Inflammatory Bowel Disease or IBD is a disease which involves chronic inflammation of your digestive tracts, and can have life threatening complications. IBD is usually found to include ulcerative colitis and Crohn’s disease, both o
Inflammatory Bowel Disease or IBD is a disease which involves chronic inflammation of your digestive tracts, and can have life threatening complications. IBD is usually found to include ulcerative colitis and Crohn’s disease, both of which have symptoms such as severe diarrhoea, pain, fatigue, and weight loss.
Upon recognising these IBD symptoms it is necessary to consult a doctor for necessary treatments. What we call Ulcerative colitis is basically a type of inflammatory bowel disease which can cause long-lasting inflammation and even ulcers in the innermost lining of the large intestine and the rectum. Crohn’s disease on the other hand is a type of IBD which causes inflammation on the lining of the digestive tract, and this inflammation could spread deep into the affected tissues. Other two types if inflammatory bowel diseases are Collagenous colitis, and lymphocytic colitis, but are regarded to be separate from the classic IBD. In this article we will learn about IBD causes, IBD symptoms, and even regarding IBD treatment.
Causes of inflammatory bowel disease
It is rather unfortunate that the exact IBD causes are not known, but previously it was suspected that diet and stress were prime factors. It has been now rectified that diet and stress merely aggravate IBD condition, but are not enough to cause the disease. There is however a possibility of an immune system malfunctions, this means that your immune system tries to fight invading viruses, and there is an abnormal immune response.
This response causes the immune system to attack the cells in the digestive tract. But in people with IBD, it has been found that those without any infection can also suffer from the disease. Also, one of the IBD causes could be hereditary, as it is more common for people who have family members with inflammatory bowel disease. Then again, most people with IBD are found not to suffer from the disease.
Symptoms of IBD
Inflammatory bowel disease has its defining symptoms that can point out to the disease. IBD symptoms largely depend on the severity of inflammation and where it occurs. Symptoms may range from mild to severe. The tell-tale signs and symptoms of the disease are as follows, and these are common to both Crohn's disease and ulcerative colitis.
• Diarrhea – a common problem for people with IBD.
• Fever and fatigue – patients often suffer from fever and fatigue in case of IBD. Additionally, they may also feel tired.
• Pain and cramping of the abdomen – another prominent IBD symptom, this is caused due to the inflammation and ulceration. It is common to also experience nausea and vomiting.
• Reduced appetite – due to the abdominal pain and cramping, and as well as inflammation, your appetite can reduce.
• Loss of blood – there could be loss of blood through stool, and you may also bleed but not see the blood.
• Weight loss – there is a major chance of weight loss for those suffering from IBD; this is primarily because the food you eat does not get digested well.
Then again, ulcerative colitis can be further classified in accordance to its location of inflammation, and the severity, and this is why it can be divided into five broad parts.
Ulcerative Protitis is when the inflammation occurs closest to the rectum and the IBD symptom here would be rectal bleeding.
Proctosigmoiditis is another type where the inflammation occurs in the rectum and sigmoid or lower end of the colon, and signs and symptoms include, diarrhoea, cramps and pain.
Left-sided Colitis inflammation extends through the sigmoid and descending colon; its symptoms include diarrhoea, cramping and pain on the left, and weight loss.
Pancolitis often affects the entire colon and causes bouts of bloody diarrhea that may be severe, abdominal cramps and pain, fatigue, and significant weight loss.
Acute severe ulcerative colitis is a rare form of colitis, which affects the entire colon and causes severe pain, profuse diarrhea, bleeding, fever and inability to eat.
Treatment of IBD
Anti-inflammatory drugs could be used as the first step in the IBD treatment –
• Aminosalicylates – It can be effective in reducing symptoms of ulcerative colitis and for some people with Crohn's disease. However, one should be aware that it has a number of side effects, including, digestive distress and headache. Certain 5-aminosalicylates — including mesalamine (Asacol, Lialda, Rowasa, Canasa, others), balsalazide (Colazal) and olsalazine (Dipentum).
• Corticosteroids – These drugs include prednisone and hydrocortisone, and are generally reserved for moderate to severe ulcerative colitis or Crohn's disease that doesn't respond to other treatments. It has been found that Corticosteroids have numerous side effects, including a puffy face, excessive facial hair, night sweats, insomnia and hyperactivity. At times there could be more-serious side effects, such as, high blood pressure, diabetes, osteoporosis, bone fractures, cataracts, glaucoma and increased chance of infection.
Then there are the immune system suppressors to tackle inflammatory bowel diseases. These drugs also reduce inflammation, but they target your immune system rather than directly treating inflammation, in other words, they suppress the immune response that releases inflammation-inducing chemicals in the intestinal lining.
• Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan) – Widely used immune-suppressants for treatment of inflammatory bowel disease, these should be taken and followed up closely with your doctor and have your blood checked regularly to look for side effects, including effects on the liver and pancreas. Additional side effects include lowered resistance to infection and a rare chance of developing cancers such as lymphoma and skin cancers.
• Cyclosporine (Gengraf, Neoral, Sandimmune) – Normally given to people who haven't responded well to other medications, the drug is generally confined to ulcerative colitis. There could be serious side effects, such as, kidney and liver damage, seizures and fatal infections — and is not for long-term use. There's also a small risk of cancer, so let your doctor know if you've previously had cancer.
• Infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi) – These drugs work by neutralizing a protein produced by your immune system. They are for people with moderate to severe Crohn's disease or ulcerative colitis who don't respond to, or can't tolerate other treatments. It should be known that certain people with certain conditions can't take TNF-alpha inhibitors, so it is important to get tested before taking them.
• Methotrexate (Rheumatrex) – Used mainly to treat cancer, psoriasis and rheumatoid arthritis, it is sometimes used for people with Crohn's disease who don't respond well to other medications. It is given by injection. Short-term side effects include nausea, fatigue and diarrhea, and rarely, it can cause potentially life-threatening pneumonia, while long-term use can lead to bone marrow suppression, scarring of the liver and sometimes cancer.
• Natalizumab (Tysabri) and vedolizumab (Entyvio) – These drugs work by stopping certain immune cell molecules — integrins — from binding to other cells in your intestinal lining.
• Ustekinumab (Stelara) – This drug is used to treat psoriasis.
Antibiotics are yet another medication given to people with ulcerative colitis, and those who run fevers. Antibiotics help in reducing the amount of drainage and sometimes heal fistulas and abscesses in people with Crohn's disease.
• Metronidazole (Flagyl) – Metronidazole was the most commonly used antibiotic for Crohn's disease. Though it can cause serious side effects, including, numbness and tingling in your hands and feet and, occasionally, muscle pain or weakness. It is important to know that patients taking this medicine should not drink alcohol.
• Ciprofloxacin (Cipro). This drug works to improve symptoms in some people with Crohn's disease. A rare side effect is tendon rupture.
The final measure taken as an IBD treatment is surgery, and this of course happens when diet and lifestyle changes, drug therapy, or other treatments don't relieve your IBD symptoms. These include the following –
• Surgery for ulcerative colitis
This surgery process can help to cope with ulcerative colitis. This means that the entire colon and rectum are removed (proctocolectomy). The process used for this is ileoanal anastomosis, and it eliminates the need to wear a bag to collect stool.
• Surgery for Crohn's disease
People suffering from Crohn's disease are found to require at least one surgery. But the irony here is that surgery does not cure Crohn's disease. During surgery, doctors remove the affected and damaged portion of the patient’s digestive tract, and then it is reconnected with the healthy sections. Surgery may also be used to close fistulas and drain abscesses.
The fact remains, that unfortunately the benefits of surgery for Crohn's disease are usually temporary. Doctors have found that the disease often recurs, frequently near the reconnected tissue, and the best possible approach would be to follow surgery with medication to minimize the risk of recurrence. For those who have had surgery on the colon, or where the small intestine and colon meet, doctor may recommend a repeat colonoscopy in six to 12 months to look for signs of disease and help with correct treatment.
Coping with IBD
For people suffering from Inflammatory Bowel Disease, it can be really difficult because it only affects you physically, but also takes an emotional toll as well. If IBD Symptoms are severe, then the affected person may have to constantly run to the toilet. Even when the IBD symptoms are mild, it can be difficult to be out in public. All of these factors can alter your life and may lead to depression. It is very important for patients to be informed, as it gives you ways to be more in control, so find out as much as possible about inflammatory bowel disease.
Patients can also join a support group, as they would provide the mental strength to go on with it, they will also give you valuable information about your condition. It is often found that group members are informed about the latest medical treatments or integrative therapies. You may also find it reassuring to be among others with IBD.
Another good way of coping with it all is by speaking to a therapist, as the professional can be a constant guide to you, and can be instrumental in changing your way of thinking and looking at life. It could be especially helpful of your therapist is someone who happens to know about inflammatory bowel disease, and he will try his best to help you. Here it should be noted that a patient suffering from IBD should have well informed relatives and friends, close people who have IBD information and can help the patient go through it with the right mind. Everything is possible with the right people and the correct attitude.
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