10 things you should know about inflammatory bowel disease (IBD)

Inflammatory bowel disease (IBD) is a term that refers to two conditions that involve inflammation of the gut – Ulcerative Colitis (UC) and Crohn’s disease. Both are long-term conditions that require constant care and attention. Dr Adam Haycock, an expert gastroenterologist guides us through his top ten facts for understanding IBD. 

1. Having a family history of IBD increases the risk of suffering IBD too.

For people with a family history of IBD, there is a 10-fold increased risk of IBD as well. For people with a sibling who suffers from IBD, there is a 30-fold increased risk, which is more prominent for Crohn’s disease than Ulcerative colitis. Therefore, if you suspect you suffer from IBD, it is helpful to review your family history to check if any relatives have suffered from IBD too.

2. Smoking affects ulcerative colitis and Crohn’s disease differently.

It is important to realise that smoking has different effects on Crohn’s disease and ulcerative colitis. People who smoke are more likely to develop Crohn’s disease than non-smokers, but they are less likely to develop ulcerative colitis. The reason for this is still poorly understood. The best advice is not to smoke!

3. IBD is not the same as irritable bowel syndrome (IBS).

Distinguishing IBD from IBS can be challenging in certain cases, particularly for Crohn’s disease, because often the symptoms are non-specific and similar. However, IBS differs to IBD in that no physical damage to the gut is caused by IBS. Therefore, making the correct diagnosis is important. One good screening test is to determine the levels of faecal calprotectin (FC) in stool samples. FC is a protein which is released by the white blood cells found in inflamed areas of the bowel in patients suffering from IBD. Therefore, a positive FC can be a good predictor for IBD, whereas a negative FC makes IBS much more likely.

4. When being diagnosed, it is important to rule out infection first.

Ruling out infection in patients suffering from bowel inflammation is important because it can help determine the best treatment to follow. In addition, testing stool samples in known IBD sufferers is key, as ruling infection out can help guide treatment options.  

5. Successful management of IBD needs to be multidisciplinary.

Treating IBD should not just involve a single specialist or GP, but should include a range of healthcare professionals. For example, most hospitals will have a dedicated IBD nurse who can be contacted for advice, support or to arrange expedited appointments with a specialist. If you suffer from IBD is important that you maintain remission, respond quickly to any relapses or flare-ups and to get advice where necessary.

6. Aminosalicylates (5-ASAs) can prevent relapse and treat flare-ups in ulcerative colitis.

5-ASAs are a group of medications that help to reduce inflammation in ulcerative colitis. They can be prescribed to reduce the risk of relapse, as well as to treat a mild-to-moderate flare-up at a higher dosage.

7. Aminosalicylates (5-ASAs) are less effective in treating Crohn’s disease.

5-ASAs are not as effective in treating Crohn’s disease, and instead antibiotics or steroids are generally recommended to treat flare-ups, and immunosuppressant medications to maintain remission.

8. Self-management is key to treating IBD.

Patients that are trained in self-management of their IBD will have quicker treatment, fewer hospital visits, reduced GP consultations and will be more satisfied with the care they receive. To achieve this, it is important that those with IBD are educated about their condition, and know what to look out for and who to contact when assistance is needed.

9. Surgery does not always have to be considered as the last resort for treating IBD.

For those suffering from ulcerative colitis, sometimes surgery is the best course of action, particularly if their symptoms are acute and ongoing or have been resistant to other treatment options. Surgery may also be required to treat complications of Crohn’s disease when medical therapies have failed. It is important that patients suffering from IBD know that surgery could be an option.

10. Having IBD affecting your colon does increase your risk of bowel cancer.

Being aware of the increased risks of developing bowel cancer in IBD patients with colonic Crohn’s or ulcerative colitis is important, and regular screenings will be advised. If you also have a family history of bowel cancer, then surveillance may be even more frequent.

If you suffer from IBD or suspect you might, you should speak to a specialist who can best advise you on diagnosis and management.