Inflammatory Bowel Disease

Inflammatory bowel disease, or IBD, refers to a group of disorders that lead to inflammation and swelling of the digestive tract tissues.

The most prevalent forms of IBD are:

• Ulcerative colitis. This condition causes inflammation and ulcers along the colon and rectum lining.

  
  

• Crohn's disease. This type of IBD involves inflammation of the digestive tract lining, often affecting the deeper layers. It typically impacts the small intestine but can also affect the large intestine and, less commonly, the upper gastrointestinal tract.

  
  

Symptoms of both ulcerative colitis and Crohn's disease often include abdominal pain, diarrhea, rectal bleeding, severe fatigue, and weight loss.

For some, IBD is a mild condition, while for others, it can cause disability and lead to life-threatening complications.

Symptoms

Symptoms of inflammatory bowel disease vary based on the severity and location of inflammation. They can range from mild to severe, with periods of active illness followed by remission.

Common symptoms of both Crohn's disease and ulcerative colitis include:

• Diarrhea.

• Abdominal pain and cramping.

• Blood in the stool.

• Loss of appetite.

• Unintentional weight loss.

• Extreme fatigue.

When to see a doctor

Consult a healthcare professional if you notice a persistent change in bowel habits or experience any symptoms of inflammatory bowel disease. Although IBD is not typically fatal, it is a serious condition that can lead to life-threatening complications in some individuals.

Causes

The precise cause of inflammatory bowel disease is unknown. While diet and stress were once suspected, they are now understood to potentially worsen IBD but not cause it. Several factors likely contribute to its development.

• Immune system. A possible cause involves changes in immune system function. When the immune system attempts to combat an invading virus or bacterium, an atypical immune response may lead to an attack on the digestive tract cells.

  
  

• Genes. Various genetic markers are linked to IBD. Family traits also seem to play a role, as IBD is more common in individuals with family members who have the disease. However, most IBD sufferers do not have a family history of the condition.

  
  

• Environmental triggers. Researchers believe environmental factors may contribute to the development of IBD, especially those affecting the gut microbiome. These may include:

  
  

  • Growing up in a sterile environment with limited germ exposure.

  • Experiencing a gastrointestinal infection early in life.

  • Taking antibiotics during the first year of life.

  • Primarily being bottle-fed.

Risk factors

Risk factors for inflammatory bowel disease include:

• Age. Most people are diagnosed with IBD before age 30, but some may not develop the disease until their 50s or 60s.

  
  

• Race or ethnicity. IBD is more prevalent among white individuals but can occur in anyone. The incidence is also rising in other racial and ethnic groups.

  
  

• Family history. Having a blood relative with the disease, such as a parent, sibling, or child, increases your risk.

  
  

• Cigarette smoking. Smoking is the most significant controllable risk factor for Crohn's disease.

  
  

  Although smoking might help prevent ulcerative colitis, its overall health risks outweigh any benefits. Quitting smoking can enhance digestive tract health and offer numerous other health benefits.

  
  

• Nonsteroidal anti-inflammatory medicines. These include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve), diclofenac sodium, and others. These medicines may increase the risk of developing IBD or worsen the disease in those already affected.

Complications

Ulcerative colitis and Crohn's disease share some complications, while others are unique to each condition. Common complications include:

• Colon cancer. Having ulcerative colitis or Crohn's disease that affects most of the colon increases the risk of colon cancer. Regular colonoscopy screenings typically begin 8 to 10 years after diagnosis. Consult a healthcare professional about when and how often to undergo this test.

  
  

• Skin, eye, and joint inflammation. Conditions such as arthritis, skin lesions, and eye inflammation (uveitis) may occur during IBD flare-ups.

  
  

• Medicine side effects. Some IBD medications carry infection risks and a small chance of certain cancers. Corticosteroids may be linked to osteoporosis, high blood pressure, and other conditions.

  
  

• Primary sclerosing cholangitis. In this rare condition associated with IBD, inflammation leads to scarring in the bile ducts, narrowing them and restricting bile flow, potentially causing liver damage.

  
  

• Blood clots. IBD increases the risk of blood clots in veins and arteries.

  
  

• Severe dehydration. Excessive diarrhea can lead to dehydration.

  
  

Crohn's disease complications may include:

• Bowel obstruction. Crohn's disease affects the entire bowel wall thickness, leading to thickening and narrowing, which may block digestive content flow. Surgery might be necessary to remove the affected bowel section. Rarely, bowel or colon obstruction can occur in ulcerative colitis and may indicate colon cancer.

  
  

• Malnutrition. Diarrhea, abdominal pain, and cramping can hinder eating or nutrient absorption, leading to malnutrition. Anemia, due to low iron or vitamin B-12, is also common.

  
  

• Fistulas. Inflammation can extend through the intestinal wall, creating a fistula, an abnormal connection between body parts. Fistulas near the anal area are most common but can also occur internally or in the abdominal wall. An infected fistula may form an abscess.

  
  

• Anal fissure. A small tear in the tissue lining the anus or surrounding skin, often causing painful bowel movements and potentially leading to an anal fistula.

  
  

Ulcerative colitis complications may include:

• Toxic megacolon. Ulcerative colitis can cause rapid colon enlargement and swelling, a serious condition known as toxic megacolon.

  
  

• Perforated colon. A perforated colon is most often caused by toxic megacolon but can also occur independently.