Top 5 Questions about Inflammatory Bowel Disease (IBD) from patients

Inflammatory bowel disease (IBD) is a broader term used to describe two gastrointestinal inflammatory disorders including Crohn’s Disease and Ulcerative Colitis. Crohn’s disease can affect different parts of the digestive tract whereas ulcerative colitis affects only the colon and rectum.

Consultant General Surgeon (Colorectal Surgery), Dr. Sim Hsien Lin answers the top 5 most frequently asked questions about IBD from patients.

Q1: Is IBD a serious condition?

Inflammatory bowel disease (IBD) is a term used to describe chronic inflammatory conditions affecting the gastrointestinal tract. IBD may present with symptoms such as abdominal pain, diarrhoea, and blood in stool. This condition usually begins in adulthood, and follows an on-off course, which means symptoms may go into remission but can relapse again.

Based on the severity of disease, people with IBD can have mild, moderate or severe symptoms. IBD is a well-known risk factor for colon cancer, however not all patients with IBD develop colon cancer. Potential severe complications of ulceractive colitis include toxic megacolon, perforation and dehydration. As for Crohn’s disease, severe complications include obstruction, fistulation, malnutrition and perforation.

Q2: What causes IBD?

The exact cause of IBD is unknown. IBD is not caused by infections, nor is it caused by stress or diet. Some of the risk factors commonly associated with IBD are:

Immune response: IBD is considered to be an autoimmune disorder, which means your own immune system attacks the tissues in your gastrointestinal tract resulting in inflammation and injury of the intestine and colon.

Smoking: Studies have found that smokers are at a higher risk of developing Crohn’s disease.

Genetics: If you have someone with IBD in your family, there is a higher likelihood that you will develop IBD yourself.

Q3: What are the symptoms of IBD?

The symptoms and signs of IBD can vary from one person to another, but most patients with IBD present with:

• Episodes of diarrhoea
• Abdominal pain and cramps
• Bloating
• Rectal bleeding
• Weight loss
• Fatigue

Other general non-specific symptoms of IBD include anaemia, fever, and poor appetite. In the long term, IBD can affect your eyes, skin and joints. If you have ulcerative colitis, extraintestinal manifestations may also occur such as:

• Skin rashes (Erythema nodosum, Pyoderma gangrenosum)
• Inflammation of the uvea in the eye (Uveitis)
• Oral ulcers
• Joint pain (Arthritis, Spondylitis)

Q4: Do I need to take any precautions or modify my diet?

IBD symptoms can affect your day to day life. There are a few really important things that you need to consider if you have IBD.

Healthy lifestyle: A balanced diet, regular exercises and stress management are key to improving your overall well-being. If you are a smoker, quitting this habit can improve IBD symptoms and prevent further relapses, especially for Crohn’s disease.

Eating nutritious food: Probiotics found in yoghurt and other supplements have been proven to be beneficial for the gut and intestines. Your diet should be more focused on fruits, vegetables, and whole grains, and eat less fatty foods. Spicy and processed foods are also bad for your gut health and should be avoided.

Q5: Is there a cure for IBD? Do I need to undergo an operation for IBD?

There is no cure for IBD but it can be controlled to a certain extent. Surgery may be needed in severe cases. The main goal of IBD treatment is to prevent further relapses and complications, as well as to achieve remission.

Medications: Various groups of drugs are currently being used for the treatment of IBD.

Anti-inflammatory drugs can help reduce inflammation in the intestine and the colon.

Immuno-suppressants may also be beneficial as it can suppress your immune system and reduce flare-ups.

Biologics are a newer group of medicines that are highly effective in preventing further progression of the disease.

Surgery: If IBD is severe enough or does not respond to medical treatment, surgery may be needed. Surgery for IBD involves removing part of the intestine or complete removal of the colon.

Conclusion

Inflammatory bowel disease (IBD) is a life-long condition. As of yet, there is no cure for IBD, but several treatment options exist that can help control symptoms and prevent flare-ups. It is always best to consult a specialist if you have symptoms of IBD.