What Is Inflammatory Bowel Disease (IBD)?

Inflammatory bowel disease (IBD) is a chronic condition of gut inflammation and includes Crohn's disease and ulcerative colitis (UC). Studies determined that IBD affected 1 in 209 adults in the United States in 2016, and rates have risen over time. It affects 3.1 million Americans. Inflammation in various portions of the gastrointestinal (GI) tract in IBD leads to abdominal pain, diarrhea, rectal bleeding, and/or weight loss symptoms.

This article will discuss the types of IBD, symptoms, causes, and treatment.

Types of IBD

"Inflammatory bowel disease" is an umbrella term that includes Crohn's disease and ulcerative colitis. Each has different patterns of inflammation.

Crohn's Disease

Crohn's disease is a chronic disease that can affect any part of the GI tract, from the mouth to the small intestine to the colon, rectum, and anus. Most commonly, the small intestine and large intestine are affected. The inflammation in Crohn's disease is usually patchy, with areas of normal tissue between inflamed areas.

The entire thickness of the GI tract wall is affected by the inflammation. Inflammation often comes and goes, resulting in flares that may worsen with time.

Ulcerative Colitis

In contrast to Crohn's, UC tends to affect just the lower portion of the GI tract, including the colon and rectum. Rather than patches of inflammation as in Crohn's, the entire portion of bowel is affected in UC, while inflammation is limited to the innermost layer of the GI tract, causing ulcers.

IBD Symptoms

IBD can cause the following symptoms:

• Diarrhea- loose stools and increased frequency and/or urgency
• Abdominal pain and cramping
• Mucus or blood in the stool
• Weight loss
• Tiredness
• Fever

Sometimes, people with IBD may experience inflammation in other body parts leading to the following symptoms:

• Joint pain and swelling
• Skin rash
• Eye problems
• Bile duct problems

What Causes IBD?

The exact cause of IBD is unknown, but research points to genetic predisposition. Some mutations involve proteins in the immune system response to bacteria in the GI tract. IBD is also more likely to occur in urban centers of developed countries.

Diagnosing IBD

If your healthcare provider suspects your symptoms may be due to IBD, you will likely be referred to a gastroenterologist, who specializes in diseases of the GI tract. Gastroenterologists can perform a specialized endoscopy, a procedure using a type of scoping mechanism with a camera, to visualize the upper or lower GI tract.

Other diagnostic tests for IBD include:

• Laboratory tests, including inflammatory markers
  
• Stool assessment to rule out infection
• Imaging tests like contrast X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans
  

Can You Reverse IBD?

IBD is not considered reversible, but rather is a chronic and often progressive condition with flares of symptoms that come and go. Some people can go years between flares and be in remission, while others have more frequent symptoms. The goal of treatment is to address symptoms and to prevent flare-ups.

Treatment for IBD

Treatment for IBD includes bowel rest and medications. Surgery to remove affected parts of the intestine or colon may be recommended in severe cases.

Medications for IBD include:

• 5-aminosalicylic acids
• Immunomodulators
• Corticosteroids
• Biologics

Over the counter medications like antidiarrheal medications, vitamins, and supplements may also be recommended.

What Helps During an IBD Flare-Up?

IBD flare-ups are periods of inflammation and symptoms for which lifestyle factors and medications can help. Severe flare-ups may require bowel rest and a stay at the hospital where intravenous medications can be given. Discuss any flare-up symptoms with your healthcare provider who can create a plan for management.

In the meantime, taking medications as prescribed, getting rest, staying hydrated, and managing stress can help.

Some other tips for managing symptoms include:

• Taking antidiarrheal medications as recommended by your healthcare provider
• Keeping the anal area clean, applying barrier ointment, and using sitz baths
• Taking pain management medications, like acetaminophen (Tylenol), which should be cleared by your healthcare provider

IBD Nutrition and Dietary Tips

The following nutrition tips to help with IBD:

• Eat a nutritious diet with plenty of fruits, vegetables, and whole grains.
• Stay well-hydrated.
• Avoid carbonated drinks.
• Avoid high-fiber foods like popcorn, nuts, and vegetable skins during flare-ups.
• Avoid foods high in fat, like fried food and fast food.
• Discuss any vitamins and supplements with your healthcare provider.

Keeping a record of what you eat can help identify any potentially triggering foods.

Long-Term Complications of IBD

Complications of IBD can be related to IBD itself or to side effects of its treatment. In general, IBD can cause malnutrition, anemia, and osteoporosis due to poor absorption of nutrients.

IBD can directly cause complications, including:

• Ulcers in the GI tract
• Bowel obstruction
• Bowel perforation
• Fistulas
• Abscesses
  
• Anal fissures
• Rectal bleeding

Additionally, problems related to malabsorption can include the following:

• Anemia
• Osteoporosis
• Weight loss
• Poor growth (in children)

Inflammation of the colon in IBD can also increase your risk of colon cancer. Discuss with your healthcare provider whether you should be screened more frequently for colon cancer than is generally recommended.

Living With IBD

IBD can significantly impact daily life, particularly when symptoms are frequent or severe, medication side effects are present, or significant surgeries are required. IBD not only causes significant stress, but it has also been linked to mood disorders, like anxiety and depression. Getting symptoms under control and achieving remission can have a positive impact, as can doing the following:

• See your healthcare provider regularly for checkups.
• Take medications as prescribed and avoid missing doses.
• Get recommended vaccines and screening tests, like colonoscopy.
• Get regular exercise.
• Manage stress levels.
• Discuss any mood symptoms with your healthcare provider.
• Avoid smoking.
  

Summary

IBD includes chronic inflammatory conditions affecting the GI tract, specifically Crohn's disease and ulcerative colitis. These conditions differ in their location and their pattern of inflammation.

People with IBD experience intermittent flares of symptoms with diarrhea, bloody stool, and weight loss, though other areas of the body may also be affected. Treatment involves anti-inflammatory medications that affect the immune response, and sometimes surgery is required.