Inflammatory bowel disease (IBD) is the name of a group of conditions that cause inflammation in the gastrointestinal system. It affects about 1 in every 250 people in America. The most common forms of IBD are Crohn’s disease and ulcerative colitis. There is no cure for IBD, but symptoms can be managed with medication and other treatment options.
Early intervention can make a big difference. When IBD is found in the early stages, treatment is likely to be more successful. Even though the disease affects millions of people, many are hesitant or embarrassed to discuss their symptoms. It is important to remember that symptoms like abdominal pain, constipation or diarrhea are not cause for shame or embarrassment.
The highly trained specialists affiliated with Memorial Hermann Health System have extensive experience with diagnosing and treating a wide range of digestive disorders, including IBD. The sooner you see a physician, the sooner you can find relief.
IBD is an autoimmune disorder affecting the digestive system. With IBD, a person’s immune system attacks their gastrointestinal tract and causes inflammation, leading to chronic symptoms including abdominal pain, fever, gastrointestinal bleeding and anemia.
There are two primary types of IBD: Crohn's disease and ulcerative colitis. Both diseases are chronic conditions characterized by inflammation of the lining of the gastrointestinal tract (mucosa).
Crohn’s disease is an inflammatory bowel disease that can affect any part of the gastrointestinal tract. Inflammation in the layers of the gastrointestinal tract can lead to obstructions, abscesses or problems with other organs.
Ulcerative colitis, also known as UC, is an inflammatory bowel disease that affects the colon or large intestine. With UC, inflammation only occurs in these areas and does not affect other portions of the gastrointestinal tract.
While the names and some of the symptoms are similar, IBD and IBS are very different conditions.
Irritable bowel syndrome (IBS) is a common condition that affects about 10% to 15% of the population. IBS causes abdominal pain or discomfort that is associated with changes in bowel habits like diarrhea, constipation or a combination of both. It is not a single disease, but is a syndrome of different symptoms, with multiple causes and treatment options. Significant intestinal inflammation does not occur with IBS, and it is not a risk factor for colon cancer.
Inflammatory bowel disease (IBD) is a serious, autoimmune disorder with potentially significant complications, including colon cancer. It is not uncommon for people with IBD to be initially diagnosed with IBS before confirming a definitive IBD diagnosis.
Experts do not know exactly what causes IBD. Studies suggest that patients with IBD have an immune system that reacts abnormally to bacteria or other antigens (such as food components or viruses) in the intestine. This reaction causes an overproduction of white blood cells in the intestinal lining, which leads to inflammation.
Although Crohn’s disease and ulcerative colitis are different, they present with such similar symptoms that they often are mistaken for each other. Both conditions can cause:
Most people have occasional gastrointestinal discomfort or symptoms. But, symptoms like abdominal pain, diarrhea, bloating or cramping that persist for about 4 weeks or longer are not normal and should be examined by a health care provider. If you experience gastrointestinal bleeding, vomiting blood or passing blood in the stool, you should seek care right away as these symptoms are never normal.
Crohn’s disease and ulcerative colitis are diagnosed with a combination of blood tests, radiographic imaging, and endoscopic procedures with biopsy of the GI tract lining. The most common type of endoscopic procedure used to diagnose IBD is colonoscopy. Imaging tests, including X-ray, magnetic resonance imaging (MRI) or computerized tomography (CT) scans, may also be used.
During a colonoscopy procedure, the physician inserts a flexible lighted camera tube that can view the entire colon. Tissue samples can be removed (biopsied) from the colon to be analyzed in a laboratory. These samples are tested to identify granulomas (clusters of inflamed cells).
Other endoscopic procedures that can help diagnose IBD include:
During an upper endoscopy procedure, the physician uses a flexible lighted camera tube to examine the esophagus, stomach and duodenum (top portion of the small intestine).
This test can be used to help diagnose Crohn’s disease in the small intestine. Patients swallow a capsule that contains a small camera device inside. Images from the camera are transmitted to a computer so the physician can view the different parts of your small intestine.
This involves specialized flexible, lighted cameras that are able to reach the more distant small intestine. Deep enteroscopy allows physicians to examine the tissue, take samples (biopsy) or conduct treatment procedures.
Diagnosing Crohn’s disease or ulcerative colitis early is very important to long-term health. Many diseases, including IBD, are much more manageable when discovered early. Chronic or recurrent gastrointestinal symptoms can significantly decrease quality of life, and may be signs of a serious condition that requires treatment.
Although there is no cure for IBD, there are treatment options that can relieve symptoms and improve quality of life. The goal of treatment is to get the symptoms under control, or to eliminate symptoms entirely (remission). During remission, intestinal tissues that have been damaged by IBD have the opportunity to heal. When symptoms are controlled, medications can be successful in reducing the frequency of “flares.”
This type of drug reduces inflammation, and is often one of the first treatments used for ulcerative colitis treatment. Your doctor will recommend a specific medication based on the location of your tissue damage.
This type of steroid medication can reduce swelling and inflammation in the intestinal tract, and is used for the short-term treatment of Crohn’s disease and ulcerative colitis. Corticosteroids can put the disease into remission and alleviate symptoms.
These drugs can extend an IBD patient’s remission by controlling the body’s overactive immune response. Immunosuppressive drugs decrease the body’s ability to create inflammation that can damage the intestinal tract.
This type of treatment is newer than other medications, and has become the standard of care for IBD. Some biologic therapies are given intravenously (through an IV), and others are injections that patients can give to themselves. The goal of biologic therapies is to reduce the activity in an overactive immune system by blocking the proteins and immune mediators in the body that cause inflammation.
These medications are used when there is a risk of infection.
When IBD is advanced, and medication has not been successful in reducing symptoms, your physician may recommend surgery. Results from surgery vary widely, and there may be significant risks involved. You should discuss different options with your physician to decide if surgery is right for you.
Surgery is used to remove damaged tissue from the intestinal tract or to close fistulas. Symptom relief from surgery may be only temporary and, in some cases, may actually make symptoms worse or more complicated.
Surgery is used to remove all of or part of the colon. Patients may require placement of an ostomy (a collection bag for stool on the outside of the body), but many people can avoid ostomy creation or have the ostomy reversed after the surgical sites have healed.
Patients with IBD can face significant physical and emotional challenges. When symptoms flare up, they can disrupt daily activities like going to work or school, or even something as simple as social interactions.
Making some lifestyle changes may help reduce the severity of IBD symptoms:
Experts are actively studying the effect of diet on inflammatory diseases, but there is currently no specific diet for Crohn’s disease or ulcerative colitis that has been shown to improve symptoms. However, you may be able to identify certain foods that trigger symptoms, like foods that are high in fiber or fat. It can be helpful to keep a record of your symptoms to look for any consistent patterns or triggers.
At Memorial Hermann, we are here to help you navigate IBD to improve your daily life. Our affiliated physicians utilize leading-edge technology and therapies to reduce or eliminate symptoms, and to provide exceptional patient care.
If you are experiencing symptoms of IBD, it is important to see a physician quickly. Early detection can give you a better chance at effective symptom relief and long-term management.
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