroids:
  • Budesonide
  • Prednisone
  • Prednisolone
  • Methylprednisolone

  • 5-ASA Drugs (Aminosalicylates)
  • Balsalazide 
  • Mesalamine
  • Olsalazine
  • Sulfasalazine 

In 2019, the American Gastroenterological Association (AGA) published treatment guidelines/ protocols for adults with extensive mild to moderate UC. Here some recommendations:

  • Standard-dose oral mesalamine
  • Diazo-bonded 5-ASA drugs (balsalazide and olsalazine)

  • Immunomodulators
  • Methotrexate 
  • Azathioprine 
  • Mercaptopurine

  • Biologics

TNF-alpha inhibitors include:

  • Adalimumab
  • Golimumab 
  • Infliximab

Other biologics include:

  • Certolizumab
  • Natalizumab
  • Ustekinumab
  • Vedolizumab

  • Other drugs

Other drugs prevent separate pathways causing inflammation that includes,

  • The UC drug tofacitinib (Xeljanz)
  • Antibiotics: It kills bacteria in the small intestine that leads to trigger or aggravate the symptoms of Crohn’s.
  • Antidiarrheal medications and laxatives. 

B. Lifestyle choices for IBD

Lifestyle choices are more important,

  • Drinking plenty of fluids: That helps the patient make up for fluids lost in your stool.
  • Avoiding triggers, i.e. dairy products & stressful situations: Helping to improve symptoms and reduce flare-ups.
  • Exercising and if you smoke, quitting smoking: Helping to preserve in health during IBD.

C. Supplements

  • Vitamin and mineral supplements may help with nutritional deficiencies. For example, iron supplements helpful for treating anemia.

D. Surgery

  • Strictureplasty to widen a narrowed bowel
  • Closure or removal of fistulas
  • Elimination/Removal (Operational Work) of affected portions of the intestines: More for people with crohn’s disease
  • Elimination/Removal (Operational Work) of the entire colon and rectum: for severe cases of UC)

Note: Written all details are educational purpose only. Consult a physician before taking any medicines.

More :

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Vitamins and Minerals

Alcohol Dose Dumping

GAMP Guideline

BCS Classification

Tablet Friability


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