A guide to inflammatory bowel disease

Inflammatory bowel disease (IBD) is an umbrella term for a variety of chronic diseases that affect the gastrointestinal (GI) tract, causing chronic inflammation. In this article, a consultant gastroenterologist explains the kinds of IBD, diagnostic methods for IBD, and treatment options.

What is an inflammatory bowel disease?

The two kinds of IBD are Crohn’s disease and ulcerative colitis. IBDs can be contracted at any age, and are commonly diagnosed in younger people from 15 to 30 years old, though cases for people in their 60s aren’t irregular. Both conditions have symptoms that develop gradually, but patients are also likely to suffer from sudden flare-ups.

Crohn’s disease can affect any portion of the gastrointestinal tract, but mostly is concentrated at the end of the small intestine or at the beginning of the colon. It is the more aggressive of the two conditions, causing symptoms such as:

• Abdominal pain and cramps
• Feverish temperatures
• Bloating
• Fatigue
• Reduced appetite and weight loss
• Fistulas, which are scar tissue connections between organs and other structures
• Diarrhoea, typically bloody

Crohn’s disease is thought to be caused by a combination of genetics, autoimmune dysfunction, and gut bacteria imbalance.

Ulcerative colitis affects part of the large intestine and the rectum, inflaming them to the point of forming ulcers along those organs, however, it is considered to be the milder of the two IBDs.

Symptoms of ulcerative colitis are very similar to those of Crohn’s disease, such as:

• Diarrhoea, typically bloody
• Stomach and rectal pain
• Increased need to use the toilet
• Weight loss and fatigue
• Mouth ulcers and swollen joints

Ulcerative colitis is thought to also be caused by genetics and autoimmune dysfunction. In fact, both conditions are very similar, differing mainly in intensity and in which gastrointestinal organs the inflammation arises.

How are IBDs diagnosed?

Typical imaging tests like ultrasounds, CT scans, and MRIs can be utilised when investigating bowel issues, but a coloscopy is one of the best methods with decisive results for diagnosing IBDs.

A colonoscopy involves a thin, flexible tube called an endoscope being inserted through the anus. At the end of the endoscope is a camera and light, which is connected to a screen with which the doctors are able to view the inflammation in real-time and high definition. With this, they can pinpoint the location of the inflammation and the extent of the damage.

How are IBDs treated?

At the moment, there is no cure for either Crohn’s disease or ulcerative colitis. However, there are ways to manage an IBD so that the symptoms are milder or less frequent, initiating periods of what is called ‘remission’.

Treatment for both kinds of IBD can include:

• Anti-inflammatory medications, such as steroids and amino-salicylates
• Immunosuppressants in cases where there are frequent flareups to stifle the immune system’s inflammation mechanisms
• Surgery, which is typically explored when patients have not responded to medicinal intervention and are suffering severely, can include procedures to remove sections of the digestive tract (such as the colon) and reconnect healthy tissue for temporary relief or implanting an ostomy pouch (in an ileostomy) for a complete ‘cure’ that has the condition of needing to make major lifestyle adjustments. 

If you are having bowel issues, you can consult with a specialist on Top Doctors today.