Inflammatory Bowel Disease
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WHAT IS IBD?
IBD or Inflammatory Bowel Disease is a chronic condition that causes inflammation in the GI tract. This means that your body reacts to different trigger events by wreaking havoc on your bowels, causing a variety of symptoms, which may be different for everyone.
IBD is really a classification for two different types of GI inflammation: Crohn’s disease and ulcerative colitis. While both of these conditions can cause similar symptoms, the two are very different. Let’s take a closer look at the differences between Crohn’s disease and ulcerative colitis.
Crohn’s disease can affect any part of the GI tract from the mouth to the anus and can occur in different areas of the digestive tract.
Some of the more common symptoms of inflammation caused by Crohn’s disease include severe diarrhea, abdominal pain, fever, and fatigue. These symptoms may be mild in some, or severe in others, and can change in each person over time. Some people may also go into periods of remission, in which they experience no symptoms at all.
The cause of Crohn’s disease is unknown, but it’s thought that a virus or bacteria may trigger Crohn’s disease. It is also more common in people who have a family history of the condition. Most people with Crohn’s disease are diagnosed before the age of 30.
While Crohn’s disease may affect any part of the GI tract, ulcerative colitis, occurs when the lining of the large intestine (or colon), or the rectum, becomes inflamed. When the inflammation occurs, small ulcers are formed on the lining of the colon.
The inflammation of the colon and/or rectum can cause you to need to empty your bowels frequently, and the ulcers may produce bleeding or pus. Ulcerative colitis can also cause abdominal pain, fever, weight loss, and loose stools, among other symptoms.
Ulcerative colitis is typically diagnosed before 35 but can occur at any time. It’s a progressive condition that can worsen with age and is thought to develop due to an overactive immune system.
WHAT IBD IS NOT!
There is a whole range of digestive disorders, many of which have very similar symptoms. If you’ve been searching online for solutions to what you’ve been experiencing, it wouldn’t be surprising if you’ve gotten confused between the differences between Inflammatory Bowel Disease, Irritable Bowel Syndrome, and Celiac Disease. The fact that IBD and IBS have such similar acronyms doesn’t help any, either! With that in mind, here are a couple of key points to keep in mind:
- IBD is NOT IBS. The key difference between these two conditions is right in the name: Inflammatory Bowel Disease has to do with inflammation in your digestive tract, while Irritable Bowel Syndrome does not. Because of this fundamental difference between the two conditions, treatment for each of them can be very different.
- IBD is NOT Celiac Disease. Like IBD, Celiac Disease actually does involve inflammation of the digestive tract, but it’s triggered very specifically, through the consumption of gluten. Eliminate gluten from your diet and you’re likely to see the symptoms disappear, though it may take a few months before you truly feel back to normal. (3)
Also note that many patients self-diagnose themselves as being gluten intolerant, but without a professional’s insight, they may not be doing themselves as much good as they’d like. That’s because the symptoms can be similar to other conditions with different – and potentially more effective – treatment options.
To best understand what you have and find a treatment path that’s right for you, you’ll want to consult a physician. Only a doctor who understands these conditions – including their similarities and differences – can properly diagnose you and suggest a path forward.
PREVALENCE OF IBD
Both Crohn’s disease and UC are typically diagnosed in younger adults or teens. However, the disease can strike anyone at any time and it is often hereditary. According to the Center for Disease Control, an estimated 3 million US adults have IBD.
WHAT ARE THE SYMPTOMS OF IBD?
The symptoms of IBD, as well as the severity of the symptoms, can vary for everyone.
Common symptoms of IBD include diarrhea or loose stools, blood in the stool, weight loss, fatigue, fever, abdominal pain (which can sometimes be severe), and even malnutrition. In addition, some people can develop IBD-associated arthritis, which can cause pain or discomfort in the joints and lower back pain.
Symptoms of IBD may go away for months, or sometimes even years at a time before reoccurring.
The pain felt with IBD can be different for everyone. Some people may feel pain in different areas of their abdomen, some may feel back pain, and others may even feel pain in their joints.
Patients with IBD often experience emotional symptoms, in addition to physical symptoms. Anxiety about when they may have an attack, worries about their appearance, and general frustration and depression around their inability to enjoy everyday activities can affect people with IBD. Learn more about the emotional challenges people with IBD face in this video.
WHAT CAUSES IBD?
While it’s unknown why IBD occurs, it is thought that it may be triggered by an irregularity in the immune system and how it responds to bacteria, viruses, or certain foods.
Heredity also plays a role in IBD, as it’s been found that people who have a close family member with IBD may also develop the condition.
IBD is typically diagnosed before someone reaches the age of 30, and it is more common in Caucasians and people of Ashkenazi Jewish descent.
Other risk factors for IBD include where you live (people in urban areas are more likely to be diagnosed with IBD), taking certain medications, such as anti-inflammatories, and smoking. Smoking is associated with Crohn’s disease.
HOW IS IBD DIAGNOSED?
Because the symptoms of IBD vary for everyone, and symptoms can also be caused by other conditions, IBD is sometimes difficult to diagnose.
There are many different types of tests that your doctor may perform to properly diagnose IBD. These include blood tests, endoscopic procedures or exams, or imaging procedures to get a better look at the colon and tissues of the bowel. Here are some of the most common diagnostic tools you’re likely to encounter:
- Tests for Anemia or Infection – Simple blood tests can detect whether you have a deficiency in oxygen-carrying red blood cells or if you have an infection that may be causing problems.
- Stool Studies – Your doctor may test a stool sample to see if you have any irregularities in your stool, including blood or parasites.
- Flexible sigmoidoscopy – This is a procedure where your doctor will use a thin lighted instrument to examine your rectum and sigmoid, which is the last part of your colon. This test may be performed in place of a full colonoscopy for patients who have significant inflammation.
- Colonoscopy – A thin tube with a camera will be used to examine your colon for any signs of disease, and small tissue samples may be taken to further diagnose your condition.
- Upper Endoscopy – Here the doctor will use a flexible, lighted instrument to examine your upper gastrointestinal tract, including the esophagus, stomach and first part of your small intestine. This type of test is most common on patients who are experiencing nausea, vomiting, difficulty eating or pain in the upper abdomen.
- Capsule Endoscopy – This is a procedure that may be performed if your doctor suspects Crohn’s disease related to your small intestine. The patient swallows a tiny capsule with a camera inside it (don’t worry – you’ll pass it as part of a normal bowel movement without any discomfort), and the images are used to develop a diagnosis.
- Balloon-assisted Enteroscopy – In this procedure, the doctor uses an instrument to examine portions of your small bowel that are usually out of reach with other forms of examination.
- X-rays – An x-ray of your abdomen may be helpful to rule out certain serious conditions like a perforated colon.
- CT Scans – This imaging procedure can provide a detailed picture of your entire bowel and surrounding tissue. When particularly accurate images of the small bowel are needed, a type of CT scanning called CT enterography may be ordered.
- MRIs – Magnetic Resonance Imaging is especially beneficial when it comes to examining organs and tissues around the anal area or in the small intestine. One benefit these offer over CT scanning is that there is no exposure to radiation.
IBD can take some time to diagnose, and your doctor may recommend that you see a gastroenterologist (a doctor specializing in the digestive tract) if he or she suspects that you have inflammatory bowel disease.
Keeping a diary of your symptoms can help your doctor better understand what you’re experiencing and may help in recommending the tests needed to diagnose IBD.
HOW DO I TREAT IBD?
There are many approaches to treating IBD.
For many people, a good place to start is by altering their diet and lifestyle. That’s because certain foods can cause flare-ups, and avoiding those foods can help prevent symptoms.
For example, many IBD patients find that symptoms like diarrhea, abdominal pain, and gas can be improved with certain dietary changes, particularly the elimination of dairy products. As many as 30 million Americans are unable to properly digest the sugar in dairy products (1) – they’re lactose intolerant – and that’s especially true among Asian, African American, and Native American populations. Those who do suffer from lactose intolerance often find that specialty dairy products or the use of supplements like Lactaid can dramatically improve their ability to digest and enjoy dairy.
Dairy isn’t the only culprit, either. While everyone is affected differently, other foods that have been found to cause digestive problems for many include high-fat foods, spicy foods, alcohol, and caffeine. High fiber foods can also worsen symptoms of IBD for some. Keeping a food diary can be helpful in identifying foods that trigger your IBD symptoms.
- Multivitamins may also play a role in your treatment. Those who suffer from digestive disorders often don’t absorb nutrients as well as they should, and that can be compounded by limited diets. Supplementing with vitamins and minerals can be a helpful way to ensure that your body is getting everything it needs – though you should always check with your doctor first. Remember, not every vitamin is right for every patient.
Smoking can also increase your risk of IBD, or make symptoms worse, so if you’re a smoker, it’s another great reason to quit.
Many also believe that stress can aggravate IBD symptoms, so finding ways to reduce it, such as practicing meditation and adhering to a regular exercise routine are also often recommended.
When it comes to medications, anti-inflammatory and immunosuppressant drugs are often used for IBD. In fact, anti-inflammatories are often the first treatment prescribed, and they have a good track record of helping many sufferers. There are a number of medications your physician may consider, and the one that he or she prescribes will likely depend on your particular symptoms and which area of your colon is affected.
- Immunosuppressants work on your immune system by reducing your body’s production of chemicals that promote inflammation. These medicines are often beneficial to those living with bowel disorders because those inflammatory chemicals can damage the lining of your digestive tract; by suppressing them, you may be reducing a direct source of irritation.
- Another type of therapy that you may be presented with involves the use of biologics. If you’re not familiar with this class of treatments, don’t be surprised – they’re relatively new, but they’ve also been found to be very effective for many. The way they work is by neutralizing the activity of certain proteins that can produce inflammation. They’re typically administered either by injections that you can administer yourself – and we promise it doesn’t hurt! – or by intravenous infusion that can be performed in your doctor’s office.
- Anti-diarrheal medications are also commonly used, for obvious reasons, as are pain killers like ibuprofen, naproxen sodium, and diclofenac to deal with mild discomfort. Keep in mind that some of these medications can actually exacerbate your symptoms, so you’ll want to monitor your response to them closely to see if they’re making things worse. (3) Finally, your doctor may prescribe certain vitamins or supplements if it looks like you’re not getting the nutrients you need from the food you consume.
This is not an exhaustive list of the treatments you may be presented with. There are many options available that can vary by your symptoms, your current health status and other factors, including things like surgery for those who aren’t finding success with medication, diet and behavioral changes.
TALKING TO YOUR DOCTOR
If you have noticed any of the symptoms listed above, talk to your doctor about your concerns. He or she may refer you to a specialist to treat your symptoms and to perform the necessary tests to determine if you do in fact have IBD.
Your doctor will want to hear about all your symptoms, any changes in medication, and any stressful life changes that may have recently happened. Be sure to write down all your questions before your visit so that you don’t forget them during your appointment.
To make sure you don’t overlook anything important during your consultation, take a couple of minutes to write down the following information so you can be certain that you’ll review it in person:
- Your symptoms – List anything that you believe may be a symptom of your condition, including how severe it is and how long you’ve been experiencing it.
- Your medications – List all of the medications you’re taking. This doesn’t only include prescriptions; be sure to include any vitamins or supplements you’re taking, too.
- Questions for the doctor – It’s easy to get flustered during an appointment, so writing out the following questions is a good way to ensure that you don’t forget to ask them:
- What could be causing these symptoms?
- What tests do I need to take?
- Is this a temporary condition or something that may last a while? If so, how long does it usually last?
- Are there things I can do on my own to help improve my condition? Diet, exercise, or behavioral changes that might make a difference?
- What treatment options are available to me?
- With medications and other therapies, are there side effects?
- What results do these treatments usually produce?
IBD can be a difficult condition to live with, but by talking to your doctor and finding treatment, it can be managed.
Need help finding a specialist near you? Try our doctor finder!
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