Inflammatory bowel disease (IBD) describes a group of long-term conditions that cause the digestive tract to become inflamed (red and swollen). Dr Jamal Hayat, Consultant Gastroenterologist at Parkside Private Hospital, explains the main symptoms and causes of IBD. He also discusses how IBD is diagnosed and possible treatments that can help.
What is IBD and is it different from Irritable Bowel Syndrome (IBS)?
It is easy to confuse IBD and IBS. Both are chronic (long-term) conditions that can cause diarrhoea, urgent bowel movements, tummy pains and cramps. Although they have similar sounding names and symptoms, there are different causes and treatments for the two conditions.
IBD refers to inflammation and ulceration of the bowel wall. This can lead to sores and narrowing of the large or small intestine (the part of your gut that helps with the absorption of food and water). IBD is the name for a number of different conditions. The most common are ulcerative colitis and Crohn’s disease.
IBS can have similar symptoms to IBD, but the bowel wall is not damaged in the same way. For this reason, the main types of treatment are also different. The causes of IBS are still being researched. It is thought that the symptoms of IBS may be caused by:
- oversensitive nerves in your gut
- changes to the bacteria in your gut
- the body’s response to different hormones or chemical substances
What are the symptoms of IBD?
The signs and symptoms of IBD include:
- cramps and pain in the tummy
- recurring or bloody diarrhoea
- a severe, urgent need to have a bowel movement
- a high temperature (fever)
- loss of appetite
- weight loss
- anaemia (a lack of iron in the body because of blood loss)
Not everyone has all of these symptoms. Some people may have other symptoms, such as being sick (vomiting).
The symptoms of IBD generally stop and start again at intervals. There may be times when the symptoms are severe (a flare-up), followed by long periods when you have few or no symptoms (remission). This is particularly the case with ulcerative colitis and Crohn’s disease.
Can you tell me more about ulcerative colitis and Crohn’s disease?
Ulcerative colitis and Crohn’s disease are long-term conditions that involve inflammation of the gut.
Ulcerative colitis, often called UC, affects your large intestine (bowel) and rectum (back passage). The inner layer of the gut becomes inflamed and ulcers (sores) 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. It most often causes inflammation in the lower part of your small bowel (the ileum), large bowel (the colon) and rectum. The inflamed areas are usually separated by unaffected (healthy) areas of bowel, called skip lesions.
Sometimes other parts of your body and 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?
The exact cause of ulcerative colitis and Crohn’s disease is unclear. We know that the damage is caused by the body’s own immune system attacking the digestive tract.
A combination of factors is thought to cause IBD, including:
- an overreaction of the immune system
- genetics (a family history of the condition)
- environmental factors or ‘triggers’
About 1 in 5 people with IBD have a close family member who is also affected. This may be a parent, child, brother or sister.
You can get IBD at any age. It is most common to be diagnosed between the ages of 15 and 35. In general, IBD affects men and women equally. However, ulcerative colitis is slightly more common in men when it is diagnosed over the age of 50.
About 240 in every 100,000 people have ulcerative colitis. This is equivalent to about 146,000 people in the UK. Crohn’s disease affects about 157 in every 100,000 people. In other words, about 115,000 people in the UK have Crohn’s disease.
How is IBD diagnosed?
You should see your GP in the first instance if there are any changes in your health or daily bowel habit. Your doctor will ask about your symptoms and any family history of bowel conditions. They may order some tests to rule out other conditions. These tests can include a physical examination, blood tests and stool tests (tests on a poo sample).
If you are very unwell with diarrhoea, bloody stools, a high temperature, fast heart rate or low blood pressure, your GP will refer you to hospital immediately.
If your blood and stool tests show inflammation, your GP should refer you to a specialist gastroenterology team like ours at Parkside. They may carry out more tests, including:
- A colonoscopy: Your doctor inserts a narrow, flexible tube with a small camera called an endoscope through your back passage (rectum) into your bowel. They then look inside your bowel and take tissue samples that can be tested in a laboratory.
- A CT scan or MRI scan: These scans take pictures of the inside of your tummy.
- A capsule endoscopy: Your doctor gives you a small capsule to swallow. The capsule contains a tiny video camera. As it passes through your small bowel, the camera takes digital pictures. These pictures can be recorded and your doctor can see them on a screen.
What treatments can help with IBD?
There is currently no cure for ulcerative colitis or Crohn’s disease. However, various treatments can help significantly to reduce your symptoms and improve your quality of life.
Everyone’s condition is different and treatment options are tailored to your individual needs. The main aims of treatment are to:
- reduce inflammation
- relieve your symptoms
- prevent flare-ups
IBD is mainly treated with different medicines. Treatments can also include special diets, lifestyle changes and surgery.
Where can I get more information about IBD?
You can find more information about IBD, ulcerative colitis and Crohn’s disease on the Crohn’s and Colitis UK website at: www.crohnsandcolitis.org.uk
About Dr Jamal Hayat
Dr Jamal Hayat is a Consultant Gastroenterologist with specialist interests in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).
You can read more about Dr Hayat and his expertise here. To make an appointment with Dr Hayat at Parkside Private Hospital, please call 020 3944 0568 or complete this form online.