Inflammatory Bowel Disease refers to a group of diseases characterized by swollen or inflamed intestines or colon. This is due to an immune reaction of the body against its own tissues. Some symptoms of the disease include abdominal cramps, fever and bloody diarrhea. The main goal for treatment is to reduce inflammation caused by abnormal autoimmune reactions of the body.

Types:

Inflammatory Bowel disease affects around one million Americans yearly; it is one of a hundred or more autoimmune diseases. The two most common manifestations are Crohn’s Disease and Ulcerative Collitis.

Lesser forms include:

• Collagenous colitis
• Lymphocytic colitis
• Ischaemic colitis
• Diversion colitis
• Behcet’s syndrome
• Infective colitis
• Indeterminate colitis

Inflammatory Bowel Disease Causes:

The disease is idiopathic or the real cause is unknown. The inflammation is due to an auto-immune response of the body to its own tissues. It is believed that an abnormality in the immune system causes its inability to recognize normal cells and attack it. The disease progresses when bacteria and gastric contents pass through damaged tissues and enters the body’s bloodstream. The digestive system especially the small intestines are highly vascularized meaning it is very well connected to the bloodstream. Absorption of nutrients is usually done through the small intestine and received through the blood stream. Tissue damage can easily spread infections to the body through the bloodstream.

Cases of Inflammatory Disease are high in patients whose family has a history of the disease. It’s still not considered a major factor since the percentage of developing the disease is minimal. It is believed that genes may play a factor but this is in conjunction with other factors.

Persons of Northern European and Jewish descent have higher incidents of the disease. Cases of IBD in people of Jewish descent grow with Ashkenazi Jews (European descent).

Recent studies identified that certain genes present may enhance an individuals chances of getting the disease. In researches the first gene associated with Crohn’s disease was identified. The NOD2 gene is suspected as one of the factors responsible for the development of the disease.

Inflammatory Bowel Disease Symptoms:

Patients suffering from Chronic (persist for a long periods) IBD may experience periods of remissions and attacks. Symptoms range from mild to severe. Severity depends on the area affected by the disease. Inflammatory Bowel Diseases interferes with normal function of the intestines.

• Chronic diarrhea
• Abdominal cramps and pain
• Fever
• Blood and mucus in the stool
• Abnormal weight loss
• Loss of appetite
• Nausea and Vomiting
• Inflammation (results due to infections released to the bloodstream)

Inflammatory Bowel Disease Diagnostic Tests:

Differential diagnosis

Signs and symptoms for Inflammatory Bowel Disease are similar to other medical conditions. Elimination of other possible diseases is done to increase the possibility of the person suffering from IBD.

Laboratory Studies

Clinical studies of blood and stool testing determine if there is an infection and to identify the causative agent of infection

• CBC (Complete Blood Count)
• ESR (Erythrocyte Sedimentation Rate)
• Serum Chemistry
• Stool Exam
• Blood Culture

Imaging Studies

Doctors perform a series of procedures to view your intestines for inflammation or bleeding.

• X-ray
• Sigmoidoscopy or Colonoscopy

Management and Treatment of Inflammatory Bowel Disease :

Diet

Management of patients suffering form IBD includes eating a healthy diet. Inadequate absorption of nutrients is common because the disease affects the small intestines. Eating a low residue diet and restricting or minimizing foods rich in fiber is also advised. Fats are also avoided to control instances of diarrhea.

Pharmacologic

Drugs are prescribed to control or suppress the body’s immune system. Because IBD is an autoimmune disease these drugs are used to reduce the body’s natural defense system from attacking normal tissue. Antibiotics are also used to treat infections brought about by IBD. Medications which reduce peristalsis or movements in the digestive tract are also used to control diarrhea.

Surgery

Advanced stages of IBD may require surgery as drug interventions alone can not treat the disease.

Crohn’s Disease

Surgery does not cure Crohn’s Disease. Inflammation may transfer to another part of the intestines or may develop near the affected area. If a blockage or fistula (abnormal connection between organs) develops surgery is indicated.

Ulcerative Colitis

Removing the entire colon area, rectum and anus eliminates the possibility of developing colon cancer. Surgery is indicated when drugs or medications have failed to arrest the progress of the disease. People suffering from chronic symptoms of  Ulcerative Colitis are also candidates for surgery.

Prevention:

Inflammatory Bowel Diseases are idiopathic diseases. There are no known causes for IBD, diet or lifestyle changes may not affect the possibility of a person acquiring the disease. Diet and lifestyle changes are done to manage or treat symptoms of persons suffering from IBD.

Inflammatory Bowel Disease affects millions of Americans today. Visiting your doctor for a daily checkup helps in detecting diseases at their early stages. Preventing and detecting diseases at their early stages is the best way of treating an illness. Signs and symptoms of IBD like diarrhea, loss of appetite and weight loss are often neglected as everyday occurrences. Crohn’s disease and Ulcerative Colitis are only noted when a patient has been suffering from chronic symptoms of IBD. Education and yearly visits helps in early detection and gives you the best chance of coping with Inflammatory Bowel Diseases.

Written by,

Ronald Uy, RN

© 2009  Hemorrhoid Information Center

Sources:

Inflammatory Bowel Disease. Retrieved Aug 28, 2009 from emedicine: http://medgenmed.medscape.com

Digestive Diseases: Causes of Inflammatory Bowel Disease: Retrieved Aug 28, 2009 from MedicineNet.com: http://www.medicinenet.com/script/main/art.asp?articlekey=41964

Inflammatory bowel disease. Retrieved Aug 28, 2009 from Wikepedia: http://en.wikipedia.org

Inflammatory Bowel Disease. Retrieved Aug 28, 2009 from UCSF Children’s Hospital: http://www.ucsfhealth.org

Surgical Procedures for Inflammatory Bowel Disease. Retrieved Aug 29, 2009 from Beth Israel Deaconess Medical Center:  http://www.bidmc.org

Ulcerative Colitis is a condition in which the lining of the colon develop ulcers, or sores, which in turn generate rectal inflammation and a variety of painful symptoms.  The condition is one of what are known as inflammatory bowel diseases, or IBSs, and is typically caused when swelling in the rectal area has become severe enough to have destroyed the cells that line the walls of the colon, eventually producing bleeding, prolonged diarrhea, or the presence of pus or blood in the diarrhea or the stool.

Ulcerative Colitis typically manifests in individuals who range in age from their mid-teens to their early thirties.  In less frequent cases, it can also manifest in people who are in their fifties, in their sixties, and even in their seventies.  It does not seem to favor men over women and is thought to be hereditary, passing from one generation to the next.  As noted, the most common symptoms of Ulcerative Colitis are abdominal pain or diarrhea in which blood or pus is evident.  However, in addition to these universal symptoms, other symptoms can include fatigue and anemia, rectal bleeding, abrasions on the skin, soreness in the joints, as well as both appetite loss and weight loss.  Approximately fifty percent of individuals diagnosed with Ulcerative Colitis report relatively mild symptoms, while the other fifty percent experience more severe symptoms, including severe abdominal cramping, nausea and fevers.  Although there is no conclusive data yet to support the hypothesis, these more severe symptoms are thought to be the result of immunological failure in the patient.

Ulcerative Colitis’s exact cause or causes as yet remains obscure, although researchers conclusively assert that, unlike Irritable Bowel Syndrome, it is not typically excited by, or the result of, certain dietary habits, foods, spices, or poor stress management.  There are several theories proposed why the condition occurs, one of which is outstanding peculiarities in the immune system, which involves the body responding in an abnormal fashion to the bacteria commonly found in the intestines that is responsible for breaking down foods for digestion.  This is supported by the apparent correlation between immunological abnormalities and the presence of the disease.  Another theory, complimentary to the first, is heredity; the fact that the condition appears to run in families, therefore indicating genetic predisposition as a causal factor. Ulcerative Colitis is diagnosed through a series of tests, which seek confirmation of conditions that in turn indicate the presence of the disorder.  For example, one’s physician will test for anemia, which, if present, might indicate that bleeding in the rectum is occurring.  In the event anemia is present, tests will then be performed to determine the exact state of one’s anemic condition, specifically testing for an elevated white blood cell count, which indicates the presence of an infection in the body or the presence of inflammation.  Stool samples might also be collected, which can reveal if bleeding is present in the colon as well as allow for one’s physician to rule out the presence of bacterial infection, or the presence of parasites.

Ulcerative Colitis is detected with the greatest accuracy if one undergoes either a colonoscopy or what is known as a sigmoidoscopy, both of which involve the doctor inserting a tool called an endoscope (a long camera that is attached to a monitoring device) into the anus, which then reveals if bleeding, inflammation, or sores on the walls of the anal canal are present.  If necessary, material from the anus in the form of tissue might be collected and later biopsied to ensure that colon cancer is not developing.

Ulcerative Colitis affects people differently, depending on a variety of considerations, including one’s individual health and their particular hereditary factors.  Because no two cases are identical, no two treatments can be exactly alike.  However, because there are also consistent similarities both causally and symptomatically, treatments follow fairly standard procedures.  Drug treatments are often prescribed to address the attendant symptoms mentioned previously, and in rarer cases that are more severe, surgery might be recommended.  The three drugs that are commonly prescribed to help alleviate symptoms are 1) Aminosalicylates, 2) Corticosteroids, and 3) Immunomodulators.  If one does not respond to drug therapy, or if the side-effects produced by the medications become intolerable or further compromise one’s health, surgery or hospitalization may be advised.  For example, in the event one experiences heavy bleeding or chronic diarrhea that is severe enough to generate dehydration, it might become necessary to be hospitalized, during which time doctors will replenish bodily fluids, or, if necessary, recommend a procedure to counter the loss of blood.

Ulcerative Colitis is one of the most common IBSs diagnosed today in the United States, and because of this, there is substantial information and a variety of Colitis treatment options available.  Current research focuses on the various factors that operate on the immune system, in what ways the immune system is either compromised or activated, the ways in which the disorder impacts the colon, and which treatments best foster rectal healing.  It is imperative one remains informed to make the most effective and comprehensive decision possible, which will enable them to successfully treat and prevent a worsening or continuation of Ulcerative Colitis.

David Gilbert received his BA from U.C.L.A. He is currently doing graduate work in psychology at California Graduate Institute, in Los Angeles, CA. Throughout his career in the mental health field he has worked clinically with several populations, and also contributed to academic works whose topics address both health and mental health issues.

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