Understanding Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is characterised by chronic inflammation of the digestive tract.

IBD consists of two main types:

1. Crohn’s disease is a type of IBD that may affectany part of the gastrointestinal tract – from the mouth to the anus. However, it is more commonly known to affect the end of the small intestine (ileum) and the beginning of the colon.
2. Ulcerative colitis is a disease characterised by inflammation of the colon and rectum.
   

Differentiating IBS and IBD

Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are gastroenterological conditions that affect the digestive system but are different from one another.

Risk Factors of IBD

The exact causes of IBD are not yet known, but some variables can increase the risk of developing the condition:

• Genetic factors: An increased risk of IBD may be due to a family history. People who have a first-degree relative (parents, siblings, or children) with IBD have a higher risk of also developing the disease.

• Smoking: Crohn’s disease is known to be caused by cigarette smoking.

• Diet and lifestyle: A diet high in fats, refined sugars, and processed foods may increase the risk of developing IBD. In contrast, a diet rich in fruits, vegetables, and fibre, on the other hand, can reduce the likelihood of developing IBD.

Complications of IBD

There are two categories of complications associated with inflammatory bowel disease (IBD): intestinal and extraintestinal.

• Intestinal: Haemorrhage, strictures, colon perforation, anal fistulas, pelvic or perirectal abscesses, toxic megacolon, cholangiocarcinoma, colon cancer.
• Extraintestinal: Osteoporosis, deep vein thrombosis, anaemia, gallstones, primary sclerosing cholangitis, aphthous ulcers, arthritis, iritis, pyoderma gangrenosum.

Diagnosis and Treatment Options

The diagnosis of IBD usually requires a combination of medical history, physical examination and diagnostic tests.

Diagnosis

1. Blood tests
2. Stool tests:To detect blood, infections and inflammation in the digestive tract.
3. Endoscopic procedures
   • Colonoscopy: A camera attached to a flexible tube is inserted into the rectum, allowing the doctor to examine the colon and take biopsies (small tissues samples) for further examination. This procedure is one of the main methods for IBD diagnosis.
   • Sigmoidoscopy: A procedure similar to colonoscopy, with the only difference being that only the rectum and the lower part of the colon are examined. It can be used when a colonoscopy is not necessary as it is less invasive.
   • Upper GI endoscopy: If the symptoms examined indicate inflammation in the gastrointestinal tract, an endoscopy of the oesophagus, stomach and upper part of the small intestine is performed instead for examination.
4. Imaging studies
   • CT scan (computed tomography): Produces detailed images of the intestines which can be used to detect complications such as abscesses, fistulas or bowel obstructions.
   • MRI (Magnetic Resonance Imaging): Visualises the small intestine which aids in the diagnosis and monitoring of Crohn’s disease. It also assists in the assessing the severity and extent of the disease without any exposure to radiation.
   • Abdominal ultrasound: Checks for bowel wall thickening and other signs of inflammation.

Treatment

Treatments may vary depending on the severity and symptoms of the patient’s IBD:

1. Medications
   • In the short term, patients are prescribed steroids such as prednisone to quickly reduce inflammation during flare-ups. However, due to the side effects, they are not suitable for long-term use.
   • Immunosuppressants are administered to the patient to reduce the inflammatory reaction.
2. Surgical intervention
   • If medications do not work or complications such as strictures, abscesses or excessive bleeding occur, surgery may be necessary to cure the disease.
3. Certain dietary approach
   • There is no specific diet that has been proven to cause or cure IBD, but there are certain dietary changes that can help manage symptoms. It is recommended to have a balanced diet that is low in processed foods and rich in fruits, vegetables, lean proteins and whole grains.

Schedule an Appointment at Gleneagles Hospitals

A life with IBD can be a challenge but many have adapted to the conditions that the disease brings by changing their lifestyle, taking medication and seeking support. It is crucial to take your prescribed medication and have regular medical check-ups to monitor your condition and adjust your treatment if necessary.

Always inform your doctor if your symptoms change and ask or seek help if necessary.

For any questions or concerns IBD, contact us to schedule an appointment today for a consultation, or visit our team of Gastroenterologists at your nearest Gleneagles Hospital.