Inflammatory bowel disease: diagnosis, symptoms and treatment
Inflammatory bowel disease (IBD) is a term used to describe a group of disorders associated with a long-term inflammation of the gut.
Everything you need to know about IBD
The most common forms of IBD are ulcerative colitis and Crohn’s disease. Both conditions are linked to inflammation, with ulcerative colitis caused by inflammation of the large intestine and Crohn’s disease associated with inflammation in any part of the digestive system.
Symptoms of IBD
The main symptoms of IBD are:
- Pain, cramps or swelling in the tummy
- Recurring or bloody diarrhoea
- Unintentionally losing weight
- Extreme fatigue
Patients with IBD can also experience a high temperature and vomiting associated with their IBD, but this is less common.
All of these symptoms can vary in severity and duration from person to person. For example, patients with IBD may go months without symptoms, and then have a sudden, intense flare up, before going back to having no or few symptoms.
Who is at risk of getting IBD?
There is no clear cause of IBD, but certain factors are thought to influence your risk of developing the disease. These include:
- Family history of IBD
- Smoking - this can double your risk of developing Crohn’s disease
- Issues with your immune system
- Your age - most people who develop IBD are diagnosed between the age of 15 and 30 years old
Your consultant may suggest blood tests which can pick up whether you are experiencing anaemia or have an infection. They may also ask you to supply a stool sample, so that they can carry out what is known as a fecal occult blood test. This checks if there is any blood in your poo which might be indicative of IBD.
During this procedure your surgeon uses a small, thin tube with a camera to look inside your body. Samples (biopsies) can then be removed from the area under investigation and sent to the lab for testing.
The most common types of endoscopy for IBD are:
- Flexible Sigmoidoscopy: This enables your surgeon to look inside your rectum (back passage) and the lower part of the large bowel (sigmoid colon). You will be given a sedative and generally the procedure only takes 15 minutes.
- Colonoscopy: This allows your surgeon to view your entire colon by inserting a long thin tube with a camera attached to it into the colon. You will be given laxatives prior to the procedure to make sure your colon is empty, and you can also be given painkillers and sedatives to ensure the procedure is as comfortable as possible.
There currently is not a cure for either ulcerative colitis or Crohn’s disease. However, the two conditions can be managed and symptoms greatly relieved by being prescribed a tailored treatment plan.
Depending on your personal needs and situation, the following treatments may be recommended to you:
Different medications may be recommended to you to help treat and alleviate the symptoms associated with ulcerative colitis and Crohn’s disease. These could be:
- Anti-inflammatory drugs – aimed at reducing inflammation in the gut and therefore reducing the side effects associated with this inflammation
- Immunosuppressants – designed to suppress the immune response and prevent it from releasing chemicals which trigger inflammation in the gut
- Biological and biosimilar medicines – these are generally given through a transfusion or regular injections
- Antibiotics – these may be prescribed alongside other medications where there are signs of infection
If other treatments such as medication don’t alleviate IBD symptoms, surgery might be recommended by your healthcare team.
The most common types of surgery for ulcerative colitis and Crohn’s disease include:
- Proctocolectomy – where your entire colon and rectum are removed.
In some instances, surgeons will then create a permanent opening in your abdomen called a stoma. Waste/stool is passed through the stoma into an attached bag.
In other proctocolectomy cases, the surgeon will create a pouch from the end of your small intestine. The pouch is then attached directly to your anus, allowing waste to leave your body relatively normally.
- Colectomy resection – where the damaged part of your small and large intestine are removed and the healthy sections of the intestinal tract are reconnected.
- Strictureplasty surgery – this type of surgery is used to open up narrowings of the bowel, caused by scar tissue building in the intestine wall due to damage associated with Crohn’s disease.