Understanding inflammatory bowel disease: Causes, symptoms, and management

In this article, esteemed consultant gastroenterologist, Professor Naila Arebi, explains what inflammatory bowel disease is, whilst also outlining the associated symptoms and causes. 

What is IBD?

Inflammatory bowel disease (IBD) is a chronic condition characterised by inflammation of the digestive tract. IBD primarily includes two types: Crohn's disease and ulcerative colitis.

While both involve inflammation, they affect different parts of the gastrointestinal (GI) tract. Crohn's disease can affect any part of the GI tract, from the mouth to the anus, often spreading deep into affected tissues. Ulcerative colitis, on the other hand, typically impacts the colon and rectum, affecting only the innermost lining of the colon.

What causes inflammation of the bowel?

The exact cause of IBD remains unknown, but it is believed to result from an interplay of genetic, environmental, and immune system factors. Individuals with a family history of IBD are at a higher risk, suggesting a genetic predisposition.

Environmental factors, such as diet and exposure to pollutants, may also contribute to the development of the disease. Additionally, IBD is considered an autoimmune condition, meaning the immune system mistakenly attacks the body's own tissues, causing inflammation.

What are the main symptoms of IBD?

Symptoms of IBD can vary widely depending on the severity and location of the inflammation. Common symptoms include persistent diarrhoea, abdominal pain, cramping, and rectal bleeding. Other symptoms may include weight loss, fatigue, and a reduced appetite.

A family history of IBD or autoimmune diseases increases the risk of having IBD.

The chronic nature of IBD can lead to periods of remission, where symptoms are minimal or absent, interspersed with flare-ups, where symptoms become more severe.

How is it diagnosed?

Diagnosis of IBD typically involves a combination of medical history review, physical examinations, and diagnostic tests such as colonoscopy, endoscopy, and imaging studies such as a CT scan or MRI scan. Blood and stool tests are also commonly used to identify inflammation markers and rule out other conditions.

How is inflammatory bowel disease managed?

Management of IBD aims to reduce inflammation, alleviate symptoms, and achieve and maintain remission to prevent development of complications. Treatment options include medications like aminosalicylates, corticosteroids, immunomodulators, biologic agents and new class of drugs called small molecules that target specific parts of the immune response. In severe cases, surgery may be necessary to remove damaged portions of the GI tract.

Living with IBD can be challenging, but with proper management and support, individuals can lead active, fulfilling lives. Regular medical care, a healthy diet, stress management, and support from healthcare providers and patient communities are crucial in managing the disease effectively. As research continues, new treatments and a better understanding of IBD will hopefully improve outcomes for those affected by this condition.