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Inflammatory Bowel Disease: Causes, Symptoms, Diagnosis, and Treatment

Inflammatory bowel disease (IBD) refers to the variety of conditions in which there is inflammation of the digestive tract. The digestive tract is helps in digestion of food, absorption of nutrients and elimination of waste. Due to inflammation in the digestive tract, all these functions are impaired.

Inflammatory bowel disease

The two most common conditions of IBD include ulcerative colitis and Crohn’s disease.

  • Ulcerative colitis: In this condition, inflammation occurs only in the inner lining of the colon and rectum.
  • Crohn’s disease: In this condition, the inflammation occurs in full thickness of the bowel wall in any part from the mouth to the anus. In most cases, last part of small bowel called as ileum and colon are affected with inflammation.

What are the Causes of Inflammatory Bowel Disease?

The exact cause of inflammatory bowel disease is unclear. However, the following factors contribute to the development of inflammatory bowel disease:

  • Immune function: The body’s immune system responds to certain bacteria, virus and food particles to destroy them. This process may trigger an inflammatory reaction in gastro intestinal system leading to inflammatory bowel disease.
  • Genetics: Inflammatory bowel disease is believed to be caused by certain gene mutations.
  • Bacteria or virus: According to research E.coli and enteroviruses contribute to the development of inflammatory bowel disease.
  • Other factors: Oral contraceptives, a diet rich in fat and refined foods, antibiotics, and vaccinations are believed to be potential causes of inflammatory bowel disease.

What are the Symptoms of Inflammatory Bowel Disease?

The symptoms of inflammatory bowel disease are based on the severity of inflammation. The following are the common symptoms for both Crohn’s disease and ulcerative colitis.

  • Abdominal pain and cramping
  • Blood in your stool
  • Diarrhea
  • Fever
  • Fatigue
  • Reduced appetite
  • Sudden weight loss

What are the Risk Factors for Inflammatory Bowel Disease?

Anybody can develop inflammatory bowel disease. But people with the following factors are at increased risk of developing this disease:

  • Age: This disease is generally diagnosed before the age of 30 years
  • Race: People belonging to White race and Ashkenazi Jewish decedents are more likely to develop this condition.
  • Family history: It is likely for the person to develop this disease if any of family members such as parent, sibling or child is known to have inflammatory bowel disease.
  • Cigarette smoking: Chemicals in cigarette smoke is believed to damage the lining of the stomach. It is considered as the controllable risk factor for IBD.
  • Nonsteroidal anti-inflammatory medications: Drugs such as ibuprofen, naproxen sodium, diclofenac sodium increase the risk of IBD.
  • Environment: The chance of developing IBD is high in people living in the industrialized areas.

What are the Complications of Inflammatory Bowel Disease?

Untreated or poorly treated IBD can lead to long-term complications. They include:

Perforation:

In severe cases of inflammation, the intestinal wall becomes thick and breaks forming a hole in the intestine. Intestinal contents leak into surrounding areas through this hole and cause infection (peritonitis).

Strictures:

Due to prolonged inflammation, a scar may be formed in the intestine which leads to narrowing of the intestine forming stricture. It obstructs the passage of gastric contents. It is one of the common complications of Crohn’s disease.

Abscesses:

This is seen in patients affected with Crohn’s disease. Bacterial infections lead to the formation of pus filled-pockets called abscesses. They usually occur near the anus but also seen inside the intestine.

Fistulas:

This condition is seen in patients affected with Crohn’s disease. Fistula refers to small painful cracks or tears formed around the anus.

How is Inflammatory Bowel Disease Diagnosed?

The doctor would diagnose IBD by the patient’s signs and symptoms. The following diagnostic tests are recommended to confirm the disease:

Blood Tests:

  • Blood tests for infection and anaemia: The patient’s blood sample is collected and tested to determine the bacterial or viral infection. The patient’s hemoglobin level is checked to rule out anemia.
  • Fecal occult blood test: The stool sample obtained from the patient and is tested for the presence of blood.

Endoscopic Procedures:

  • Colonoscopy: In this procedure a thin, flexible tube called a colonoscope is used to examine the inner lining of the colon. This procedure also helps in obtaining small sample tissues for biopsy.
  • Flexible sigmoidoscopy: With the help of a flexible, thin, lighted tube the lower part of colon called as sigmoid is examined.
  • Upper endoscopy: A flexible, thin, lighted tube is used to check the esophagus, stomach and first part of the small intestine.
  • Capsule endoscopy: For this procedure the patient is given a capsule containing a camera to swallow. The images captured by the camera which are transferred to the recorder; the recorder is worn by patient on the belt. After the procedure the capsule is painlessly passed out of the body along with the stool.
  • Balloon-assisted enteroscopy: The endoscope is fitted with a balloon or over tube is used to examine the esophagus, stomach, and deep small intestine (duodenum, jejunum and ileum). It is used to examine hard to reach areas.

Imaging Tests:

  • X-ray: The doctor recommends standard X-ray to rule out other health conditions that would contribute to symptoms of IBD.
  • Computerized tomography (CT) scan: The doctor recommends CT as the images obtained from this test are clear and provide more information than standard X-ray images. In this procedure, the doctor would give a contrast substance by mouth or through an intravenous line to get a detailed and improved image of the targeted region.
  • Magnetic resonance imaging (MRI): In this test, the doctor injects a dye into the patient’s veins. An MRI uses powerful radio waves and magnetic fields to obtain a detailed image of the internal body parts. The doctor would recommend this test to assess if there is any fissure around the anal area and the small intestine.

How is Inflammatory Bowel Disease Treated?

Inflammatory bowel disease is a chronic condition which cannot be cured but can be managed with some drugs.

Medications:

  • Immune-suppressants to prevent body’s immune system from attacking the intestinal lining and causing inflammation
  • Antibiotics to treat the bacteria that trigger or aggravate IBD symptoms
  • Anti-inflammatory drugs such as sulfasalazine and corticosteroids to decrease the symptoms of IBD. They include.
  • Laxatives are used to soften the stools.
  • Antidiarrheals are used to treat diarrhoea.

Surgery:

The doctor would advise surgery for treating the severe cases of IBD, such as:

  • Strictureplasty, a procedure to widen the narrowed bowel.
  • Treating the fistulas surgically.
  • In Crohn’s disease, the doctor would consider surgically removing the affected parts of the intestine.
  • In severe cases of ulcerative colitis, the entire colon and rectum are removed surgically.

How is Inflammatory Bowel Disease Prevented?

The risk of inflammatory bowel disease can be decreased by eating the healthy diet, regular exercises and smoking cessation.

However, complete prevention is not possible as the cause of disease in unclear.

 

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