Inflammatory Bowel Disease (IBD)

What is IBD?

Inflammatory bowel disease (IBD) is used to describe conditions involved with chronic inflammation of a portion or all of the digestive tract, primarily ulcerative colitis and Crohn’s disease. Lymphocytic colitis and collagenous colitis are considered inflammatory bowel disease as well, but are usually seen as separate entities from traditional IBD.

Ulcerative Colitis

Ulcerative colitis is an IBD that causes chronic inflammation and sores known as ulcers within the innermost lining of the colon and rectum. There are five types of ulcerative colitis, classified by the location of the inflammation and severity of symptoms:

  • Acute severe ulcerative colitis: Formerly known as fulminant colitis, this rare type affects the entire colon and causes violent diarrhea, intense pain and bleeding as well as fever and inability to consume food.
  • Left-sided colitis: Inflammation reaches from the rectum up through the sigmoid (low end of the colon) and descending colon. Symptoms include diarrhea, inadvertent weight loss and pain/cramping on the left side of the abdomen.
  • Pancolitis: This form typically affects the entire colon and causes symptoms including severe bloody diarrhea, pain/cramping, fatigue and substantial weight loss.
  • Proctosigmoiditis: Inflammation of the rectum and sigmoid colon occurs, with symptoms including pain/cramping, blood diarrhea and tenesmus, an inclination to constantly have a bowel movement.
  • Ulcerative proctitis: Considered the mildest type of ulcerative colitis, this form is exclusive to the area around the anus. Rectal bleeding is the only symptom for ulcerative proctitis.

Crohn’s Disease

This IBD causes inflammation of the lining of sections of both the large and small intestine, spreading deeply into the affected tissues.

What are the symptoms of IBD?

Symptoms for ulcerative colitis and Crohn’s disease may vary depending on the location and severity of the inflammation, with flare-ups of symptoms followed by remission. Symptoms for both include:

  • Abdominal pain and cramping
  • Bloody stool
  • Reduced appetite
  • Diarrhea
  • Fatigue
  • Fever
  • Unintended weight loss

Diagnosing IBD

In order to diagnose IBD, other causes for symptoms must first be ruled out, including:

Your physician will use a combination of tests to confirm a diagnosis. One or more of the following tests may be conducted:

  • Blood tests for anemia or infection
  • Capsule endoscopy
  • Colonoscopy
  • Computed tomography (CT) scan
  • Double-balloon endoscopy
  • Fecal occult blood test
  • Flexible sigmoidoscopy
  • Magnetic resonance imaging (MRI)
  • Small bowel imaging using x-ray and the consumption of a liquid containing barium to highlight the small bowel
  • Upper endoscopy
  • X-ray

What are the treatment options for IBD?

While there is no cure for IBD, the goal for your physician is to reduce the amount of inflammation that initiates symptoms, potentially leading to symptom relief and remission of symptoms overall as well. To accomplish this, your physician may either begin with milder drugs for the beginning of treatment and gradually move to stronger drugs, or start with stronger drugs and progressively move to milder drugs.

Treatments for IBD may include:

  • Anti-diarrheal medications
  • Anti-inflammatories
  • Antibiotics
  • Calcium and vitamin D supplements
  • Iron supplements
  • Pain relievers
  • Vitamin B-12 shots

Surgery may be recommended to treat IBD when all other forms of treatment have been exhausted:

Surgery for ulcerative colitis

The surgical treatment for this condition is known as a proctocolectomy, a procedure in which the colon and rectum are surgically removed and a pouch is created from the end of the small intestine. The pouch is then attached directly to the anus to allow for normal excrement.

When a pouch is not possible, an opening in the abdomen is created through which waste passes and is collected in a bag.

Surgery for Crohn’s disease

While almost half of patients need at least one surgery for Crohn’s disease, it does not cure the condition.

During the procedure, the damaged portion of the intestine is removed and the healthy portions are connected together. However, the benefits of this surgery are temporary, with the disease typically reoccurring at the reconnected tissue. Medication may be recommended following surgery to aid in minimizing the risk of reoccurrence.

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