Inflammatory bowel disease refers to a group of diseases of the digestive system, which have inflammation as the main symptom. Primary inflammatory bowel diseases are ulcerous colitis and Crohn’s disease. Ulcerous colitis manifests in the large intestine, and Crohn’s disease involves any part of the digestive tract, from the mouth to the anus, but often occurs in the small intestine or the colon area.
When inflammation is severe, the condition is considered to be at an active stage, and the manifestations are obvious. When the degree of inflammation is low the patient has no symptoms and the disease is in remission. Inflammatory bowel disease is affecting both men and women, in the same measure, and it is a common condition worldwide, but lately, inflammatory bowel disease is on rise in the US.
Causes of Inflammatory Bowel Disease
The etiology of the intestinal inflammatory diseases is unknown, and for that reason, these diseases are considered idiopathic (diseases whose causes are unknown). An unknown agent, or a combination of risk factors, affects the immune system of the body, and the result consists of an inflammatory reaction in the intestinal tract which can not be kept under control. As a result of this reaction, the intestinal wall is damaged, causing bleeding, diarrhea, and abdominal pain.
It is believed that genetic, immunological, infectious, and psychological factors are implicated in the occurrence of inflammatory bowel diseases. However, trigger factors have not yet been identified.
It may be an immune response to an antigen (e.g. the protein found in dairy products) or an autoimmune process. Because the digestive tract is frequently exposed to agents that cause immune reactions, recent approaches suggest that this process takes place as the body fails to try triggering normal immune responses.
Symptoms of Inflammatory Bowel Disease
Because the intestinal inflammatory disease is a chronic disease, there will be periods when the symptoms will manifest more intensely. These episodes are followed by remissions when the symptoms disappear or are diminished.
Symptoms may range from mild to severe and generally, depend on the affected intestinal tract. These can be:
- abdominal pain and pain
- decreased appetite
- anemia (as a result of bleeding)
Complications of inflammatory bowel disease include:
- abdominal bleeding at the affected area level
- gut perforation (rupture)
- strictures and obstructions – in people who develop Crohn’s disease, strictures are inflammatory and can be cured following a medical treatment. Fixed or fibrous strictures may require surgical or endoscopic surgery to relieve occlusion. In ulcerous colitis, the colon strictures are supposed to be malignant (cancerous)
- toxic megacolon (acute, nonobstructive dilation of the colon) – is a complication of ulcerous colitis requiring emergency surgery because the patient’s life is endangered
- malignancy – the risk of colon cancer in ulcerous colitis begins to increase significantly after 8 to 10 years after diagnosis. The risk of developing cancer due to Crohn’s disease is the same as in ulcerous colitis, only if the whole colon is involved. Instead, the risk of malignancy in the small intestine increases in Crohn’s disease.
People with inflammatory bowel disease may suffer from arthritis, skin diseases, eye inflammation, liver diseases, kidney diseases, and bones’ structure disorders.
Of all the extraintestinal complications, arthritis is the most common. Often, common symptoms of the eyes and skin manifest themselves concurrently.
Exams, diagnosis, and tests
The gastroenterologist will make the diagnosis based on a series of clinical investigations and symptoms.
- The cropoparasitological exam.
Faeces analysis is done to eliminate the viral, bungalow, or parasitic causes that could trigger diarrhea.
- Complete blood tests.
And increased number of white blood cells indicates the existence of an infection in the human’s organism.
In the case of internal hemorrhage, the number of red blood cells decreases as well as the level of hemoglobin, causing anemia.
These blood tests must be accompanied by additional investigations because their results cannot establish the clear diagnosis of intestinal inflammatory disease because abnormal hemoglobin or red blood cell counts are specific to several conditions.
- Barium radiography.
It tests the upper digestive tract (esophagus, stomach, duodenum, small intestine). The patient has to swallow a contrast substance, barium, which opacify the intestinal tract, in order to be explored under the action of the X-rays.
In the case of Crohn’s disease, the anomalies will be observed in this investigation but also other diseases such as gastroduodenal ulcers, gastritis, or the existence of possible tumors.
This test is also recommended for identifying diseases specific to the infectious digestive tract. In this situation, the barium is introduced into the colon with the help of the enema.
For this procedure, the doctor uses a special instrument called a sigmoidoscope, which is a narrow, flexible tube that has a video camera and a light source attached to it, to visualize the large intestine.
The sigmoidoscope is inserted through the anus and the intestinal wall is examined to detect the presence of ulcers, inflammation, and bleeding. During this procedure, the doctor can take samples from the intestinal mucosa for a future biopsy.
It is a similar exam to the sigmoidoscopy in matters of procedure, with the difference that the entire colon can be examined.
- Higher digestive endoscopy.
If the patient experiences symptoms specific to the upper gastrointestinal tract, such as nausea, vomiting, or burning sensation, the gastroenterologist will ask for this investigation.
An endoscope will be used to examine the esophagus, stomach, and duodenum. In the case of Crohn’s disease, the specialist will track the identification of ulceration, which occurs in about 10% of the people who will suffer from this disease.
Adopting a balanced and healthy diet is an effective treatment option for these conditions. Depending on the symptoms, the prescribing physician may recommend you to reduce the consumption of dairy products or dietary fiber. In addition to a proper diet, specialists also recommend a lot of rest and to avoid stress in everyday life.
The treatment is set up by a team of doctors consisting of a family physician, gastroenterologist, and, eventually, a surgeon.
The main purpose of the treatment is to cure the inflammation. Medication treatment helps relieve inflammation. Anti-inflammatory drugs are administered, such as:
Also, suppressors of the immune system may be prescribed:
Effective is also the administration of an antibiotic like Metronidazole to kill the germs in the intestines, especially if the patient suffers from the Crohn’s disease.
In the event of severe symptoms (diarrhea, fever, vomiting, and so forth), the patient should be admitted to hospital for treatment which will consist in intravenously administration of special fluids and medications.
Ulcerous colitis may worsen in time, so the action of the drug may become insignificant. In this case, surgical intervention for the total or partial ablation of the colon is the only solution.
There is no special diet to prevent the development of inflammatory bowel disease.
A balanced and healthy diet may relieve the symptoms, especially from the inflammation in people suffering from inflammatory bowel disease. However, it has not been scientifically proven that avoiding or predominantly consuming a food triggers the inflammatory bowel disease.
Quitting smoking is the only thing that relieves the symptoms of people with Crohn’s disease. According to the studies, there is a close relationship between the number and severity of Crohn’s disease-specific crises and smoking. Sometimes, even occasional smoking is effective in relieving the symptoms of these conditions.
Inflammatory Bowel Disease on Rise in US
The CDC conducted a national survey on this topic, and the results were alarming.
Inflammatory bowel disease affects approximately 3 million people in the United States, men and women being equally affected.
Americans of European or Jewish origin are 5 times more likely to develop inflammatory bowel disease than the general population.
Historically, inflammatory bowel disease was predominantly considered a Caucasians-specific disease but there was an increase in the reported cases in African-Americans suffering from this disease.
Prevalence seems to be lower among the Hispanic and Asian populations, though.
Inflammatory bowel disease begins, most commonly, during the adolescence and in early adulthood, usually between the ages of 15 and 35.
Crohn’s disease tends to be more common in relatives of those who suffer from the Crohn’s disease, which could mean that this disease is somehow hereditary, but more scientific studies are needed into that direction.
The number of new cases (incidence) and the total number of cases (prevalence) of Crohn’s disease in the United States are increasing, meaning that the inflammatory bowel disease is on rise in the US, although the reason why is this happening is not fully understood.