Inflammatory bowel disease (abbreviated as IBD) refers to a group of debilitating conditions that are characterized by an inflammation of the bowels, especially the colon or large intestine. The inflammation in IBD may also affect other parts of the gastrointestinal tract. In some cases, the inflammation affects only a portion of the gastrointestinal tract. In other cases, the entire gastrointestinal tract may be affected by inflammation.
Types of IBD
Inflammatory bowel disease is typically classified into two broad types: ulcerative colitis and Crohn’s disease. Ulcerative colitis is characterized by the formation of ulcers in the walls of the large intestine. The inflammation in Crohn’s disease affects the deeper layers of the gut. The condition may also progress beyond the gut and affect other tissues of the body.
The symptoms of inflammatory bowel disease vary on a case-to-case basis. In some individuals, the symptoms are mild. In others, the symptoms are severe. Some of the common symptoms of inflammatory bowel disease are fatigue, weight loss, diarrhea, fever, abdominal pain, and bloody stools. The symptoms may come and go at different times, with alternating periods of flareup and remission. The condition is also potentially life-threatening, especially when complications arise.
Some people may confuse irritable bowel syndrome (commonly abbreviated as IBS) with inflammatory bowel disease (abbreviated as IBD). However, these are two entirely different conditions. Unlike inflammatory bowel disease, irritable bowel syndrome is not characterized by inflammation of the gut tissue. In fact, IBS is a functional disorder that is characterized by a dysfunction of the gut without any discernible tissue abnormality.
The muscles of the gut wall do not function properly in irritable bowel syndrome. However, there is no inflammation or ulcer formation in the wall of the gut. Unlike IBD, irritable bowel syndrome is not a potentially life-threatening condition. Still, IBS can severely impact the quality of life.
Read more on inflammatory bowel disease.
Dangers of Inflammatory Bowel Disease
Inflammatory bowel disease is a very serious condition. The dangers of inflammatory bowel disease are mostly due to life-threatening complications (such as colorectal cancer) that may arise during the course of the disease. The risk of developing serious complications such as colorectal cancer is higher in patients with ulcerative colitis than in normal individuals.
However, it is important to stress that not everyone who suffers from inflammatory bowel disease has severe symptoms or potentially fatal complications. Apart from colorectal cancer, inflammatory bowel disease could also pave the way for other serious complications such as disturbances in blood clotting, perforations in gut wall, and acute megacolon. These are all potentially life-threatening conditions.
Complications of inflammatory bowel disease typically arise when the inflammation is persistent and chronic. Development of complications further worsens the disease, leading to potentially lethal consequences. However, not all complications are life-threatening. Some are more serious than others. In fact, the majority of complications in inflammatory bowel disease are not lethal.
Depending on the type of inflammatory bowel disease, the complications may either be localized to the intestine or can spread to other tissues of the body. For example, the complications of ulcerative colitis are typically restricted to the regions of the gut (such as the rectum and colon). However, the complications of Crohn’s disease may spread well beyond the intestine. The intestinal and extra-intestinal complications of inflammatory bowel disease are described next.
The following are some of the main types of complications of inflammatory bowel disease that may arise in the gut:
Intestinal strictures: An intestinal stricture refers to a narrowing of the passage through the gut. This narrowing could result from swelling or scar tissue formation that usually occurs in inflammatory reactions. The extent of the narrowing varies with the severity of the inflammatory bowel disease. No problems occur if the narrowing is minor. However, a significantly major stricture can block the passage of digested food material through the gut.
A fistula refers to an abnormal passage that forms between two adjacent hollow tissues. Fistula formation could connect the bowels to other nearby organs such as the rectum, vagina, urinary bladder, and skin. Fistulas may also form among the distinct regions of the intestine. The risk of fistula formation is high in Crohn’s disease.
Abscess or pus formation can occur in the intestinal wall as well as in the surrounding tissues and organs. The risk of abscess formation in the pelvic and abdominal cavities is high in Crohn’s disease.
Perforation of the wall of the gut
Another serious complication of inflammatory bowel disease is the formation of holes in the wall of the intestine. This can lead to the spilling of gut contents (including bacteria) into the abdominal cavity, resulting in serious widespread infection. Perforations of gut wall can occur in both ulcerative colitis and Crohn’s disease.
Toxic megacolon refers to a swelling of the colon that is caused by inflammation of the colon. Patients with ulcerative colitis have a high risk of developing toxic megacolon. Toxic megacolon increases the risk of perforation in the walls of the colon.
Infections can occur in the inflamed parts of the colon resulting in infectious colitis. The most common infection in inflammatory bowel disease is caused by the bacterial species, Clostridium difficile.
Colorectal cancer refers to a cancer of the colon and rectum. This is a very serious and potentially lethal complication of inflammatory bowel disease. The risk of getting colorectal cancer is high in patients with ulcerative colitis.
Read more on signs of bowel cancer.
Apart from complications in the gastrointestinal tract, inflammatory bowel disease may also cause complications in other tissues and organs of the body. The following are some of the extraintestinal complications that are seen in cases of inflammatory bowel disease:
Mouth ulcers: Also known as aphthous ulcers, mouth ulcers are a common occurrence in inflammatory bowel disease.
Pyoderma gangrenosum and erythema nodosum are examples of a couple of skin conditions that may occur in inflammatory bowel disease.
Inflammation of the joints may also occur in inflammatory bowel disease (especially in Crohn’s disease). Both peripheral and central arthritis may be seen.
Due to problems in the absorption of calcium from the gut, inflammatory bowel disease may also lead to a reduction of bone density. Calcium absorption in inflammatory bowel disease may also be adversely affected by corticosteroid medications that are used to treat the condition.
A variety of diseases that affect the gallbladder can occur in inflammatory bowel disease. Examples include gallstones, primary sclerosing cholangitis and pericholangitis.
Crohn’s disease may also affect the urinary system and cause ureteritis and kidney stones.
The risk of blood clot formation increases in inflammatory bowel disease. This can lead to serious outcomes such as pulmonary embolism and stroke.
Problems in the eyes: Inflammatory bowel disease may also affect the eyes. Both superficial and deep layers of the eye may get inflamed, leading to conditions such as episcleritis and iritis.