bowel disease (IBD) represents a group of intestinal disorders that cause
prolonged inflammation of the digestive tract.
digestive tract is composed of the mouth, esophagus, stomach, small intestine,
and large intestine. It’s responsible for breaking down food, extracting the
nutrients, and removing any unusable material and waste products. Inflammation
anywhere along the digestive tract disrupts this normal process. IBD can be
very painful and disruptive, and in some cases, may even be life-threatening.
What Are the Main Types of
Inflammatory Bowel Disease?
diseases are included in this IBD umbrella term. The two most common diseases are
ulcerative colitis and Crohn’s disease. Crohn’s disease can cause inflammation
in any part of the digestive tract. However, it mostly affects the tail end of
the small intestine. Ulcerative colitis involves inflammation of the large
What Causes Inflammatory
cause of IBD is unknown. However, genetics and problems with the immune system
have been associated with IBD.
You might be
more likely to develop IBD if you have a sibling or parent with the disease. This
is why scientists believe IBD may have a genetic component.
The Immune System
system may also play a role in IBD. Normally, the immune system defends the
body from pathogens (organisms that cause diseases and infections). A bacterial
or viral infection of the digestive tract can trigger an immune response. As
the body tries to fight off the invaders, the digestive tract becomes inflamed.
When the infection is gone, the inflammation goes away. That’s a healthy response.
with IBD, however, digestive tract inflammation can happen even when there’s no
infection. The immune system attacks the body’s own cells instead. This is
known as an autoimmune response.
IBD can also
occur when the inflammation doesn’t go away after the infection is cured. The inflammation
may continue for months or even years.
What Are the Risk Factors for
Developing Inflammatory Bowel Disease?
The Crohn’s & Colitis Foundation
of America (CCFA)
estimates that 1.6 million people in the United States have IBD. The biggest
risk factors for developing Crohn’s disease and ulcerative colitis include:
one of the main risk factors for developing Crohn’s disease. Smoking also aggravates
the pain and other symptoms of Crohn’s disease and increases the risk of
complications. However, ulcerative colitis primarily affects nonsmokers and ex-smokers.
present in all populations. However, certain ethnic groups such as Caucasians
and Ashkenazi Jews have a higher risk.
IBD can happen
at any age, but in most cases, it starts before the age of 35.
have a parent, sibling, or child with IBD are at a much higher risk for
developing it themselves.
People who live in urban areas and industrialized countries
have a higher risk of getting IBD. Those with white collar jobs are also more
likely to develop the disease. This can be partially explained by lifestyle
choices and diet. People who live in industrialized countries tend to eat more
fat and processed food. IBD is also more common among people living in northern
climates, where it’s often cold.
IBD affects both genders equally. Ulcerative colitis is more common among men,
while Crohn’s disease is more common among women.
What Are the Symptoms of
Inflammatory Bowel Disease?
IBD vary depending on the location and severity of inflammation, but they may
when affected parts of the bowel can’t reabsorb water
- bleeding ulcers, which may cause
blood to show up in the stool (hematochezia)
- stomach pain, cramping, and bloating due to bowel obstruction
loss and anemia, which can cause delayed growth
or development in children
Crohn’s disease may get canker
sores in their mouths. Sometimes ulcers and fissures also appear
around the genital area or anus.
IBD can also
be associated with problems outside of the digestive system, such as:
What Are the Possible
Complications of Inflammatory Bowel Disease?
complications of IBD include:
with resulting weight loss
(ulcers that go through the bowel wall, creating a hole between different parts
of the digestive tract)
rupture (or perforation)
cases, a severe bout of IBD can make you go into shock. This can be life-threatening.
Shock is usually caused by blood loss during a long, sudden episode of bloody
How Is Inflammatory Bowel
IBD, your doctor will first ask you questions about your family’s medical
history and your bowel movements. A physical exam may then be followed by one
or more diagnostic tests.
Stool Sample and Blood Test
can be used to look for infections and other diseases. Blood tests can also
sometimes be used to distinguish between Crohn’s disease and ulcerative
colitis. However, blood tests alone can’t be used to diagnose IBD.
enema is an X-ray exam of the colon and small intestine. In the past, this type
of test was often used, but now other tests have largely replaced it.
Flexible Sigmoidoscopy and Colonoscopy
procedures use a camera on the end of a thin, flexible probe to look at the
colon. The camera is inserted through the anus. It allows your doctor to look
for ulcers, fistulas, and other damage. A colonoscopy can examine the entire
length of the large intestine. A sigmoidoscopy examines only the last 20 inches
of the large intestine, the sigmoid colon.
procedures, a small sample of the bowel wall will sometimes be taken. This is
called a biopsy. Examining this biopsy under the microscope can be used to diagnose
inspects the small intestine, which is much harder to examine than the large
intestine. For the test, you swallow a small capsule containing a camera. As it
moves through your small intestine, it takes pictures. Once you’ve passed the
camera in your stool, the pictures can be seen on a computer.
This test is
only used when other tests have failed to find the cause of Crohn’s disease
Plain Film or X-Ray
abdominal X-ray is used in emergency situations where intestine rupture is
Computer Tomography (CT) and Magnetic Resonance Imaging (MRI)
CT scans are
basically computerized X-rays. They create a more detailed image than a
standard X-ray. This makes them useful for examining the small intestine. They
can also detect complications of IBD.
magnetic fields to form images of the body. They’re safer than X-rays. MRIs are
especially helpful in examining soft tissues and detecting fistulas.
and CT scans can be used to determine how much of the intestine is affected by
How Is Inflammatory Bowel
There are a
number of different treatments for IBD.
Anti-inflammatory drugs are the first step in IBD treatment. These drugs decrease
inflammation of the digestive tract. However, they have many side effects.
Anti-inflammatory drugs used for IBD include sulfasalazine and its byproducts as well as
Immune suppressants (or immunomodulators) prevent the immune system from
attacking the bowel and causing inflammation. This group includes drugs that
block TNF. TNF is a chemical produced by the immune system that causes
inflammation. Excess TNF in the blood is normally blocked, but in people with
IBD, higher levels of TNF can lead to more inflammation. Immune suppressants
can have many side effects, including rashes and infections.
used to kill bacteria that may trigger or aggravate IBD symptoms.
Antidiarrheal drugs and laxatives can also be used to treat IBD symptoms.
Lifestyle choices are
important when you have IBD. Drinking plenty of fluids helps to compensate for
those lost in your stool. Avoiding dairy products and stressful situations also
improves symptoms. Exercising and quitting smoking can further improve your
Vitamin and mineral supplements can help with nutritional deficiencies.
For example, iron supplements can treat anemia.
sometimes be necessary for people with IBD. Some IBD surgeries include:
to widen a narrowed bowel
or removal of fistulas
of affected portions of the intestines, for people with Crohn’s disease
of the entire colon and rectum, for severe cases of ulcerative colitis
Routine colonoscopy is used to monitor for colon cancer, since those with IBD are at a
higher risk for developing it.
How Can Inflammatory Bowel
Disease Be Prevented?
hereditary causes of IBD can’t be prevented. However, you may be able reduce
your risk of developing IBD or prevent a relapse by:
cause some discomfort, but there are ways you can manage the disease and still live
a healthy, active lifestyle. Visit www.ccfa.org for resources and more
information on IBD, including Crohn’s disease and ulcerative colitis.