Inflammatory Bowel Disease (IBD)

What is IBD?

Inflammatory Bowel Disease is a set of conditions that affects the colon and small intestine. There are two primary forms of inflammatory bowel disease (IBD), Crohn's disease and ulcerative colitis. Both are classified as autoimmune disorders. An autoimmune disorder is a condition that takes place when the body's immune system errantly attacks its own healthy tissue.

Together these disorders, which may run in families, affect more than 500,000 Americans with men and women being equally affected. Although a compromised immune response is implicated in the typical inflammatory reactions in the intestinal wall, the triggering event, possibly a bacterial or viral infection, is as yet unknown.

What are the symptoms of IBD?

Symptoms may include:

• persistent abdominal pain
• bowel sores
• diarrhea
• intestinal bleeding
• weight loss

In some cases, the inflammatory processes associated with Crohn's disease and ulcerative colitis trigger skin lesions, joint pain, inflammation of the eyes, and liver disorders.

Diagnosing IBD

Inflammatory bowel diseases are diagnosed through:

• physical examination
• tests for anemia resulting from blood loss in the stool
• increased white blood cells indicative of an inflammatory condition
• flexible sigmoidoscopy, whereby the intestinal lining is viewed directly through a flexible tube inserted through the anus
• X-rays (small bowel follow-through and/or barium enema), which can indicate abnormal inflammation, thickening or constriction of the small intestine and colon
• Samples of inflamed intestinal tissue may also be taken for microscopic examination.

What are the treatments for IBD?

Treatment for both disorders includes:

• dietary adjustments
• medication
• surgery

No specific dietary regimens have proved fully effective, although avoidance of foods which exacerbate inflammation is recommended.

Both Crohn's disease and ulcerative colitis are initially treated with sulfasalazine and mesalamine. More serious cases of Crohn's disease are treated with prednisolone, metronidazole or azathioprine. With ulcerative colitis, surgery becomes necessary in one in four patients, for whom the prognosis is usually good.

While medication, diet, and surgery may lead to temporary remission, both disorders persist throughout the patient's lifetime.