Inflammatory bowel disease (IBD) refers to two chronic conditions that cause inflammation and ulcers in the digestive tract. The two main types of IBD are ulcerative colitis and Crohn's disease. While their symptoms and treatments are similar, they differ in where inflammation occurs and symptoms. IBD requires lifelong management to control symptoms and prevent complications.
What is Inflammatory Bowel Disease?
Inflammatory bowel disease is an autoimmune disorder where the body's immune system mistakenly attacks healthy cells in the gastrointestinal tract resulting in chronic inflammation. The exact cause of IBD is unknown but it is believed to be due to a combination of environmental, genetic, and immunologic factors. Some examples that may trigger IBD include changes in the gut microbiome, diet, smoking habits, and various infections.
Two Main Types
Ulcerative colitis causes long-lasting inflammation and ulcers in the innermost lining of the large intestine and rectum. The inflammation usually affects the bottom part of the colon but in some cases can involve the entire large intestine. Crohn's disease, on the other hand, can impact any part of the gastrointestinal tract from mouth to anus. It often causes patches of inflammation in the lining that can be separated by normal areas of the digestive tract. However, in Crohn's disease the inflammation usually affects the full thickness of the intestinal wall.
Common Symptoms
Some common symptoms of both ulcerative colitis and Crohn's disease include abdominal pain, diarrhea, bloody stools, fatigue, loss of appetite and weight loss. The symptoms are variable depending on the severity and location of inflammation. They can range from mild to severe resulting in life-altering complications like abscesses, colon or intestinal cancer, or sometimes even need for surgery.
Diagnosis and Testing
Diagnosing Inflammatory Bowel Disease requires ruling out other conditions through medical history, physical examination, stool tests, endoscopy, colonoscopy, biopsy, imaging tests and blood work. Since symptoms are similar to other intestinal disorders, diagnosis involves confirmation of characteristic gastrointestinal inflammation through specialized tests.
Treatment Goals
The goals of treatment are to induce and maintain remission of symptoms by reducing gut inflammation, allowing for healing of intestinal lining and prevention of complications. Lifestyle changes such as diet and stress management along with medications are used to manage the disease. Common oral medications include aminosalicylates, corticosteroids, immunomodulators and biologics. For patients with severe disease, hospitalization may be required for intravenous steroids or nutrition support. In some cases when medications fail surgery may be necessary.
Living with IBD
IBD is a chronic condition requiring lifelong treatment and monitoring even during remission. Individual treatment plans are tailored based on the extent and location of disease as well as response to medications. Close monitoring by a gastroenterologist is important for early detection of complications or worsening of disease. Vaccination against infection is also recommended. While IBD cannot be cured, with proper management people can lead fulfilling lives with few symptoms or limitations. Support groups are also beneficial for coping with this condition both physically and emotionally.
IBD Research
Researchers are constantly working on understanding the causes, improving current treatments and developing new management options for IBD. There has been promising development in biologic therapies targeting specific parts of the immune system. Studies are also investigating the role of gut microbiome and probiotics to restore intestinal balance. Advances in surgical techniques make resection of affected bowel segments less invasive. With ongoing worldwide collaboration and clinical trials, there is hope that in the future IBD may transform from a chronic illness to one that can potentially be controlled or even cured.
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