Q&A: Inflammatory Bowel Disease

IBD describes two conditions — ulcerative colitis and Crohn’s disease. Both long-term conditions involve gut inflammation. Ulcerative colitis affects only the colon or large intestine. Crohn’s disease can affect any part of the digestive system.

Both illnesses cause a person’s immune system to mistake food, bacteria and other materials often present in the intestine as hostile foreign substances. The immune system then attacks the lining of the intestines, resulting in chronic inflammation and severe gastrointestinal (GI) symptoms.

The symptoms may include abdominal pain and cramps, diarrhea, rectal bleeding, weight loss, fatigue, fever and anemia — all of which may come and go. Symptoms are often severe in the form of a flare-up followed by long periods of remission with few or no symptoms.

Blood tests, including complete blood count, electrolytes and renal function, liver function tests and markers of inflammation, such as C-reactive protein or CRP, are typically the first tests performed. After diagnosis, additional tests, including endoscopy, may be required before starting treatment. Endoscopic procedures allow the doctor to view many sections of the GI tract. These include colonoscopy, upper endoscopy, capsule endoscopy or balloon assisted enteroscopy. Imaging procedures, such as a CT scan and MRI, may also be needed to show more of the GI tract and tissues outside the bowel.

Patients with ulcerative colitis and Crohn’s disease do have a higher risk for developing colorectal cancer than the general population. It is important to discuss your risk factors with your doctor.

• Ulcerative colitis or a type of Crohn’s disease called Crohn’s colitis
• Eight to 10-year history of IBD
• Severe and/or extensive colon inflammation
• Bile duct inflammation and scarring
• Changes in cells that are precursors of cancer in the colon or rectum
• Family history of colorectal cancer

Treatment usually involves various drug therapies or surgery. The goal is to reduce the inflammation that triggers signs and symptoms. In the most positive outcomes, this may lead to symptom relief and long-term remission.

Unfortunately, nothing will prevent IBD. Certain dietary and lifestyle changes may help control the symptoms. Examples include smoking cessation, exercise, a healthy diet, prescribed medications, stress management and mental health care for anxiety or depression.

Digestive health issues are a common concern for many Americans. People with IBD are at a greater risk of developing other chronic health conditions, such as cancer, kidney disease and heart disease. As more people develop these diseases, the need grows for research and advances in treatment.