What Is Inflammatory Bowel Disease?

Inflammatory Bowel Disease (IBD) affects more than 10 million people in the world, according to the European Federation of Crohn’s and Ulcerative Colitis Associations (EFCCA). Characterized by the inflammation of the intestines, this condition varies in severity and can cause unpredictable flare-ups followed by periods of remission.

IBD shouldn’t be confused with Inflammatory Bowel Syndrome (IBS), which is a functional disorder of the gastrointestinal (GI) tract. IBD can damage the bowel wall, leading to sores and narrowing of the intestines. Meanwhile, IBS doesn’t cause physical damage but can lead to similar symptoms due to altered gut mobility and function.

In this article, we’ll discuss everything you need to know about IBD, including symptoms, causes, diagnoses, and treatment methods. 

What Is Inflammatory Bowel Disease?

Inflammatory Bowel Disease (IBD) is a chronic (long-term) condition that causes inflammation in the intestines. It’s divided into two primary disorders: Crohn’s disease and Ulcerative colitis.

• Crohn’s disease: Characterized by the inflammation of the lining of the gastrointestinal tract. It usually affects the end of the small intestine (ileum), but it can also affect the large intestine and the upper GI tract, including the mouth and the esophagus. 
• Ulcerative colitis: Characterized by inflammation and ulcers (sores) in the digestive tract, usually in the lining of the colon and rectum. 

IBD has no cure, but treatment can control or reduce the symptoms. Treatment involves a combination of medications, lifestyle changes, nutritional therapy, and, in severe cases, surgery.  

What Are the Symptoms of Inflammatory Bowel Disease? 

Inflammatory Bowel Disease can cause a range of symptoms, and their severity can vary depending on the extent of the inflammation and where it occurs. 

Common signs and symptoms include: 

• Persistent diarrhea, often lasting more than four weeks 
• Abdominal pain and cramping 
• Sudden and unexplained weight loss 
• Rectal bleeding or blood in the stool 
• Fatigue 
• Fecal incontinence (not being able to control bowel movement) 
• Fever 
• Anemia 
• Reduced appetite

For some people, IBD can affect areas outside the intestines. Studies have shown that 10% to 43% of people affected by IBD develop eye problems, particularly episcleritis (inflammation between the inside of the eyelid and the scera) and uveitis (inflammation of the middle layer of the eye). 

It can also cause stomatitis (inflammation of the mouth and lips), mouth sores, and ulcers, as well as skin conditions like erythema nodosum and pyoderma gangrenosum, characterized by painful, red nodules or bumps on the shins and skin ulcers on the legs, respectively. People with IBD can often experience periods of active illness followed by periods of remission. Because of this, it isn’t uncommon for IBD to go undiagnosed or misdiagnosed.  

If you experience any of the symptoms mentioned above—especially concerning abnormal bowel movements—consult a physician immediately. IBD isn’t fatal, but it can result in life-threatening conditions if left untreated for extended periods.

How Common Is Inflammatory Bowel Disease? 

IBD affects up to 10 million people worldwide, so while not rare, it is still relatively uncommon. The incidence and prevalence of IBD have been increasing worldwide, particularly in newly industrialized countries and Westernized populations. 

IDB can affect people of all ages, including children and older adults. According to Nature, the peak onset for ulcerative colitis and Crohn’s disease is 30 to 40 years and 20 to 30 years, respectively. 

What Causes Inflammatory Bowel Disease?

The exact cause of IBD is yet to be fully understood, but most cases are linked to weakened or compromised immune systems. A 2022 study published in Genes reveals that IBD results from hereditary, genetic, and/or environmental factors. 

IBD is believed to trigger an abnormal immune response wherein the body’s immune system mistakenly attacks the cells of the digestive tract, leading to chronic inflammation. People with a family history of IBD have a higher risk of developing the condition themselves, as well as those with a high-fat or high-sugar diet. Smoking, infections, and prolonged or frequent use of antibiotics also increase the risk of IDB. 

How Is IBD Diagnosed? 

Depending on your symptoms and medical history, doctors may conduct stool or blood tests to check for signs of inflammation or anemia, which are common in people with IBD. Doctors may also perform imaging tests such as CT scans, MRI scans, and X-rays to identify abnormalities, such as inflammation, ulcers, or strictures (narrowing of the intestines). 

The same is said with endoscopy and colonoscopy, which allows doctors to examine the lining of the gastrointestinal tract. During these procedures, doctors take a biopsy sample to confirm IBD and differentiate between Cronh’s disease and ulcerative colitis. 

Inflammatory Bowel Disease Treatment 

IBD treatment involves a combination of medications and lifestyle changes. A physician may recommend surgery if the condition becomes debilitating or medications no longer provide symptom relief.

Lifestyle Changes 

Certain lifestyle changes may help manage symptoms of IBD and reduce the risk of flare-ups. Depending on the symptoms, a doctor may suggest dietary changes, regular exercise, stress management techniques, and/or ceasing or stopping smoking altogether. 

Maintaining a healthy lifestyle, complete with proper diet and adequate sleep, often contributes to better management of IBD symptoms. 

Medical Treatment 

Medication prevents abnormal inflammation, allowing intestinal tissues to heal. Treatment typically begins with aminosalicylates, which reduce inflammation in the bowel. The doctor may also prescribe antispasmodics, anti-diarrheal agents, and acid suppressants for symptom relief. 

Immunomodulators like azathioprine (Imuran), 6-mercaptopurine, and methotrexate (Rheumatrex) help regulate the immune system and are often used to maintain remission alongside other medications. 

Surgery 

In cases where medications don’t provide relief, a doctor may recommend bowel resection. During this procedure, a surgeon removes the damaged portion of the digestive tract and connects two ends of the healthy bowel together. 

Another surgical option is proctocolectomy. In this procedure, a surgeon removes the large intestine (colon) and rectum, leaving the small intestine disconnected from the anus. The surgeon then redirects the ileum, the last part of the small intestine, into a collection pouch worn on the abdomen. Feces are emptied into the pouch. 

An alternative to proctocolectomy is ileoanal anastomosis, where the surgeon removes the colon and rectum and connects the small intestine to the anus, allowing the patient to expel waste normally instead of a pouch. 

Conclusion 

Inflammatory Bowel Disease is a condition characterized by the inflammation of the GI tract. Symptoms range from mild to severe and can include abdominal pain and cramping, diarrhea (often with blood), rectal bleeding, fatigue, and weight loss. These symptoms are often intermittent, with periods of remission alternating with flare-ups of symptoms. 

If you’re experiencing digestive issues lasting more than four weeks, visit a physician immediately. IBD, while not fatal, can lead to life-threatening complications.