Inflammatory Bowel Disease: Information on Causes, Diagnosis & Treatments
Inflammatory bowel disease (IBD) is a chronic condition where the digestive tract remains inflamed. The condition also includes Crohn's disease and ulcerative colitis that share the same symptoms including pain, diarrhea, weight loss, and fatigue. This condition is highly debilitating and often results in life-threatening complications including cancer. IBD is not to be confused with IBS (irritable bowel syndrome) which does not involve intestinal damage or inflammation.
The Centers for Disease Control and Prevention estimates that more than one million individuals in the U.S. suffer from inflammatory bowel disease, where the initial symptoms typically start between 15 and 30 years of age.
- Types of Inflammatory Bowel Disease (IBD)
- What Causes IBD?
- Risk Factors
- Inflammatory Bowel Disease Symptoms
- Diagnosing IBD
- Treating IBD
Types of IBD?
The most common forms of inflammatory bowel disease involve ulcerative colitis and Crohn's disease. However, there are other classifications of ulcerative colitis that include:
- Ulcerative proctitis where the closest area to the rectum (anus) becomes inflamed causing rectal bleeding.
- Proctosigmoiditis where the sigmoid colon and the rectum become inflamed. Typically, males and females experience symptoms involving abdominal cramps, abdominal pain, bloody diarrhea, and the inability to defecate.
- Left-Sided Colitis – Inflammation of the descending colon, the rectum and the sigmoid, all on the left side of the body, often produce symptoms including unexpected weight loss, left side pain, abdominal cramping, and bloody diarrhea.
- Pancolitis – This inflamed condition affects the entire large intestine and may produce severe abdominal pain, cramps, bloodied diarrhea, significant weight loss, and fatigue.
- Acute Severe Ulcerative Colitis (fulminant colitis) – Though rare, this form of colitis affects the entire large intestine causing profuse diarrhea, severe pain, loss of appetite, rectal bleeding, and fevers.
- Crohn's Disease – This intestinal inflammation can display itself differently in different patients who suffered pain anywhere in their digestive tract. However, inflammation of the small intestine (Ilium) seems to be the most common form of Crohn's disease where the inflammation stays in the bowel wall, tunnels through a fistula to another area of the intestine, or scars and inflames the bowel that leads to narrowing.
What Causes IBD?
Scientists, researchers, and doctors have yet to determine why individuals develop inflammatory bowel disease. However, they suspect that stress, diet and lifestyle choices may aggravate the condition if not actually causing the disease. Some scientists believe that a malfunctioning immune system is the root cause of the problem when it can no longer fight off bacteria or virus in the digestive tract.
However, heredity might also be a factor because the condition seems to be handed out to family members who have also suffered from the disease. That said, many individuals suffering from IBD have no family history of the disease. Doctors have yet to make a correlation between inflammatory bowel disease and stress levels. Individuals in stress often experience a flare-up of their condition.
The CCFA (Crohn's and Colitis Foundation of America) estimate that more than 1.5 million individuals in the U.S. suffer from IBD. In addition, their research is shown the biggest risk factors associated with the development of inflammatory bowel disease involve:
- Smoking – Smokers tend to experience a high rate of IBD compared to those who do not smoke. This might be the result of aggravating most of the symptoms associated with the disease.
- Age – Most individuals who suffer from inflammatory bowel disease are 35 years or younger.
- Ethnicity – Every population and demographic experiences inflammatory bowel disease. However, Ashkenazi Jews and Caucasians are at the highest risk out of all ethnic groups.
- Genetic Predisposition – Patients with a family history (a child, sibling, parent, grandparent) of inflammatory bowel disease have a higher risk of developing the disease on their own.
- Gender – While inflammatory bowel disease affects both men and women equally, females are more likely to develop Crohn's disease and males are more likely to develop ulcerative colitis.
- Geographics – Inflammatory bowel disease tends to affect people in industrialized countries and urban areas more than their counterparts. This means individuals in white-collar jobs tend to develop the disease over blue-collar workers. Additionally, there seems to be a correlation between cold environments and the increasing numbers of cases involving inflammatory bowel disease.
Inflammatory Bowel Disease Symptoms
Not every individual suffering from inflammatory bowel disease will experience identical symptoms that can range from severe to mild. Often, the symptoms are highly active only to go into remission and seem to disappear. Many of the common symptoms associated with inflammatory bowel disease and Crohn's disease include:
- Bloody stool
- Abdominal cramping
- Abdominal pain
- Unintended weight loss
- Reduced appetite
Patients who suffer from inflammatory bowel disease often face unexpected complications including weight loss-associated malnutrition, colon cancer, bowel obstructions, intestinal perforation (rupture), and fistulas where an ulcer penetrates the bowel wall and creates a whole to gain access to other parts of the digestive tract.
No single test can verify completely validate or diagnose inflammatory bowel disease. Because of that, the doctor will perform a comprehensive medical examination including a personal and family medical history followed by a complete physical exam. During the examination, the doctor will likely recommend a variety of diagnostic tests that include:
- Blood Test and Stool Sample Test – These tests can determine if the individual is suffering from a disease or infection. Once IBD has been confirmed, these tests can help distinguish between ulcerative colitis and Crohn's disease cases.
- Flexible Colonoscopy and Sigmoidoscopy – These flexible, thin scopes have an attached camera that provide an internal view of the small and large intestines for determining if any damage has occurred or fistula has developed. During the procedure, the doctor may take a biopsy and diagnose the condition using a microscope.
- Barium Enema – Though this test is outdated, and examination of the large and small intestines using x-ray technology can provide the doctor valuable clues as to whether the patient is suffering from the disease.
- Capsule Endoscopic – An examination of the small intestine can be completed after the patient swallows a small camera capsule that takes pictures as it passes through the intestines. The camera is then retrieved and pictures are analyzed on a computer monitor.
- Imaging Technology – The doctor may recommend an MRI (magnetic resonance imaging) scan, CT (computed tomography) scan, x-rays, or other imaging equipment to examine soft tissue and look for fistulas are other indicators of inflammatory bowel disease.
Treating Inflammatory Bowel Disease
Doctors have several options for treating inflammatory bowel disease including anti-inflammatory medications, immunomodulators (immune suppressants), antibiotics and others.
- Medications – Doctors often prescribe drugs to treat inflammatory bowel disease by reducing inflammation, preventing flare-ups, and relieving symptoms. However, every case is different and one treatment that is effective on one patient might not work at all and relieve pain and discomfort in another. These medicines include aminosalicylates and corticosteroids that suppress the body's immune system.
- Immunomodulators – These immunosuppressive drugs diminish the action of the immune system. However, they often take up to six months or longer to be highly effective. However, doctors often prescribe these drugs because, unlike corticosteroids, the patient can take these drugs much longer without having a relapse of their condition.
- Antibiotics – While antibiotics are effective at treating Crohn's disease, they simply do not work for individuals with ulcerative colitis.
Often, doctors will treat the patient's dehydration that tends to exacerbate many of the symptoms. This is because patients often experience diarrhea that flushes away nutritional supplements, minerals, and fluids necessary to remain healthy.