Inflammatory Bowel Disease: When life has become uncomfortable

Jul 29, 2018 Dr Zulfikar Bux, Features / Columnists

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By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
Inflammatory bowel disease (IBD) is rapidly increasing as more countries become industrialized. Studies are showing that the westernized diet and lifestyle is putting more persons at risk for IBD. It’s starting to creep up in Guyana also.
Today we will shed some light on this condition so that you can be more aware in the event you, or someone you know, develop symptoms suggestive of it.
WHAT IS INFLAMMATORY BOWEL DISEASE (IBD)?
IBD is the name of a group of disorders that cause the intestines to become inflamed (red and swollen). The inflammation lasts a long time and usually comes back over and over again. The two primary types of inflammatory bowel disease are Crohn’s disease and ulcerative colitis.
WHAT IS CROHN’S DISEASE?
Crohn’s disease is an IBD that causes ulcers to form in the gastrointestinal (GI) tract anywhere from the mouth to the anus. Crohn’s disease can have areas that are normal, in between areas that are affected. Some people who have Crohn’s disease have severe symptoms, while others have less severe symptoms. Some people who have the disease have long periods without symptoms, even without getting treatment. Others with more severe disease will need long-term treatment or even surgery.
WHAT IS ULCERATIVE COLITIS?
Ulcerative colitis is an IBD that causes your colon (large intestine) to become red and swollen. The redness and swelling can last for a few weeks or for several months. Ulcerative colitis always involves the last part of the colon (the rectum) and can go higher up in the colon, up to involving the whole colon, but is continuous unlike Crohn’s disease which skips areas. Symptoms may come and go for up to a year. These occurrences are called flare-ups.
WHAT ARE THE SYMPTOMS OF CROHN’S DISEASE?
The symptoms of Crohn’s disease vary, depending on which part or parts of the gastrointestinal (GI) tract is affected. Common symptoms include the following:
• Diarrhea
• Stomach cramps
• Abdominal pain that comes and goes
• Blood in your stool
• Low appetite
• Unintended weight loss
Other less common symptoms may include fever, joint pain, eye problems, skin problems, and feeling tired (called fatigue). The symptoms of Crohn’s disease may be mild or severe and may also come and go.
WHAT ARE THE SYMPTOMS OF ULCERATIVE COLITIS?
Symptoms of ulcerative colitis vary depending on how severe your case is and how much of your large intestine is affected. Common symptoms include the following:
• Rectal pain or bleeding
• Frequent, small bowel movements
• Feeling an urgent need to have a bowel movement
• Diarrhea
• Blood in the stool
• Abdominal cramping and pain
• A strong feeling that you need to have a bowel movement, but not being able to do so (called tenesmus)
• Pain on the left side of the abdomen
• Unintended weight loss
• Fatigue
In most people who have ulcerative colitis, these symptoms tend to come and go. You may have periods where you have no symptoms, followed by periods where you do have symptoms.
WHAT CAUSES IBD?
It is not yet known exactly what causes these inflammatory bowel diseases. These diseases seem to run in families, which mean that genetics may play a role. Many researchers believe that inflammatory bowel diseases are caused by a problem with the immune system. Normally, the immune system protects your body from infection. In people who have an inflammatory bowel disease, the immune system mistakes food, healthy bacteria, and other substances for an infection. This causes the immune system to attack the cells of the intestine, which leads to inflammation.
HOW IS IBD DIAGNOSED?
Your doctor will give you a physical exam and listen to you describe your symptoms. To help diagnose your problem your doctor may order a number of tests, including blood tests and stool samples. Your doctor may also order one or more procedures to help him or her view your colon. These procedures usually require them to look into your intestines with a camera.
HOW IS IBD TREATED?
The goal of treatment is to get rid of the inflammation that causes your symptoms. Many types of medicine can help reduce inflammation, including anti-inflammatory drugs and drugs that suppress the immune system. Depending on your symptoms, your doctor may also recommend an antibiotic, anti-diarrheal, laxative, pain reliever or vitamin supplements. In severe cases of inflammatory bowel disease, you may need to go to the hospital for intravenous (IV) fluids or surgery.
WHAT CAN YOU DO TO RELIEVE THE SYMPTOMS?
The best thing you can do is to take good care of yourself. It’s important to eat a healthy diet. Depending on your symptoms, your doctor may ask you to cut down on the amount of fibre or dairy products in your diet. It also may be necessary to limit or avoid caffeine, alcohol, and carbonated beverages. In addition to eating well, you need to get enough rest and exercise regularly. It’s also important that you learn to manage the stress in your life. When you become overly upset by things that happen at home or at work, your intestinal problems can get worse.
If you have inflammatory bowel disease, you are at an increased risk of colon cancer. It is therefore best that you get checked early if you think you have any symptom(s) suggestive of IBD.

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