Inflammatory Bowel Disease (IBD)

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is a group of conditions characterized by inflammation of the various parts of the intestine (bowels). IBD is a chronic (long term) condition that keeps abating and recurring in affected individuals. The two most common types of inflammatory bowel disease are Crohn’s disease and ulcerative colitis.

Crohn’s disease mostly affects the small intestine but can afflict any part of the put, whereas ulcerative colitis is confined to the large intestine (colon). Though both these diseases cause inflammation of the intestine, they can be distinguished based on their specific manifestations. Inflammatory bowel disease can occur in individuals of any age and gender. However, it is most common in young adults below 30 years of age.

What are the symptoms of inflammatory bowel disease?

The following are the common symptoms of inflammatory bowel diseases:

  • Abdominal pain
  • Diarrhea
  • Blood in stools might occur in ulcerative colitis due to ulcers and tears in the large intestinal wall.
  • Weight loss can occur in Crohn’s disease due to insufficient absorption of nutrients from the small intestine.
  • Anemia can occur in Crohn’s disease due to insufficient absorption of vitamin B12 from the intestine.

Apart from the intestine, other organs of the body are also affected in patients with inflammatory bowel diseases. These extra-intestinal manifestations include arthritis, inflammation of the tissues of the eyes, mouth ulcers, inflammation of fat cells under the skin, gangrene, spondylitis, inflammation of the bile ducts, liver diseases, and kidney stones. These manifestations may or may not be caused directly by IBD but are usually found to occur and recur along with the IBD.

The symptoms of inflammatory bowel disease can subside and reappear without warning. This makes it difficult to predict the progression of the symptoms. Colon cancer is a long-term risk in patients having chronic ulcerative colitis.

What causes inflammatory bowel disease?

The exact cause of inflammatory bowel disease is not known as no environmental, dietary or infectious causative agents have been identified. However, the inflammation of the intestine in IBD results from an attack by the body’s own immune cells, which release several inflammatory chemicals like cytokines, tumor necrosis factor, and interleukins.

This immune response against body’s own intestinal cells is thought to be triggered by the normal intestinal microbial flora. The susceptible individuals might have a genetic predisposition (certain gene mutations that compromise the structure and immune system of the intestines) to develop inflammatory bowel disease. Also, individuals living in (or moving into) certain geographic locations (like northern Europe, North America) are at a higher risk of developing inflammatory bowel disease, suggesting that certain environmental factors might cause or worsen the disease.

Cigarette smoking and non-steroidal anti-inflammatory drugs (NSAIDs) are thought to cause or worsen the inflammatory bowel disease.

How is inflammatory bowel disease treated?

Treatment of inflammatory bowel disease includes supportive care and medications. Stress management may help in IBD cases. However, dietary modifications have not been shown to be extremely effective clinical trials.

Medications used to treat inflammatory bowel diseases include 5-aminosalicylic acid, corticosteroids, immunomodulating drugs, anti-cytokine drugs, antibiotics and probiotics. These drugs help by either blocking the inflammatory response by the cells of the immune system or by changing the intestinal microbial flora.

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