There is a lot that can go wrong with your digestive tract. Scary names like toxic megacolon are attached to some of these conditions, but sometimes it is hard to pinpoint the exact cause of your discomfort. If you are experiencing diarrhea, bloating, unexpected weight loss, you might be diagnosed with a blanket term simply known as inflammatory bowel disease.
What is IBD?
Inflammatory bowel disease (or IBD) is a blanket term that covers several maladies of the gastrointestinal tract. This term covers several types of chronic gi tract conditions, with the two most common being Crohn’s disease and ulcerative colitis.
In the simplest terms, inflammatory bowel disease is a condition in which the tissues of the GI tract become inflamed and irritated. There can be a host of causes, and there is a list of common symptoms that are usually present. Diarrhea, abdominal pain, bloating, cramps, fever and sometimes blood in the stool are all common signs of IBD. Reduced appetite and unintended weight loss are also possible signs you have inflammatory bowel disease.
It is still not known exactly why people get IBD. There are a host of possible contributing factors that may aggravate IBD or increase the severity of symptoms, but these are not root causes. Stress and diet were at one time suspected as being causes of inflammatory bowel disease, but medical research has shown these are not the source of the disease. Now the focus is on IBD as an autoimmune disease.
Being diagnosed with inflammatory bowel disease is not a death sentence. There are some very serious conditions that can arise from IBD, and Crohn’s disease, in particular, can lead to life-threatening complications. Despite this, there are plenty of things you can do to help decrease the severity of your symptoms and help your body heal from the damage IBD can do.
IBD vs IBS
Though similar in name, inflammatory bowel disease and irritable bowel syndrome are not the same condition. IBD is an umbrella term for a wide range of diseases whereas IBS is a term reserved for a more specific malady of the lower GI tract. While IBD has a genetic component in the development of symptoms, IBS is a condition, not a disease, and is often associated with food poisoning.
Since these two conditions produce some initial common symptoms, it can be difficult and dangerous to attempt to self diagnose. Chronic symptoms should always be the trigger to consult a gi physician. It is important to know exactly what you are suffering from, though, as the treatments and potential complications of these two conditions are very different.
One of the primary differences between IBD and IBS is the presence of long-term inflammation of the intestines. In the case of IBD, long term inflammation can lead to permanent damage to your intestines, as well as increase your risk of colon cancer. With IBS, this inflammation is not present, even in a medical examination.
Stress is linked to many different medical conditions, and long-term exposure to stressful environments can have a detrimental effect on your health. With IBD and IBS, though, stress can affect you differently. Urban living and white-collar jobs, both linked to higher levels of stress, are correlated with being diagnosed with IBD, but there is not usually a direct link between the onset of symptoms and exposure to stress. In the case of irritable bowel syndrome, on the other hand, periods of intense emotional stress, particularly in late adolescence and early adulthood are more highly correlated to the sudden appearance of IBS.
What Causes Inflammatory Bowel Disease?
We do not know for certain what causes inflammatory bowel disease. What we do know is IBS is closely linked to an inappropriate reaction by your body’s immune system. This form of autoimmune disorder occurs when the body’s response to normal bacteria in the gut is disrupted. Normally your immune system is only activated in the presence of harmful bacteria. In the case of certain autoimmune conditions, your immune system continues to react, even when there are no harmful bacteria to eliminate. This can cause damage and inflammation in the tissues of your intestines as they become irritated.
Who Gets IBD?
We do not know for certain who might develop IBD in their lifetime, but there are several established risk factors that put you at a greater chance of developing symptoms. These include ethnicity, lifestyle habits, the use of medications and even where you live.
Age is not a predictor of symptoms, but many people who develop irritable bowel syndrome begin showing signs in their twenties. It is possible to develop the disease later in life, though, with some people being diagnosed into their fifties and sixties.
Ethnicity and family background may also play a factor, with Caucasians being among those more likely to get IBD. Other people groups, including Ashkenazi Jews, are also more likely to develop the disease than others, as are some Hispanics. Taking a closer look at your individual family history, there is a higher chance you will develop IBD if someone in your immediate family has irritable bowel syndrome regardless of your ethnicity.
Your lifestyle choices may also contribute to your chances of developing IBD. Cigarette smoking is one factor linked to the development of Crohn’s disease in particular. Along with the risk of lung and other cancers, the increased chance of developing Crohn’s disease provides yet another compelling argument against smoking.
Sometimes the drugs you are taking to help manage other medical problems can contribute to IBD. Taking over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen sodium (Aleve) can damage tissues in the stomach and intestines. In some cases, the long-term use of these drugs is linked to the onset of IBD, while in other cases taking theses drugs simply aggravates the already ongoing symptoms of the disease.
Are Women at a Higher Risk of IBD?
The common symptoms of IBD are unpleasant on their own, but women with the disease can face extra complications as well. Premenstrual symptoms such as menstrual pain and headaches are more common in women with IBD. Symptoms such as diarrhea and abdominal pain are also likely to be more pronounced during and before your period.
A more worrisome concern for women with inflammatory bowel disease is the increased likelihood of iron-deficiency anemia. The irritation in your digestive tract can decrease your body’s ability to absorb nutrients. Iron can be difficult for your body to process, which can compound the loss of iron from bleeding during your cycle, as well as the increased possibility of intestinal bleeding from irritation in your digestive tract.
What are the Symptoms of IBD?
The symptoms of inflammatory bowel disease are common to many GI tract ailments. This can make diagnosing IBD difficult, and only increases the importance of talking to your doctor to get a diagnosis. Since many different conditions of the digestive tract share common symptoms but are treated very differently, it is important to know what you are up against.
The irritation in your intestines will produce a wide range of symptoms. Diarrhea is at the top of the list, though it will differ depending on what type of IBD you have. With Crohn’s disease, your stool will be loose and watery, whereas ulcerative colitis will often result in blood in your stool as well. Severe abdominal cramps are another common symptom of IBD. These can be debilitating in some cases, particularly as they are chronic.
Loss of appetite may also be a common complaint if you have IBD. This is understandable given your abdominal cramps and diarrhea, but a loss of appetite can complicate matters. Since your body is also absorbing nutrients at a lower rate than it would if you were healthy, eating less can only heighten your risk of malnutrition.
How is IBD Diagnosed?
If you think you may have IBD, you should talk to your doctor sooner rather than later. The process for diagnosing irritable bowel syndrome can be lengthy, especially as it is very important to differentiate it from irritable bowel syndrome or other gastrointestinal disorders that have many similar symptoms.
Blood tests and stool samples will be the place your doctor or healthcare provider is likely to start when they begin trying to diagnose your IBD. Blood tests can help diagnose inflammation, as well as identify potential anemia. Following these tests, your doctor will likely order an x-ray and possibly a CT scan to get a better idea of what is going on. Imaging like this can provide more clues to what is going on inside you, but there are still limitations.
There is no substitute for seeing what is going on inside you. Depending on your symptoms and the results of your blood tests and stool samples, your doctor will order one or more of a few different procedures. From top to bottom, an upper endoscopy, colonoscopy, and sigmoidoscopy. All of these procedures involve inserting a camera on a thin, flexible tube into a portion of your gastrointestinal tract to visually inspect your GI tract for damage. It is also possible your gastroenterologist may take a sample of tissue to perform a biopsy.
An upper endoscopy involves inserting a tube through the mouth and down the esophagus into the stomach. This procedure allows your doctor to visually inspect the upper portion of your digestive tract and small intestine to look for telltale signs of specific conditions. This can help rule out things like gastritis or other diseases that can produce similar symptoms to IBD. One advantage of this procedure is you do not need to be put under full anesthetic. This lowers the chances of complications during surgery and allows for a quicker recovery.
A colonoscopy is the most thorough examination your doctor can make of the lower part of your digestive tract. Similar to an endoscopy, a small camera on the end of a long, flexible tube is inserted through the anus and threaded through the entire length of the large intestine. Colonoscopy also allows for tissue samples to be retrieved for biopsy. Unlike an endoscopy, this procedure requires you are placed under full anesthesia.
A sigmoidoscopy is similar to a colonoscopy, though it is less invasive. The sigmoidoscope is only inserted through the rectum and lower part of the large intestine. This allows your doctor to examine the lower portion of the colon and rectum for any damage to tissues at the bottom end of your digestive tract.
How Is IBD Treated?
IBD covers a range of specific maladies of the digestive tract, so treatment can vary widely depending on what is at the root of your irritable bowel syndrome and what symptoms you are experiencing. Treatment for your inflammatory bowel disease will focus on two different areas; addressing the root cause of your IBD and providing relief from symptoms with the goal of remission.
The primary goal of treating IBD is suppressing the runaway immune system response that is causing the inflammation and damage to your intestines. If you can calm the autoimmune response, symptom relief will sometimes follow. In other cases, you may need to pursue a more active program of symptom management.
Treating your IBD will almost certainly involve your doctor prescribing two classes of drugs; an anti-inflammatory drug like aminosalicylates and corticosteroids to reduce the inflammation in your intestines and an immunosuppressant to help lower the intensity of your body’s immune response. These drugs include options such as mercaptopurine (Purixan, Purinethol), cyclosporine (Neoral, Gengraf, Sandimmune), azathioprine (Azasan, Imuran), and methotrexate (Trexall).
There are some forms of IBD that can be treated with antibiotics as well. Perianal Crohn’s disease is one of the varieties of inflammatory bowel disease where infection management is a part of a path to healing. In these cases, broadband antibiotics such as metronidazole (Flagyl) and ciprofloxacin (Cipro) are sometimes prescribed.
To treat your symptoms, everything from anti-diarrheal medication and pain relieves to supplements and vitamins may be prescribed. Treating diarrhea and helping with pain management is part of the cure, but ensuring you are getting enough vitamins and other nutrients in your diet is also crucial. Iron supplements are often prescribed to women with IBD in an effort to stave off iron-deficiency anemia.
When Should I Get Treatment for Inflammatory Bowel Disease?
If you have experienced a long-term change in the consistency and frequency of your stool, find yourself fighting chronic diarrhea or are suffering through abdominal pain that has begun to severely impact your life, it is probably time to talk to your doctor. Sudden, debilitating pain, particularly in the upper portion of the abdomen may indicate other, more acute diseases such as a gallbladder attack. In this case, you should seek medical treatment immediately. The sudden appearance of large amounts of blood in your stool is also a reason to seek medical attention quickly.
If you are suffering from IBD, ongoing treatment and management of symptoms will be a part of your life. Partnering with a healthcare provider who can help you understand your disease, establish an accurate diagnosis, work with you on medications, and help you manage flare-ups will make all the difference down the road. Make an appointment at Carolina Digestive today. We can help you make informed decisions about your health so you can reclaim your life from the discomfort and worry of inflammatory bowel disease.