Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) includes Crohn's disease, ulcerative colitis and other conditions such as collagenous colitis and lymphocytic colitis.

IBD conditions cause your digestive tract to become inflamed and can cause pain, impair your quality of life and possibly have life-threatening complications.

Crohn's disease is a form of inflammatory bowel disease that affects the lining of your digestive tract and can spread to your bowel tissue. Crohn's disease causes severe diarrhea and stomach pain. It cannot be cured.

Ulcerative colitis also causes inflammation in your digestive tract, usually the interior lining of the large intestine and rectum. Symptoms include severe diarrhea and stomach pain.

It's not clear what causes IBD. A virus or bacteria could trigger it. Your immune system fights back, inflaming your digestive tract. There also could be a genetic (inherited) factor.

Complications of IBD include:

  • Bowel obstruction
  • Ulcers
  • Fistulas
  • Malnutrition
  • Anal fissure
  • Colon cancer
  • Arthritis
  • Kidney stones
  • Gallstones
  • Inflammation of eyes or skin
  • Osteoporosis

You Are at Risk for Inflammatory Bowel Disease (IBD) if You:

  • Are younger than 30, although IBD can happen at any age
  • Have a family history of IBD
  • Are a certain ethnicity – It occurs most in white people, but the risk is higher among people of Eastern European Jewish (Ashkenazi) descent
  • Smoke cigarettes – A controllable risk factor for Crohn's disease
  • Live in an urban area or a northern climate
  • Use pain-relieving medications including ibuprofen, naproxen and aspirin
  • Use the medication isotretinonin to treat acne; the link between this drug and IBD is not certain

Symptoms

Symptoms of inflammatory bowel disease differ depending on where the condition occurs in your body.

Crohn's disease

Symptoms include:

  • Diarrhea – Inflamed intestines make a lot of extra water and salt that your colon can't absorb, causing diarrhea
  • Abdominal pain and cramps – Inflamed intestines can cause swelling and, sometimes, scar tissue, which can cause pain and cramps as food moves through your system. This can be mild or severe, and may be accompanied by vomiting.
  • Ulcers – Sores in your small intestine can grow and poke through the walls of your intestine. You also can get these sores in your mouth.
  • Blood in stools – Food moving through your inflamed digestive system can cause bleeding, which you might notice in your stool.
  • Appetite loss
  • Weight loss
  • Tiredness
  • Arthritis
  • Fever
  • Inflammation in your eyes
  • Skin problems
  • Mouth sores
  • Developmental problems (children)

Ulcerative colitis

Symptoms depend on the location of ulcerative colitis in your body but can include:

  • Rectal bleeding
  • Rectal pain
  • Feeling of needing to have a bowel movement urgently
  • Stomach pain and cramping
  • Bloody or extreme diarrhea
  • Trouble having bowel movements despite the urge
  • Weight loss
  • Tiredness
  • Shock
  • Dehydration

If you notice changes in your bowel habits – especially diarrhea that doesn't get better, stomach pain or blood in your stool – or have other symptoms that worry you, talk to your doctor.

Diagnosis

The diagnosis of IBD is a process of ruling out other conditions. You may have tests including:

  • Blood tests
  • Fecal occult blood test (stool)
  • Flexible sigmoidoscopy – Your doctor inserts a flexible tube in your anus and views pictures on a monitor to see inside your digestive system
  • Colonoscopy – Your doctor inserts a flexible tube in your anus and views pictures on a monitor to see inside you
  • Capsule endoscopy – You swallow a capsule to get pictures of your digestive tract for your doctor to review
  • Imaging including X-rays, small bowel images, MRI (magnetic resonance imaging) and CT (computed tomography) scans
  • Barium enema – Your doctor gives you an enema to coat the lining of your bowls with a dye (barium), which helps show your rectum, colon and part of your intestine on X-rays
  • Double balloon endoscopy – Your doctor inserts an endoscope (long tube) down your throat to see inside you, from your esophagus to your colon

Treatment

IBD treatment focuses on reducing the inflammation in your digestive tract to improve your symptoms. Treatment also prevents complications. Usually, treatment is medication and, sometimes, surgery.

Medication

Medications to treat IBD include:

  • Anti-inflammatory drugs
  • Immune system suppressor drugs
  • Antibiotics
  • Anti-diarrheal drugs
  • Pain relieving drugs
  • Iron, calcium and vitamin supplements
  • Laxatives
  • Nutrition – This may be necessary with either an injection or feeding tube to treat malnutrition and let your bowel rest

All medications have side effects. Talk to your doctor about the risks and benefits of any medications you take.

Surgery

Surgery for Crohn's disease:

  • Removing part of the digestive tract and reconnecting the remaining portions
  • Widening portions of your intestine that have become narrowed
  • Fixing fistulas and abscesses

Surgery for Ulcerative Colitis

Surgery to treat ulcerative colitis involves removing your colon and rectum (proctocolectomy). You can still have normal bowel movements after this surgery with an ileoanal anastomosis procedure. A pouch is created at the end of your small intestine and attaches to your anus.

Our gastroenterology specialists are experienced in treating every colorectal condition, including IBD disease.

How to Prevent Inflammatory Bowel Disease (IBD)

The exact cause of Crohn's disease is unknown. You can't prevent it. If you do have Crohn's disease and you smoke cigarettes, quitting smoking is the most important step you can take to keep your condition from getting worse.

The cause of ulcerative colitis also is not known, but stress can make it worse. If you have ulcerative colitis, you may benefit from managing your stress.

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