A gut feeling – inflammatory bowel disease

A gut feeling – inflammatory bowel disease

Ulcerative colitis affects the large intestine (purple). Crohn’s disease affects the entire digestive tract.

For years, Jim thought that his gastrointestinal problems were just an annoying sign of the aging process. In reality, he was experiencing something much more serious.

When symptoms began to worsen, he visited a gastroenterologist, a doctor who specializes in the diseases of the digestive system. His symptoms of bleeding, fever and persistent pain ruled out irritable bowel syndrome (IBS), which also causes cramping, constipation and diarrhea.

Other tests ruled out bacterial, viral or parasitic infection. However, his blood tests showed anemia, low blood count and high white blood cell counts. During a colonoscopy, his doctor was able to view the inside of Jim’s large intestine – the tests confirmed that Jim had joined an estimated one million Americans who suffer from inflammatory bowel disease (IBD).

What is inflammatory bowel disease?

Inflammatory bowel disease is a general term for a condition that causes inflammation in the lining of the intestines. IBD occurs when the immune system overreacts and mistakes food and good bacteria in the intestines for invaders. The immune system then sends white blood cells to the intestines to attack healthy cells.

This leads to inflammation, swelling, ulceration, bleeding and scarring. Two major conditions are associated with IBD – ulcerative colitis and Crohn’s disease. The diseases have similar symptoms.

Ulcerative colitis is the chronic inflammation and ulceration of the innermost lining of the colon (large intestine). Although the disease can occur at any age, it is usually diagnosed when people are in their mid 30s.

Crohn’s disease usually refers to the chronic inflammation and ulceration in the deep layers of the small and large intestines, but can affect any location along the entire digestive tract. Crohn’s disease mainly affects people between the ages of 15 and 35.

Who’s at risk?

People who have a close relative with IBD are at 10 times greater risk than the general population for the development of either Crohn’s disease or ulcerative colitis. Other risk factors include ethnicity (people of Jewish or Scandinavian descent have a higher risk), cigarette smoking and eating a high-saturated-fat diet that is also low in fruits and vegetables.

There is no clear cause of IBD, nor is there a cure for ulcerative colitis or Crohn’s disease. More research is needed to understand the association between IBD and liver, eye and joint conditions, which are more common in patients suffering with Crohn’s disease.

Living with IBD

Many times an IBD diagnosis causes anger and fear. Patients often ask, “How will IBD change my life?” “Will I still be able to work?” “Do I need to follow a special diet?” “What is the treatment?”

“Though challenging, IBD is not fatal,” said Christopher Magiera, MD, gastroenterologist, Ministry Medical Group in Stevens Point and Weston. “People can lead full, active and productive lives. Since each person’s body responds differently, it is important to know what foods and environmental factors have the potential to trigger a flare-up. Initially, some people may prefer not to eat in social situations or may lose their appetite,” said Dr. Magiera.

“It is critically important to maintain a healthy diet with IBD because diarrhea and bleeding rob the body of nutrients, fluids and electrolytes,” he said. “Making sure the body has the vitamins and minerals that it needs can help the digestive tract heal and minimize fatigue.”
Since every person’s body chemistry is different, there is no prescribed diet for treatment of IBD. Keeping a food diary, along with a list of symptoms experienced, can help a person avoid foods that trigger inflammation while making sure he or she receives adequate nutrition. During a flare up, soft, bland foods may be easier to digest than raw fruits and vegetables or foods that are spicy or high in fiber.

Stress does not cause IBD but can make it worse. If you have IBD, limiting the stress in your life is important.

Support groups and educational resources are available to help patients understand and adjust to IBD.

IBD is treatable

The goal of treatment is to stop the inflammation and prevent recurrence. Medication and lifestyle changes may allow periods of remission, which give the colon time to heal and may relieve some of the symptoms. Rarely, in severe cases, surgery to remove all or part of the colon may be necessary.

There are five major types of medications that help patients keep inflammation under control. These are effective in treatment of both ulcerative colitis and Crohn’s disease.

  • Aminosalicylates (5-ASA) are anti-inflammatory drugs used to treat mild or moderate symptoms.
  • Corticosteroids can suppress the immune system and treat moderate to severe symptoms.
  • Immune modifiers may be helpful in maintaining remission and help heal fistulas common with Crohn’s disease.
  • Antibiotics control bad bacteria.
  • Biologic therapies can help reduce the inflammation of moderate to severe symptoms by blocking specific pathways of the disease.
Do probiotics help?

There is ongoing research regarding the effectiveness of probiotics in the treatment of IBD. Since the immune system is attacking the good bacteria in the gut, it may make sense to replace it through the use of probiotics. However, there have been conflicting reports as to the effectiveness of probiotics to prevent inflammation.

Follow-up is vital

If you have been diagnosed with IBD, it is important that you continue to see your doctor regularly. People who have had ulcerative colitis for 8 years or longer have a higher risk of developing colon cancer. Talk to your doctor about regular cancer screenings.

For more information about IBD or IBS, visit ministryhealth.org or contact your health care provider.

What about irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a common digestive problem that causes abdominal cramping, gassiness, bloating, diarrhea, constipation or passing mucous with a bowel movement. Though painful, IBS does not indicate colon disease.

Since there is no sign of disease, IBS is classified as a functional disorder. It is caused by muscle spasms stimulated by environmental triggers which may include: certain foods, stress, medications, caffeine and hormones.

Though uncomfortable, IBS does not appear to cause disease. Bleeding, fever, weight loss and persistent severe pain are not symptoms of IBS.

The best defense against IBS is avoiding triggers and eating a healthy, low-fat diet.  

Did you know?

Eating triggers a gastrocolic reflex which causes the colon to empty itself. The larger the meal and the higher the fat and fiber content, the more intense the gastrocolic reflex. Our bodies have an amazing design.

 

Symptoms and complications Crohn's Ulcerative Colitis
Diarrhea & cramps X X
Severe urgency X  
Fever X X
Rectal bleeding X X
Nausea X X
Loss of appetite X X
Weight loss X X
Fatigue X X
Intestinal blockage X  
Anemia   X
Delayed growth X X
Fistulas (ulcerative tunnels) X  
Joint pain X X
Liver problems X X
Redness and swelling of the eyes X X

 

 
 
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