What Is Inflammatory Bowel Disease?
Types of Inflammatory Bowel Conditions
- Crohn’s Disease and ulcerative colitis are diseases of the digestive tract, sharing many of the same characteristics and symptoms. Crohn’s disease affects the lining of the digestive tract whereas ulcerative colitis causes inflammation in the digestive tract. These conditions are treated differently.
- On diagnosis, if it isn’t clear which type of IBD exists, the physicians term the condition as indeterminate colitis.
Statistics From Around The World
Causes And Risk Factors
- Genetic Factors - According to the Crohn’s and Colitis Foundation of America (CCFA), roughly 20 percent of Crohn’s and Colitis patients have a close relative with IBD.
- Immune Function - The intestinal inflammation seen in IBD seems to be the result of an overactive immune response. When a foreign substance enters the intestinal lining, the body overreacts, causing an unusual amount of inflammation that does not go away once the threat has been eliminated.
- Bacterial Infection - Many people with Crohn’s Disease often show evidence of having been infected with E.coli. People can be infected by these bacteria if they drink water or eat food that has been contaminated by fecal matter from other infected individuals.
- Environmental Factors - Numerous environmental risk factors exist that can lead to IBD including smoking, oral contraceptive pills, appendectomy, dietary animal protein and high sugar content, non-steroidal anti-inflammatory drugs, antibiotics, postmenopausal hormone use, stress and depression.
- Most find out they have IBD as adolescents or young adults. Children as young as a few months old can have IBD.
- Smokers have a 2-fold increased risk of Crohn’s disease compared with persons who have never used tobacco products.
- In developed countries, IBD seems to affect all ethnic groups, although, it is most common among Caucasians.
- People of Jewish descent living in Europe, North America, and Israel have roughly a five times higher risk of developing IBD.
- People with a close relative with IBD are more susceptible.
- Use of antibiotic and non-steroidal anti-inflammatory drugs can alter the flora in the intestine and increase the risk of disease.
- Individuals raised in smaller households and with fewer siblings were highly prone to Crohn’s disease.
- Lower birth rank is associated with an increased risk of IBD.
- Exposure to pets like cats in early ages is a risk factor in the onset of Crohn’s disease.
- Densely populated areas are associated with an increase in incidence of IBD.
- Differences in lifestyles and environmental exposures for e.g. the diet may contribute to higher occurrence of IBD in urban areas.
Diagnosis - The Symptoms
- Abdominal cramping and pain
- Appetite loss
- Weight loss
- Joint pain
- Rectal bleeding
- Slowed Growth and Late Puberty in children
Tests And Assessments
- Blood tests
- Radiological tests including X-rays, CT scans, MRI and Ultrasound
- laboratory tests like the blood serum and fecal markers
- new endoscopic methods like the capsule endoscopy and double-balloon enteroscopy
- radiologic studies and,
- endoscopic imaging techniques
Snippet Highlight: It is normal to require a combination of these tests and many of them are also useful in monitoring the progress of the condition. These tests may need to be repeated to reassess the disease. Check with the doctor for the exact test to be taken as not all hospitals provide all tests and some tests are better than others for looking at specific problems.
Post-Diagnosis: The Path To Follow
- Specialized medication including antibiotics and corticosteroids are used to help relieve symptoms, reduce inflammation and prevent exacerbation.
- Biologic Therapy using TNF inhibitors is used to treat by affecting substances in the body to block inflammation.
- Surgery is a last resort treatment; however, about 20% of people with ulcerative colitis will require surgery at some time in the course of illness. Approximately, 75% of people with Crohn’s disease who have disease in the small bowel will have surgery in the first 10 years after diagnosis.
Complementary and alternative medicine is frequently used by patients with IBD; the most common are massage, acupuncture and moxibustion therapy (using herbs in acupuncture points through burning or needling). These therapies have been shown to improve inflammation and symptoms.
However, current clinical trials are of insufficient quality to recommend these therapies as alternative treatments for IBD. Nonetheless, because these therapies seem generally to be safe, they may have a role as complementary to conventional therapy.
In traditional Chinese medicine and Ayurveda, herbal extracts are used in treatment for IBD and appear to be effective. Polyphenols, found in food substances produced from plants, are believed to play a biologically active role.
- Turmeric has been used in Ayurvedic medicine since ancient times. Administering 1 gram of curcumin or turmeric twice daily results in improvement of symptoms like inflammation and decrease in the rate of relapse.
- Administering 350 mg of the Ayurvedic herb, Boswellia serrata (Indian frankincense) 3 times a day improves symptoms of active Crohn’s disease.
- Nutritional supplements for supplying antioxidants that include beta carotene, vitamin C, vitamin E, selenium, zinc, magnesium and vitamin D are given for people with IBD.
- People with IBD should avoid all allergens especially that are most commonly implicated in IBD: wheat, chocolate, dairy, corn, artificial sweeteners, eggs and yeast.
- Elimination diet high in complex carbohydrates and fiber and low in sugar and refined carbohydrates is good for consumption for people with IBD.
- Eating a diet that is rich in whole foods and consists of fresh fruits and vegetables and protein derived from fish and plant sources would provide all the essential nutrients and fiber.
- Probiotics including plant-derived yeast and prebiotics including wheatgrass juice and inulin are beneficial in treating symptoms of IBD like diarrhea.
Yoga, meditation and exercise are an integral part of living a healthy and happy life with IBD.
Moving meditation practices such as walking meditation, yoga, tai chi and qigong follow the same general principles of meditation but add movement to the mix.
Breathing techniques like pranayama, qigong movements coordinated with breathing and a type of meditation called Open Focus Attention Training were found to be beneficial in increasing mindfulness and managing stress.
Prevention- How to reduce risks
- Reduction of exposure to infection may be achieved by hand-washing, careful food and personal hygiene.
- Avoiding unpasteurized milk and cheese, uncooked meat and eggs, raw vegetables and raw seafood prevents food poisoning risk.
- For female patients with IBD receiving immunosuppressive treatment, more frequent cervical pap smear is recommended to reduce infection risk.
- Consultation with the doctor is essential before travel to regions with infection risk.
- People with IBD should safeguard themselves from insect bites which may transmit disease and be careful with food and water intake to reduce infection risk, skin infection and gastroenteritis.