Inflammatory Bowel Disease: Diagnosis and Treatment
Table of Content
This is a chronic condition that affects the digestive tract. Patients with this disease have chronic inflammation in some parts of the digestive tract.
- Ulcerative colitis and Crohn’s disease are the two main subtypes of IBD.
- A characteristic feature of ulcerative colitis is that it affects only the large intestine, while Crohn’s can affect any part of the digestive tract.
- However, Crohn’s disease most frequently affects the end of the small intestine and beginning of the large intestine.
Figure1: Ulcerative and Crohn’s Disease
- Researchers have been unable to uncover the cause of IBD.
- Research till date suggests that 4 factors, genetics, the environment, intestinal bacteria, and an abnormal immune response in the gut interact to cause IBD.
- IBD tends to occur in young people between the ages of 15-30 years.
- The severity of symptoms can range from mild to very severe.
- It frequent involves bloody diarrhea.
- Other symptoms include diarrhea, bleeding from the rectum, abdominal pain, fever, fatigue and weight loss.
- Sometimes IBD could lead to inflammation in body parts outside the digestive tract. This inflammation is often seen to affect the joints, eyes, skin and liver. Other organs could also be affected.
- The symptoms of this disease can reduce or disappear and then suddenly worsen, requiring treatment. Symptom flares can be very dangerous and should not be ignored.
- The diagnosis of IBD requires a combination of careful patient history, imaging tests such as radiography or computed tomography scans, and endoscopic evaluation with a camera inside the GI tract.
- Infections that cause similar symptoms are ruled out with the help of stool and/or blood tests.
- Blood tests help identify abnormalities like anemia, electrolyte abnormalities due to diarrhea and low albumin due to both inflammation and poor absorption or nutrients and vitamin deficiencies due to poor absorption of nutrients.
- Endoscopies, either upper gastrointestinal endoscopy or lower gastrointestinal endoscopy are required for the diagnosis of IBD. This helps the doctor to locate the region affected by the disease, collect tissue specimens and differentiate between Ulcerative colitis and Crohn’s Disease.
Figure 2:Upper and Lower Endoscopy
- The treatment of IBD is aimed at reducing the symptoms, prevent symptom recurrence and reduce complications.
- Different medicines are used based on the severity of the disease.
- Mild disease is most often treated with anti-inflammatory medications. Depending on the location of the inflammation the medication can be taken either orally or rectally.
- Severe disease is treated with stronger agents like immunomodulators or immunosuppressants.
- When the disease flares up, steroids are often required to control symptoms.
- Patients may require surgery if medications are unable to control the disease.
- There is an increased risk of colon cancer in patients with IBD that affects the colon.
- Colonoscopies are needed at regular intervals to detect any abnormalities that may develop during the course of the disease.
- While the disease is likely to flare up at intervals, it is possible to reduce the risk and frequency of relapse.
- Having the medications prescribed by your doctor as directed particularly when one does not experience any symptoms plays a large role in preventing flares.
You will find further information about IBD on any of these websites:
This information is intended as a guide only and cannot replace a discussion with a doctor. The information given here is current at the time of publication, but may change in the future. If you have further questions, you should discuss them with your treating doctor.