IBD refers to two conditions of the digestive system (Crohn’s disease and ulcerative colitis) which are characterized by inflammation of the gastrointestinal (GI) tract. Prolonged inflammation causes GI tract damage.

Many diseases are grouped together under the general term IBD. The two most common are:

  • Ulcerative colitis (UC). This is an inflammation of the colon. It can cause other non-digestive problems.
  • Crohn’s disease. This can cause inflammation of the digestive tract at any part. However, it primarily affects the posterior end of the small intestine. 

Symptoms of IBD depend on the location and severity of the inflammation, but may include:

  • Diarrhoea that occurs when the affected part of the intestine cannot reabsorb water
  • Bleeding ulcers
  • Blood in the stool (Hematochezia).
  • Stomach pain, bloating and cramps due to bowel obstruction
  • Weight loss and anemia. May cause physical growth and developmental delays in children
  • Ulcers and fissures may also appear on the genitals and anus.
  • Crohn’s disease may also cause mouth ulcers. 

IBD may also be associated with non-digestive problems eye inflammation, Skin disease, Arthritis 

What Causes IBD?

Researchers are trying to figure out why some people develop IBD. There are three major factors playing a role in the onset of the disease:

  • Genetics: One in four patients with IBD has a family history of the disease. So, genetics have a key role in the onset of this condition
  • Autoimmune response: The immune system normally fights infections. In people with IBD, the immune system mistakes food for foreign material and start fighting against its own cells. This releases antibodies (proteins) to fight off this threat, causing symptoms of IBD.
  • Environmental trigger: People with a family history of IBD may develop IBD if they are exposed to triggers like smoking, stress, drug use, and depression. 


Possible complications of IBD include:

  • Malnutrition with weight loss
  • Colon cancer
  • A fistula or tunnel that passes through the intestinal wall and creates a hole between different parts of the digestive tract
  • Intestinal perforation
  • Bowel obstruction

Diagnosis:

To diagnose IBD, doctors first understand the family’s medical history and bowel movements.

  • Stool samples and blood tests can be used to check for infections and other illnesses.
  • A barium enema (which involves an x-ray of the colon and small intestine.)
  • Flexible sigmoidoscopy and colonoscopy
  • Capsule endoscopy: The test requires patients to swallow a small capsule with a camera. This is usually recommended to examine/ view the parts of the small intestine. 
  • Plain abdominal X-rays are used in emergencies when intestinal rupture is suspected.
  • CT scan provides a more detailed image than regular X-rays. This helps in examining the small intestine. Complications of IBD can also be recognized through this test
  • MRI: It is particularly useful for examining soft tissue and detecting fistulae.


    Treatment: 

Medical management:

  • Doctor may recommend medications to treat the signs of inflammation or to treat symptoms by prescribing Anti-diarrheal medications, Pain relievers, Vitamins, and supplements, or both

Surgical management:

  • Surgery for ulcerative colitis: In this surgery, the entire colon and rectum are removed and an inner pouch is created that attaches to the anus and allows bagless bowel movements.
  • Crohn’s disease surgery. Up to two-thirds of people with Crohn’s disease will need surgery at least once in their lifetime. Crohn’s disease cannot be cured with surgery, but there can be a symptomatic relief.
Dr. Giridhar Reddy
Consultant Gastroenterologist

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