Inflammatory bowel disease is a condition involving autoimmune reaction against the gastrointestinal tract, which subsequently damages the normal intestines. Inflammatory bowel disease involves two diseases: Crohn’s disease and ulcerative colitis causing symptoms like diarrhea, stomach cramps and flatulence. With the right treatment from Best Gastroenterologist in Karachi the condition can be put into remission and the flares can be treated. Read on to know more about inflammatory bowel disease:

What is inflammatory bowel disease?

Inflammatory bowel disease or IBD is a condition of chronic pain and swelling of the intestines due to persistent autoimmune reaction. IBD involves two types of diseases:

• Ulcerative colitis: in this type of disease, there are sores and ulcers along the large intestine and rectum. As evident from the name, ulcerative colitis is found mainly in the large intestine or colon, sparing the small intestine.  
• Crohn’s disease: this is the type of inflammatory bowel disease in which any part of the digestive tract can be involved, particularly the deeper layers. The flares of Crohn’s disease mostly occur in the small intestine, less often in the large intestine and rarely the upper gastrointestinal tract.

The symptoms of inflammatory bowel disease can be variable for different individuals depending on the severity of the illness. In some individuals the disease can be debilitating, while for others there can be mild discomfort only.

What are the causes of inflammatory bowel disease?

The exact cause of inflammatory bowel disease is not understood but the following factors may play a role in the cause:

• Genetics: in most patients with inflammatory bowel disease, there is positive family history of disease. This is likely due to the genetic involvement in the pathogenesis of disease.
• Environment: environmental factors play an important role in the pathogenesis of IBD. External exposure to triggers like smoking, stress, depression and even certain medication can induce autoimmunity and disease development.
• Autoimmunity: the immune system of the body is responsible for fighting diseases and infections. In people with autoimmunity, the defense mechanism of the body fights the body’s own cells and makes antibodies to fight them. This causes destruction of the body’s own cells and symptoms of IBD.

What are the symptoms of inflammatory bowel disease?

The symptoms of inflammatory bowel disease are:

• Diarrhea
• Blood and mucus in the stool
• Abdominal pain
• Cramps in the abdomen
• Fatigue
• Unintended weight loss
• Reduced appetite

Additional symptoms may include:

• Itchy, red eyes
• Fatigue
• Fever
• Vision problems
• Nausea and vomiting
• Joint pain
• Rashes and sores on the skin

How is inflammatory bowel disease diagnosed?

The diagnosis of inflammatory bowel disease involves the following investigations:

• Complete blood count (CBC): the blood picture may reveal low red blood cell count and high leukocyte count.  
• Colonoscopy: an endoscope is inserted in the colon through the anus to look at the walls of the colon and take biopsy sample.
• Sigmoidoscopy: to examine the inside of the rectum.
• Imaging studies: such as CT and MRI scans to look for presence or extent of abscess.
• Upper GI endoscopy: to examine the upper gastrointestinal tract.

What are the complications of inflammatory bowel disease?

The complications of inflammatory bowel disease include:

• Increased risk of developing colorectal cancer.
• Anal fistula is common in people with chronic inflammatory bowel disease. In an anal fistula a tunnel forms under the skin, connecting the anus with the anal gland.
• Liver disease
• Decrease in red blood cells or anemia
• Kidney stones are common in such patients
• Osteoporosis due to decreased calcium absorption
• Perforated bowel is a complication seen due to thinning of the bowel wall. A perforated bowel is a medical emergency and can cause peritonitis and sepsis.
• Strictures can form anywhere in the gastrointestinal tract but commonly in the large bowel.
• Toxic megacolon or severe swelling of the intestine.

What are the treatment options?

The treatment options for inflammatory bowel disease include:

• Anti-inflammatory aminosalicylates: these drugs decrease inflammation and minimize the irritation to the intestines.
• Antibiotics: help to treat any abscesses and superadded infection.
• Immunomodulators: help to mitigate the immune response.
• Biologics: combat inflammatory response of the body
• Corticosteroids: such as prednisolone manage acute flares.
• Probiotics: are prescribed by experts such as Assist. Prof. Dr. Fahmina Ashfaq for better gut health.