Inflammatory Bowel Disease

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The gastrointestinal tract is the passage through which food travels from the mouth to the anus. When an immune response causes parts of this tract to swell and become inflamed, it is called inflammatory bowel disease (IBD).

IBD causes the body’s immune system to attack the cells of the bowels, causing persistent inflammation.

IBD differs from irritable bowel syndrome (IBS), in that IBD causes inflammation in the GI lining, while IBS is a neuromodulatory disorder. IBD often begins early in life, during the late teens and 20s.

There are two types:

  • Ulcerative colitis – This form of the condition is limited to inflammation of the colon, or large intestine.
  • Crohn’s disease – Inflammation that extends deeper into the intestines, to include the small intestine and/or colon.

The inflammation caused by IBD can lead to rectal bleeding, diarrhea, malnourishment, and in serious cases, colorectal cancer. Ulcerative colitis and Crohn’s disease have slightly similar symptoms, the most common including:

  • Diarrhea or loose stools that are bloody
  • An urgent need to go to the bathroom, and more frequently
  • Abdominal pain and cramping
  • A diminished appetite and weight loss
  • An unexplained fever
  • Joint pain and swelling (during flareups of Crohn’s)
  • Skin rashes (during flareups of Crohn’s)

IBD may be progressive, so an early diagnosis is important. Your gastroenterologist will likely recommend more than one of a variety of tests:

  • Blood and stool samples – These would be tested for the presence of inflammation and to rule out other causes of IBD, such as infection.
  • Imaging tests – A variety of X-rays, including MRIs and CT scans, can provide cross-sectional imaging of the colon and upper GI tract.
  • Upper Endoscopy – In cases of upper GI symptoms, such as nausea and vomiting, the gastroenterologist may examine the esophagus, stomach, and duodenum (the small intestine entry) using a camera-equipped flexible tube, or endoscope.
  • Colonoscopy – Similar to an upper endoscopy, this procedure involves the insertion of the tube through the anus, to examine the entire colon. If polyps are present, they will be removed during the procedure.
  • SigmoidoscopyThis procedure is similar to a colonoscopy but examines just the last two feet of the colon.
  • Capsule endoscopy – To determine if the IBD is occurring in the small intestine, the patient may be prescribed a capsule containing a tiny camera, which the doctor can track as it passes through the GI tract.

Because there are no known cures for IBD, the goal of treatment is to ease the symptoms by reducing inflammation and therefore preventing complications. The most common course of treatment for IBD will likely include medications to keep the disease under control.

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