Inflammatory Bowel Disease: Symptoms, Causes, Diagnosis and Management

Inflammatory Bowel Disease: Symptoms, Causes, Diagnosis and Management

Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn’s disease and ulcerative colitis .

Ulcerative colitis is a type of an inflammatory bowel disease that causes long lasting inflammation in a part of digestive tract. Symptoms generally develop with the time. It generally involves the innermost lining of large intestine (colon) and rectum. It occurs only through continuous stretches of colon.

Crohn’s disease is an inflammatory bowel disease that causes inflammation along the lining of the digestive tract, and generally spreads deep into affected tissues. This can cause abdominal pain, severe diarrhoea and even malnutrition. The inflammation due to Crohn’s disease can involve different areas of the digestive tract in different people.

Collagenous colitis and lymphocytic colitis  are also considered inflammatory bowel diseases, but are usually regarded separately from classic inflammatory bowel disease.

Symptoms

The main symptoms of Crohn’s disease and ulcerative colitis are similar.

They include:

  • Abdominal pain –  seen commonly in Crohn’s disease than in ulcerative colitis
  • Change in bowel habits- urgent or bloody diarrhoea or sometimes constipation
  • Weight loss
  • Extreme tiredness

Causes

The exact causes of Crohn’s disease and ulcerative colitis are not clear.

Genetic: IBD is a disease related to genetic causes and is also subjected to selective pressures, there is a strong relation between defense and autoimmunity, suggesting a key role for maintaining the genetic relationship between inflammation and infection.

Diagnosis

Following tests and procedures are used to diagnosis:

  • Blood tests: Blood tests are generally done to know the presence of certain antibodies. Antibodies can sometimes help to diagnose   type of inflammatory bowel disease, but these tests can’t definitely make the diagnosis.
  • Colonoscopy: This  procedure allows to view the inside of the entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, small samples of tissue (biopsy) are taken for laboratory analysis. Sometimes a tissue sample can help in confirming  a diagnosis.
  • X-ray: A standard X-ray of abdominal area may be done to rule out toxic mega colon or a perforation of the colon, if these conditions are suspected because of severe symptoms.
  • Flexible sigmoidoscopyIn this procedure, doctor uses a slender, flexible, lighted tube to examine the last portion of colon (sigmoid colon).
  • Barium enema: This diagnostic test allows to evaluate the entire large intestine with an X-ray. Barium, a contrast solution, is placed into the bowel using an enema. Sometimes, air is added as well. The barium coats the bowel lining, creating a silhouette image of rectum, colon and a portion of the small intestine. This test is rarely and can be dangerous because the pressure required to inflate and coat the colon can lead to rupture of the colon.
  • Computerized tomography (CT) scan: A CT scan of the abdomen or pelvis may be performed if physician   suspects a complication from ulcerative colitis or     Crohn’s disease. A CT scan may also reveal how much of the colon is inflamed.
  • Stool sample: The presence of white blood cells in the stool indicates an inflammatory disease, possibly IBD. A stool sample is done to rule out other disorders, such as those caused by bacteria, viruses and parasites.
  • Magnetic resonance imaging (MRI): An MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. Most MRI machines are large, tube-shaped magnets. During the test, the patient lies on a movable table inside the MRI machine. This test is very helpful in diagnosing and managing Crohn’s disease. Its biggest advantage is that there is no radiation exposure. It’s particularly useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MRI enterography).
  • Capsule endoscopy: If there are symptoms that suggest Crohn’s disease but other diagnostic tests are negative, the physician   may perform capsule endoscopy. For this test patient needs to swallow a capsule that has a tiny camera in it. The camera takes pictures as it moves through the digestive tract, and the images are transmitted to a computer. The physician  can see the images, which are then displayed on a monitor and checked for signs of Crohn’s disease. Once  it has made the trip through the digestive system, the camera exits the body painlessly in stool.
  • Double-balloon endoscopy: For this test, a longer scope is used where standard endoscopes don’t reach. This technique is useful when capsule endoscopy shows abnormalities but the diagnosis is still not clear. It allows for biopsy of the abnormal area. It’s usually performed in specialized endoscopy centers.

Management

One should eat well balanced and healthy food.

Medications: Anti-inflammatory drugs like Sulfasalazine (Azulfidine) are used to control disease flares and were once acceptable can be used as a maintenance drug. They were used for several years in Crohn’s disease.

Surgeries: Like

  • Bowel resection
  • Stricture plasty
  • Temporary or permanent colostomy or ileostomy.

Note : This  information provided in the website of AIMU is only for  understanding the subject . If one has such symptoms/ condition, he/she should consult a doctor for diagnosis and treatment.

References:

www.cdc.gov
www.nhs.uk
www.uhs.nhs.uk
www.nlm.nih.gov

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