The term Inflammatory Bowel Disease (IBD) is a global concept that refers to diseases involving chronic inflammation of the intestine, of which Crohn’s Disease and Ulcerative Colitis are the two most important forms.
According to specialists, in Crohn’s disease, the inflammation can affect any part of the digestive tract, from the mouth to the anus, and the entire wall of the digestive tract becomes inflamed in a discontinuous manner. However, the area most frequently affected is the final part of the small intestine (ileum) and the large intestine (colon). Ulcerative Colitis, on the other hand, is characterized by inflammation with ulcers of the mucosa that affect only the large intestine (colon), either a part of it or all of it, not normally affecting the rest of the bowel wall as in Crohn’s disease.
Causes of Inflammatory Bowel Disease (IBD)
The cause of IBD is unknown, however, it is recognized that it is an immune-mediated disease, that is, where the patient’s defenses (immune system) act abnormally against the mucosa of his or her own intestine. Possibly, although not fully demonstrated, this abnormal immune response is precipitated by a mixture of genetic factors not well known and environmental factors (tobacco, drugs such as antibiotics, contraceptives, anti-inflammatory drugs, etc.).
Symptoms of inflammatory bowel disease (IBD)
The symptoms, although similar, are usually different in Crohn’s disease and Ulcerative Colitis and have in common the appearance in outbreaks with variable periods without symptoms.
Crohn’s disease, as it can affect different sections of the digestive tract and affect with greater or lesser severity, has very variable and heterogeneous symptoms. However, the most frequent symptoms are abdominal pain, diarrhea with or without blood, fever and weight loss. In patients with involvement of the final part of the colon and rectum, perianal fistulas (tracts between the rectum and the skin surrounding the anus) may appear.
Ulcerative colitis, when affecting the colon, usually produces bloody diarrhea and abdominal pain. In patients who only have ulcers in the final part of the colon (rectum), the most frequent symptom is the presence of blood with stools of normal consistency.
In both diseases there may be extraintestinal symptoms (outside the intestine) such as joint pain, red skin lesions, eye inflammation (uveitis), etcetera.
Treatment for Inflammatory Bowel Disease (IBD)
Although the drugs used in both diseases are similar, each disease is treated in a different way, depending on the severity of the symptoms, the location, the previous response to treatment and other factors that determine in most cases a personalization of the treatment. In both diseases corticosteroids, aminosalicylates (drugs that decrease inflammation of the colon), and immunosuppressants (decrease the response of the immune defenses that attack the intestine) can be used.
In recent years, drugs called biologics have been used to fight against molecules that inflame the intestine, such as TNF alpha (a molecule that produces inflammation), which is increased in IBD patients. These drugs are called anti-TNF antibodies. In some IBD patients, when medical treatment fails or complications appear, surgery may be necessary.
Prevention of Inflammatory Bowel Disease (IBD)
The onset of IBD, either Ulcerative Colitis or Crohn’s Disease cannot be prevented, since the genetic factors and the combination of these with environmental factors, which cause the disease to start in a particular person, are not precisely known. It is possible to prevent or reduce the appearance of outbreaks of the disease by following the treatment and the hygienic and dietary measures advised by the digestive system specialist.
Recommended diet for patients with Inflammatory Bowel Disease (IBD)
In general, IBD patients should follow a complete diet adapted to the time of their disease. In general, the intake of milk or any other type of food is not restricted during symptom-free periods. Patients with IBD should strictly not smoke, especially patients with Crohn’s disease. Physical exercise is beneficial in general, but especially for these patients.
It is advisable to consult the website of the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (geteccu.org), an association of medical experts with special interest in the analysis and treatment of IBD. In this page there is a section for patients with complete information about IBD.