Most people may be somewhat familiar with Inflammatory Bowel Disease (IBD) and may have heard the term before. But few people know the details about IBD, including how it comes about, the main symptoms and treatments.
In this new blog post coinciding with World IBD Day (19 May), Dr Jamal Hayat, Consultant Gastroenterologist at Parkside, shares some valuable insight on the disease.
What is IBD and is it different from Irritable Bowel Syndrome (IBS)?
It is easy to get IBD and IBS mixed up. Both are chronic conditions that cause abdominal pains, cramping, and urgent bowel movements. But despite having similar acronyms and symptoms, it is important to differentiate the two as they are treated differently.
IBD refers to inflammation and ulceration of the bowel wall, which can lead to sores and narrowing of the intestines. IBD is a term for a broad range of diseases, but Crohn’s disease and ulcerative colitis are the most common.
IBS can present with similar symptoms to IBD but the bowel wall is not damaged in the same way as with IBD. Hence the main forms of treatment are also different. The underlying mechanisms and caused of IBS are still being researched. It is thought that the symptoms from IBS may be caused by altered sensitivity of the gut wall, altered gut flora, and the body’s response to different hormonal/chemical compounds.
What are the symptoms of IBD?
Signs and symptoms of IBD include abdominal cramps and pain, recurring or bloody diarrhoea, severe urgent need to have a bowel movement, fever, loss of appetite, weight loss, and anaemia (due to blood loss).
Not everyone has all of these symptoms, and some people may have other symptoms, such as being sick (vomiting). The symptoms of IBD generally come and go. Particularly with Crohn’s disease and ulcerative colitis, there may be times when the symptoms are severe (a flare-up), followed by long periods when there are few or no symptoms at all (remission).
Tell me more about Crohn’s and ulcerative colitis…
Ulcerative colitis and Crohn’s disease are long-term conditions that involve inflammation of the gut. Ulcerative colitis, also commonly referred to as UC, is a condition that affects your large bowel and rectum (back passage). The innermost layer of the gut becomes inflamed and ulcers can develop. This can lead to bloody diarrhoea.
Crohn’s disease can affect any part of your digestive system – from your mouth to your anus (back passage). But it most often causes inflammation in the final part of your small bowel (ileum), large bowel (colon) and rectum. The inflamed areas are usually separated by unaffected (healthy) areas of bowel, called ‘skip lesions’. Sometimes, other parts of your body, not just your digestive system, can be affected by Crohn’s disease. You may have aching joints, painful ulcers in your mouth or on your skin or sore eyes.
What Causes IBD and how common is it?
Whilst the exact cause for both Crohn’s and UC is not known, we know that the damage is caused by the body’s own immune system attacking the digestive tract. IBD occurs when there is an interaction between the immune system and environment triggers if you have a genetic susceptibility. As many as 1 in 5 people with IBD will have a first degree relative (parent, child or sibling) who is also affected.
It can occur at any age group, however the most common age group for onset is between 15-35 years of age. IBD Generally affects men and women equally, but UC is slightly more common in men when diagnosed over the age of 50. The prevalence of Crohn’s is 157 per 100 000, in other words there is approximately 115 000 people in the UK affected. The prevalence for UC is 240 per 100000 with approx. 146 000 people in the UK with UC.
How can I get a diagnosis?
You should see your GP in the first instance if you are experiencing any changes to your health or daily bowel habit. Your doctor will ask about any symptoms you are experiencing, and may ask about any family history of bowel conditions. They may order some tests to rule out other conditions. These tests can include physical examination, blood and stool tests. If you are very unwell with diarrhoea, bloody stools, a fever, fast heart rate or low blood pressure, your GP will refer you to hospital immediately.
If your blood and stool tests show inflammation, you should be referred by your GP to a specialist IBD team so gastroenterology teams like ours at Parkside can take a closer look. They may conduct further tests including:
- A colonoscopy: Your doctor will insert a narrow, flexible, tube-like telescopic camera, called an endoscope, through your back passage (rectum) into your bowel. They can then look inside your bowel and take tissue samples that can be tested in a laboratory.
- A CT scan or MRI scan: These scans create images of the inside of your tummy.
- A capsule endoscopy: If you have this test, your doctor will give you a small capsule to swallow. The capsule contains a small video camera. As it passes through your small bowel, the camera takes digital pictures that can be recorded and viewed on a screen by your doctor.
Whilst there is no cure for UC or Crohn’s disease, there are treatments that can significantly help reduce symptoms and improve quality of life. As everyone’s condition is different, treatment options are catered to the individual. The main aims are to reduce inflammation, relieve symptoms and prevent flare-ups (induce and maintain remission). The mainstay of treatment is with different medications, however can also include different dietary therapies and surgery.
For more information on IBD, Crohn’s or ulcerative colitis, visit www.crohnsandcolitis.org.uk/