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Inflammatory bowel disease

What is inflammatory bowel disease?

Inflammatory bowel disease, or IBD, is a term for autoimmune diseases that cause inflammation of the bowel and digestive system.

IBD usually refers to Crohn's disease and ulcerative colitis, although the term also includes less common conditions, such as collagenous colitis and lymphocytic colitis.

 

Ulcerative colitis and Crohn's disease compared

  • Ulcerative colitis affects only the large intestine.
  • Crohn's disease can occur anywhere along the digestive tract, from the mouth to the anus, although it is most commonly found in the small intestine (particularly the end of the small intestine) and the colon.
  • Ulcerative colitis occurs generally in the superficial layers of the bowel wall, causing a uniform inflammation throughout the bowel.
  • Crohn's disease occurs deeper within the bowel wall, causing patchy or irregular inflammation. Because the inflammation affects the entire bowel wall, Crohn's disease can cause abscesses and fistulae (abnormal connections between the bowel and other organs, most usually other areas of bowel).

 

Symptoms of inflammatory bowel disease

In both ulcerative colitis and Crohn's disease, symptoms tend to come and go. Patients experience flare-ups, which can often be severe, followed by long periods of months or even years of no symptoms at all. Flare-ups cause cramping and abdominal pain, as well as altered bowel habits with bloody stools and diarrhoea.

Patients can also experience fatigue, weight loss, anaemia, raised temperature and a constant sensation of needing to empty the bowels. Additional symptoms of Crohn's disease include nausea or vomiting. Inflammatory bowel disease can also be associated with arthritic joint pains, back pain, eye irritation and painful swollen skin, particularly on the legs.

During a severe flare-up, you may need to be admitted to hospital to have your condition monitored and intravenous medications administered. If the inflammation becomes severe, it can cause blockages, or strictures, in the gut, as well as perforations and other life-threatening conditions.

 

How is inflammatory bowel disease diagnosed?

Inflammatory bowel disease is diagnosed by analysing your blood and your stools for evidence of the disease. This is then followed by more detailed investigations including colonoscopy (with biopsy) and CT and MRI scans of the bowel.

 

Inflammatory bowel disease: management at The Physicians' Clinic

The gastroenterologists within the team at The Physicians' Clinic have an international reputation for the management for all types of inflammatory bowel disease. We have imaging facilities on-site and our gastroenterologists perform colonoscopies and other diagnostic procedures at state-of-the-art endoscopy units in nearby private hospitals.

There is no cure for either ulcerative colitis or Crohn's disease, and treatment is focused on symptom management and maintaining remission. Mild cases of ulcerative colitis will often clear up on their own without the need for medical intervention.

Medical treatments for inflammatory bowel disease

  • Anti-inflammatory drugs such as aminosalicylates or corticosteroids. These are taken as tablets, enemas or suppositories depending on the site of the disease.
  • Immunosuppressants such as azathioprine or mercaptopurine, taken as tablets.
  • Biologics such as infliximab and adalimumab. These are antibodies that act against inflammatory components in the blood and reduce bowel inflammation.

Surgery for inflammatory bowel disease

Around one in five patients with ulcerative colitis and as many as three-quarters of patients with Crohn's disease require surgery at some point in their lives. This is usually because their condition does not respond to drug therapies.

  • Surgery for ulcerative colitis can solve the problem completely by removing the colon. Waste from the digestive system is then passed either via a stoma on the surface of the abdomen, or via a pouch created within the body.
  • Surgery for Crohn's disease does not solve the problem permanently but can provide significant relief by removing the affected section of the bowel. In this procedure, the functional end of the digestive tract is brought to the surface, where a temporary stoma is formed, allowing the surrounding inflammation to recover. This procedure can usually be reversed and the remaining sections of the gut reattached.
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