About Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) causes inflammation throughout the digestive tract. IBD is an autoimmune disorder that causes the body to attack the intestines as well as the upper digestive tract, including the mouth, esophagus and stomach. IBD has periods of remission when the symptoms may disappear and the intestinal inflammation reduces. There are also periods of activity called flares where the body begins to attack the intestines, resulting in inflammation and an increase in symptoms of IBD. There is no cure for IBD, but there are several treatments available to control the disease.

Types

• The two types of IBD are Crohn's disease and ulcerative colitis. Both involve inflammation of the digestive tract, but ulcerative colitis is restricted to only the large intestine. Crohn's may involve the large intestine, but can also affect the small intestine, stomach, mouth and esophagus.

Symptoms

• IBD causes a variety of symptoms. Bloody stool, mucus in the stool, severe diarrhea and abdominal pain are all common symptoms of IBD. These symptoms may occur with or without a fever. Weight loss caused by these symptoms is another key indicator of IBD.

Identification

• For both types of IBD, doctors may analyze blood work to look for signs of inflammation. The specific blood tests that indicate a problem include the erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP).

  A stool sample analysis may reveal white blood cells, which usually indicates IBD.

  Computer tomography (CT), abdominal X-ray and magnetic resonance imaging (MRI) scans may reveal abnormalities consistent with IBD. A flexible sigmoidoscopy and colonoscopy are tests that allow the doctor to see the inside of the large intestine with a small scope. Using the scope, the doctor can also take a piece of tissue and perform a biopsy to determine any tissue problems in the intestine. Ulcerative colitis causes inflammation of the rectum or large intestine, so a scope allows doctors to see its specific inflammation for confirmation of diagnosis.

  Since Crohn's disease causes inflammation all along the digestive tract, doctors may use the scope along with additional tests for diagnosis. A barium enema X-ray test allows doctors to see the outline and possible inflammation of the large intestine. To test for Crohn's, doctors may use a barium swallow study or a video capsule endoscopy to view the upper digestive tract.

  These tests, along with symptoms of IBD, lead to a diagnosis of IBD.

Misconceptions

• Many people believe that IBD and IBS are the same problem, but they are extremely different. IBS (irritable bowel syndrome) causes no long-term problems. IBD increases your risk for colon cancer and damages the intestines. IBS is just an abnormality of intestinal contractions.

Prevention/Solution

• There is no way to prevent IBD.

  Treatment for IBD involves controlling the inflammation caused by the disease. Medications such as prednisone and methylprednisolone treat flares of the disease to bring the disease into remission. Aminosalicylates are daily medications that reduce the inflammation in the intestines; 6-mercaptopurine (Purinethol), methotrexate and azathioprine (Imuran) suppress the immune system to prevent attacks on the intestine. Infliximab (Remicade) is an intravenous medication that also treats flares by suppressing the immune system.

  In cases when the medication doesn't work or IBD causes strictures, abscesses or fistulas, surgery may be necessary.

Considerations

• Because IBD increases the risk of colon cancer, a colonoscopy with biopsy is necessary every few years. These biopsies ensure that the colon stays cancer-free, and can catch colon cancer before symptoms appear, leading to a better prognosis.