Inflammatory Bowel Disease

While the exact cause of IBD is unknown, scientists believe that the chronic inflammation is a result of an immune system that doesn’t work properly. It becomes overactive when triggered by an environmental factor and mistakenly attacks the GI tract. People who develop IBDs are more likely to have a family member with one of the conditions.

This points to a genetic component to IBDs.

The most common symptoms of CD and UC are: 

• Diarrhea.
• Abdominal pain/cramping.
• Bloody stools.
• Low appetite. 
• Unintended weight loss.
• Fatigue.

The doctor will review symptoms and medical history and perform a physical exam. Two procedures are performed: endoscopy (for Crohn’s disease) or colonoscopy (for ulcerative colitis). Imaging tests may also be performed, such as magnetic resonance imaging (MRI), computed tomography (CT) or contrast radiography, Sometimes, blood tests or stool samples are done to rule out other conditions.  

Inflammatory bowel diseases are treated with five types of medications: 

• Aminosalicylates. These anti-inflammatory drugs include sulfasalazine, balsalazide, mesalamine, and olsalazine. They are most effective for ulcerative colitis and are given orally or inserted in the rectum.  
• Corticosteroids. These anti-inflammatory drugs include prednisone, prednisolone and budesonide, and are effective for short-term control of flares. They are prescribed for the shortest time due to their side effects 
• Immunomodulators. These anti-inflammatory drugs include azathioprine, 6-mercaptopurine (6-MP) and methotrexate. They help to modify the disease process and tackle inflammation 
• Biologics and biosimilars. The anti-inflammatory drugs are the newest treatments for IBD. Adalimumab (Humira), certolizumab pegol (Cimzia), golimumab (Simponi) and infliximab (Remicade) target an inflammatory protein called tumor necrosis factor (TNF). Ustekinumab (Stelara) targets the pro-inflammatory proteins interleukin-12 and interleukin-23. Natalizumab (Tysabri) and vedolizumab (Entyvio) block certain white blood cells from affecting GI tissues.

All medications come with side effects. Discuss the risks and benefits with your doctor. 

It’s common for people with IBD to get different vaccinations to help prevent infections. Surgical intervention is uncommon these days because of effective medications. But if the diseases are severe, then damaged parts of the GI tract are removed by surgery.  

What you eat can have a big impact on managing the symptoms of inflammatory bowel disease. An anti-inflammatory diet rich in vegetables, fruits, lean protein, especially fatty fish and fiber-rich foods can ease the stress on the GI tract and digestive system.  Studies show that physical activity also has anti-inflammatory benefits. Managing a chronic disease can also be tough for your emotional health. So, develop a support network of family and friends. Also, look for ways to interact and learn from other people with IBDs through in-person support groups and online communities.