Inflammatory Bowel Disease
Inflammatory Bowel Disease (IBD) is a term for chronic conditions characterized by ongoing inflammation and ulcerations (sores) in the digestive tract, specifically the small or large intestine.
The two main types of IBD are Ulcerative Colitis and Crohn’s Disease.
1. Ulcerative Colitis (UC)
Ulcerative Colitis is an inflammatory condition that causes ulcers and inflammation strictly in the large intestine (colon and rectum).
Common Symptoms:
Symptoms often involve the lower GI tract:
- Diarrhea
- Blood in the stool
- Urgency: The sudden, overwhelming need to rush to the toilet.
- Incontinence: Accidental passage of stool.
- Abdominal pain
- Weight loss
Diagnosis:
The diagnosis is confirmed through a colonoscopy, which allows doctors to visualize the colon lining, and a biopsy (tissue sample) for lab analysis.
Treatment:
Treatment intensity depends on how severe the disease is:
- Mild Disease: Usually treated with Mesalamines (medications that reduce inflammation in the gut lining).
- Moderate to Severe Disease: Requires stronger medications like Steroids, antimetabolites (drugs that suppress the immune system), and Infliximab (a biologic medication).
- Severe Cases: May ultimately require surgery to remove the diseased part of the colon.
2. Crohn’s Disease (CD):
Crohn’s Disease is unique because it can cause inflammation and ulcerations anywhere in the digestive tract, from the mouth to the anus, but it most commonly affects the small and large bowel.
Common Symptoms:
Symptoms can vary widely depending on the location of the inflammation:
- Pain: Often centered around the umbilical region (belly button).
- Diarrhea
- Blood in the stool
- Vomiting and upper abdominal pain (if the upper GI tract is involved)
- Weight loss
- Fever
- Abdominal lump (due to inflammation or abscesses)
Diagnosis and Evaluation:
Because Crohn’s can affect the entire gut, a variety of tests are used for diagnosis and assessment:
Colonoscopy and biopsy
- CT Enterography: A specialized CT scan used to visualize the small intestine.
- Barium study: X-rays taken after drinking a contrast solution.
- Double Balloon Enteroscopy and Capsule Endoscopy: Advanced procedures used to examine parts of the small intestine that traditional endoscopy cannot reach.
Treatment:
Treatment is customized based on the disease severity and how much of the bowel is affected:
- Mild Disease: Treated with Mesalamine.
- Moderate Disease: Treated with oral steroids and antimetabolites.
- Severe Disease Activity: May require stronger treatments like steroids, antimetabolites, and Infliximab.
- Surgery: Surgery is typically reserved for complications like stricturing disease (narrowing of the bowel) or when the disease is very severe but confined to a small, localized area.