About IBD (FAQ)


This is a fantastic video created by DocMikeEvans of Youtube.

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is an umbrella term referring to certain chronic diseases that cause inflammation of the intestines. Crohn’s disease and ulcerative colitis are the two terms most often assigned to the different types of IBD. Although they are different diseases with a variety of forms, each disease causes the destruction of the digestive system, producing a similar group of life-altering symptoms.

What symptoms should prompt me to see a doctor?

Persistent abdominal cramping or pain, diarrhea, rectal bleeding, weight loss or fever are symptoms that should warrant an evaluation by a physician. These could represent an underlying infection, a new diagnosis of inflammatory bowel disease or an IBD flare.

How are Crohns and Ulcerative Colitis diagnosed?

A thorough physical exam and a series of tests may be required to diagnose Crohn’s disease or ulcerative colitis. The doctor may do an upper GI series to look at the small intestine. For this test, the person drinks barium, a chalky solution that coats the lining of the small intestine, before X-rays are taken.
The doctor may also do a visual exam of the colon by performing either a sigmoidoscopy or a colonoscopy. For both of these tests, the doctor inserts a long, flexible, lighted tube linked to a computer and TV monitor into the anus. The doctor may also do a biopsy, which involves taking a sample of tissue from the lining of the intestine to view with a microscope.

What is the difference between IBD and IBS?

Inflammatory bowel disease (IBD) is easily confused with another condition known as irritable bowel syndrome (IBS). As much as 25% of the population in the United States report symptoms of IBS, and up to 50% of patients seen by gastroenterologists have symptoms of IBS.

IBD and IBS have similar symptoms, particularly cramping and diarrhea, but the underlying disease process is quite different. IBD is inflammation or destruction of the bowel wall, which can lead to deep ulcerations (sores) and narrowing of the intestines. IBS is a disorder of the gastrointestinal (GI) tract for which no apparent cause can be found. A patient can possibly have both IBD and IBS.

What is the difference between Crohn’s disease and ulcerative colitis?

Crohn’s disease can affect any part of the gastrointestinal tract, from the mouth to the anus. The inflammation of Crohn’s disease can be patchy and noncontinuous and can deeply penetrate into the bowel wall. Even if the affected part of a Crohn’s disease bowel is removed, the disease may recur.

Ulcerative colitis differs in that it affects only the colon. The inflammation does not go past the inner layer of the bowel wall. Ulcerative colitis can be limited to the rectum or can extend further up the large bowel. In some cases, it can affect the entire colon. The inflammation of ulcerative colitis is continuous, not patchy. Ulcerative colitis can be completely cured by surgical removal of the colon and rectum.

Does what I eat matter?

While little evidence exists that any particular food has a role in causing IBD, good nutrition is very important. A well-balanced diet helps make sure that patients get all the nutrients they need. Sometimes IBD reduces the body’s ability to absorb necessary nutrients. In certain circumstances, IBD may be improved with diet restrictions, which should be discussed with a physician or a dietitian.

Is IBD a genetically inherited disease?

Approximately 25% of IBD patients have a direct relative who also has the disease, leading scientists to believe that it may be hereditary. A responsible gene, however, has not yet been identified. IBD affects men and women equally and can occur at any age, from young children to the elderly. Regionally, the diseases are most often found in the United States, Canada and Europe, although the number of cases is rising in the industrialized parts of Asia. Jewish Americans are four to five times more likely to develop IBD than the population as a whole.

Is there a cure?

No, IBD cannot be cured. There will be periods of remission when the disease is not active. Medicines can reduce inflammation and increase the number and length of periods of remission, but there is no cure.

How long will IBD last?

IBD is a lifelong (chronic) condition. A few patients find their disease becomes milder (“burned out”) after age 60, but many do not.

Do I have to take medicine forever?

Probably. IBD is a chronic disease, and most patients need to take medicines to ease symptoms and reduce the number and severity of flares. You may have both maintenance medicines to prevent flares and rescue medicines during the time of an active flare.  Most maintenance medicines act fairly slowly, but rescue medicines act more quickly to reduce inflammation and ease your symptoms

Are there some medicines that can get me out of a flare quickly?

Yes. These are not used long term because of side effects. Patients will often change over from rescue medicines to long-term maintenance medicines. Rescue medicines include steroids like prednisone, and cyclosporine

Will surgery cure my IBD?

No, but surgery can be very helpful. For patients with ulcerative colitis, removal of 97% of the colon greatly reduces symptoms. Surgery is no picnic, but it can often improve quality of life if you have severe colitis. There are several ways to reconnect the intestine after the colon is removed, each of which has good and bad effects.
The effect of surgery for Crohn’s disease can often be like pushing a giant reset button.  The surgery can remove scarred tissue and strictures, fistulas, and abscesses that cause a lot of symptoms for which medicines are not very effective. After surgery for Crohn’s disease maintenance medicines often work better and help prevent further complications and may prevent future surgery.

 

Could any thing other than IBD be causing my symptoms?

Yes, patients with IBD can get IBD-like symptoms for other reasons. Infections can cause diarrhea. Previous inflammation can cause increased sensitivity of the nerves in the intestine and make you very sensitive to stomach cramps. Too much bacteria in the small intestine can cause cramping and gas. But because you cannot be sure, call your health care team if there is a change in your symptoms because it might be something other than a flare of IBD.

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