What is Inflammatory Bowel Disease (IBD)?
Inflammatory bowel disease (IBD) refers to chronic conditions that cause inflammation in some part of the intestines.
The intestinal walls become swollen, inflamed, and develop ulcers, which can cause discomfort and serious digestive problems.
The two most common forms of IBD are Crohn’s disease and ulcerative colitis.
- Crohn’s disease.
Can affect any part of the digestive tract (from the mouth to the anus) – Most often it affects the portion of the small intestine before the large intestine/colon.
Damaged areas appear in patches that are next to areas of healthy tissue. Inflammation may reach through the multiple layers of the walls of the GI tract.
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- Ulcerative colitis.
Occurs in the large intestine (colon) and the rectum.
Damaged areas are continuous (not patchy) – usually starting at the rectum and spreading further into the colon. Inflammation is present only in the innermost layer of the lining of the colon.
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How many people have IBD?
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More than 5 million people worldwide manage this chronic disease.
- Approximately 1.6 million Americans currently have IBD.
- As many as 70,000 new cases of IBD are diagnosed in the United States each year.
- There may be as many as 80,000 children in the United States with IBD.
What causes Inflammatory Bowel Disease?
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Doctors aren’t sure why some people get IBD.
Most believe something triggers the body’s immune system to produce an unhealthy inflammatory reaction in the digestive tract.
Researchers have found specific genes linked to ulcerative colitis and Crohn’s disease.
- Genetics
You might be more likely to develop IBD if you have a sibling or parent with the disease. This is why scientists believe IBD may have a genetic component.
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- The immune system
The immune system may also play a role in IBD.
Normally, the immune system defends the body from pathogens (organisms that cause diseases and infections). A bacterial or viral infection of the digestive tract can trigger an immune response.
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As the body tries to fight off the invaders, the digestive tract becomes inflamed. When the infection is gone, the inflammation goes away. That’s a healthy response.
In people with IBD, however, digestive tract inflammation can happen even when there’s no infection. The immune system attacks the body’s own cells instead. This is known as an autoimmune response.
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IBD can also occur when the inflammation doesn’t go away after the infection is cured.
The inflammation may continue for months or even years.
What are the signs and symptoms of Inflammatory Bowel Disease?
The symptoms of ulcerative colitis and Crohn’s disease are similar:
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People with IBD may have symptoms outside the digestive tract, such as:
- Mouth sores and skin problems
- Arthritis
- Eye problems that affect vision
How is Inflammatory Bowel Disease Diagnosed?
It is very important to know that there is NO single test that will give you a 100% diagnosis of Crohn’s disease or Ulcerative Colitis.
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Doctors have to put together all of the clues on history, physical exam, labs, stool studies, endoscopy and imaging in order to connect the dots to give the diagnosis.
This can be difficult and challenging in some patients.
To help confirm a diagnosis of IBD, you may have one or more of the following tests and procedures:
Blood tests
- Tests for anemia or infection.
Your doctor may suggest blood tests to check for anemia — a condition in which there aren’t enough red blood cells to carry adequate oxygen to your tissues — or to check for signs of infection from bacteria or viruses.
- Fecal occult blood test.
You may need to provide a stool sample so that your doctor can test for hidden blood in your stool.
Endoscopic procedures
- Colonoscopy
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This exam allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera.
During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis. Sometimes a tissue sample can help confirm a diagnosis.
- Flexible sigmoidoscopy
Your doctor uses a slender, flexible, lighted tube to examine the rectum and sigmoid, the last portion of your colon.
If your colon is severely inflamed, your doctor may perform this test instead of a full colonoscopy.
- Upper endoscopy
In this procedure, your doctor uses a slender, flexible, lighted tube to examine the esophagus, stomach and first part of the small intestine (duodenum).
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While it is rare for these areas to be involved with Crohn’s disease, this test may be recommended if you are having nausea and vomiting, difficulty eating or upper abdominal pain.
- Capsule endoscopy
- This test is sometimes used to help diagnose Crohn’s disease involving your small intestine. You swallow a capsule that has a camera in it.
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- The images are transmitted to a recorder you wear on your belt, after which the capsule exits your body painlessly in your stool.
- You may still need an endoscopy with a biopsy to confirm a diagnosis of Crohn’s disease.
- Balloon-assisted enteroscopy
For this test, a scope is used in conjunction with a device called an overtube. This enables the doctor to look further into the small bowel where standard endoscopes don’t reach.
This technique is useful when a capsule endoscopy shows abnormalities, but the diagnosis is still in question.
Imaging procedures
- X-ray
If you have severe symptoms, your doctor may use a standard X-ray of your abdominal area to rule out serious complications, such as a perforated colon.
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- Computerized tomography (CT) scan
You may have a CT scan — a special X-ray technique that provides more detail than a standard X-ray does.
This test looks at the entire bowel as well as at tissues outside the bowel.
CT enterography is a special CT scan that provides better images of the small bowel. This test has replaced barium X-rays in many medical centers.
- Magnetic resonance imaging (MRI).
An MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues.
An MRI is particularly useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). Unlike a CT, there is no radiation exposure with an MRI.
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IBD is not IBS
IBD is sometimes confused with IBS, which stands for irritable bowel syndrome.
Both conditions can cause chronic digestive problems, but there are key differences between the two.
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People with IBD have inflammation, ulcers, and other damage visible inside the digestive tract.
In contrast, there is no damage in IBS, despite symptoms such as cramping, diarrhea, and constipation. IBS is much more common but less serious than IBD.
IBD is not celiac disease…
Celiac disease is another condition with similar symptoms to IBD. It is also characterized by inflammation of the intestines.
However, the cause of celiac disease is known and is very specific. It is an inflammatory response to gluten (a group of proteins found in wheat and similar grains).
The symptoms of celiac disease will go away after starting a gluten-free diet, although it usually will be months before the full effects of the new diet will be reached.
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Was this article helpful? Other related articles:
Asacol – Prescription Medication for the Treatment of Ulcerative Colitis
Mesalamine for ulcerative colitis and Crohn’s disease – one drug, many options
How Prednisone Works to Reduce Inflammation
Finding relief from Crohn’s disease with Entocort® EC
Prescription Relief and Treatment of Ulcerative Colitis
If you have questions about your prescription or non-prescription medication, please contact the team at Canada Online Health by calling toll free 1-800-399-DRUG (3784) or visit their website at www.canadaonlinehealth.ca.One of the friendly and discreet pharmacy representatives will be happy to answer your questions.
This article contains medical information provided to help you better understand this particular medical condition or process, and may contain information about medication often used as part of a treatment plan prescribed by a doctor. It is not intended to be used as either a diagnosis or recommendation for treatment of your particular medical situation. If you are unwell, concerned about your physical or mental state, or are experiencing symptoms you should speak with your doctor or primary health care provider. If you are in medical distress please contact emergency services (such as 911).
References:
- https://www.ibdunmasked.com/global/
- Sunanda V. Kane: IBD Self-Management
- https://www.crohnscolitisfoundation.org/
- https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315
- www.webmd.com/ibd-crohns-disease
- www.healthline.com/health/inflammatory-bowel-diseas
- https://www.uchicagomedicine.org/forefront/gastrointestinal-articles/combination-of-ibd-medications-offers-bridge-to-avoid-surgery
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