Inflammatory Bowel Disease
Crohn’s disease and ulcerative colitis are thought to affect 300,000 people in the UK.
Whether your symptoms are recent, or you have been suffering for a long time, specialist healthcare is available to help diagnose and treat the underlying cause. Crohn’s disease and ulcerative colitis are the two most common Inflammatory Bowel Diseases (IBD). Although there is currently no cure for IBD, the symptoms they cause can be treated following diagnosis.
IBD symptoms
Common symptoms can include:
- Diarrhoea
- Bloody stools, or blood when going for a poo
- Vomiting and nausea
- Abdominal pains caused by inflammation and ulceration in the digestive tract
- Bloating
- Lack of energy or excessive tiredness for no apparent reason
- A low-grade fever
- Sudden weight loss, often caused due to the body not properly absorbing nutrients from food
- Reduced appetite
There are also other related generalised symptoms such as mouth ulcers, joint pains, rashes and eye-related symptoms. Consultation with a specialist, who can conduct the necessary diagnostic tests, is the first step to better understanding your symptoms.
IBD diagnosis
Diagnostic tests vary according to your symptoms, but may include:
Many cases are not diagnosed as symptoms cause embarrassment that can result in people not seeking the help they need and deserve. If you have been suffering in silence, seek the medical attention you deserve.
Accurate diagnosis of IBD is vital as symptoms that are left untreated can develop into wider health issues, and treatment is generally more successful the earlier it begins.
- Blood and stool tests
- A colonoscopy, which is a specific type of endoscopy that allows the doctor to explore inside your bowel
- Upper GI endoscopy is used to look for problems in the upper gastrointestinal tract
- Flexible sigmoidoscopy used to examine the lower end of your colon
What is ulcerative colitis?
It is an inflammatory condition of the colon (large bowel) and/or rectum. The extent and severity of colitis determines how severe your symptoms are likely to be. Symptoms appear to be triggered by an exaggerated immune response in the colon. The underlying cause isn’t fully understood, although genetics and immune dysfunction are thought to be contributory, along with environmental factors such as where you live, stress and smoking.
What is Crohn’s disease?
Crohn’s disease is a chronic inflammatory condition which can affect any part of the digestive system, although it is most common in the small intestine and colon.
Crohn’s disease is generally the more complex of the two inflammatory bowel diseases and surgery is typically required for more severe cases.
Like ulcerative colitis, the underlying cause is poorly understood, although dietary, genetic and environmental factors, as well as stress and smoking, are implicated.
IBD treatment
Medication typically includes:
- Aminosalicylates (5-ASAs)
- Steroids
- Thiopurines
- Biologic agents, given via injection, help supress the immune system
If the inflammation cannot be halted sufficiently with medication, and it results in narrowing of the bowel (stricturing) causing increased pain, surgery may be required.
During surgery, the inflamed or narrowed part of the bowel may need to be removed. The extent of surgery depends on which part of the bowel is affected, and what is the best option for the patient.
This decision is taken after appropriate radiological investigations have been performed and following multi-disciplinary discussion.
IBD and nutrition
There are many aspects of good IBD management including lifestyle changes (such as stopping smoking if you have Crohn’s disease), medications and nutritional therapy. The use of nutritional therapy can be as important as other factors for a variety of reasons. Firstly, nutrition in the form of liquid feeds can be a treatment of inflammation itself, thereby helping the bowel recover during disease flares. Secondly, it can prevent or alleviate malnutrition which itself puts patients at higher risk of complications with a greater chance of being admitted to hospital and with worse overall quality of life. This can be in the form of high-calorie nutritional supplements or the replacement of specific nutrients using tablets or injections, such as iron or vitamin B12. Thirdly, nutritional therapy can treat symptoms that patients with IBD experience, beyond simply the effect of the therapy on the bowel itself. Importantly, nutritional therapy has the advantage of leading to fewer complications in general than medications and can be a vital tool when used appropriately.