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Inflammatory Bowel Disease by Diana Kohnle

Definition

Inflammatory bowel disease (IBD) is the term used for a group of diseases and disorders that affect the intestinal tract. IBD causes the intestines to become inflamed and irritated. IBD is a lifelong illness that can be difficult to control.

IBD affects about 600,000 Americans every year. The two forms of of IBD are Crohn's disease and ulcerative colitis .

There is no cure for IBD. But, treatments can help control symptoms. While patients may temporarily recover and not experience any symptoms, recurring flare-ups are common.

Crohn's Disease

Causes

The exact causes of IBD are unknown, but some hypotheses include:

Heredity (having another family member with IBD)
Reaction to a virus or bacteria that damages the colon and rectum
Compromised immune system or infection that affects the immune system

IBD is not a contagious infection. It cannot be passed from person to person.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing IBD:

Having a family member with IBD
Being Caucasian or of northern European ancestry
Being of Jewish ancestry (increases the risk of certain types of IBD)
Having problems with the immune system

Symptoms

Symptoms depend on the type of IBD, but common symptoms may include:

Abdominal pain and cramping
Diarrhea
Weight loss and loss of appetite
Bleeding from the intestines
Ulcers in the intestines
Inflammation of the rectum
Draining around the rectum
Bloating or feeling of fullness
Gas
Bloody diarrhea
Abdominal sounds (eg, gurgling)
Nausea and vomiting
Joint pain

Diagnosis

Your doctor will ask about your symptoms and medical history, and do a physical exam. Tests may include:

Upper GI endoscopy —a thin, lighted tube inserted down the throat to examine the upper part of the intestines
Colonoscopy —a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon
Barium enema —injection of fluid into the rectum that makes your colon show up on an x-ray so the doctor can see abnormal spots in your colon
X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones
Capsule endoscopy —a wireless pill-sized camera that you swallow; the camera takes pictures of the small intestine as it passes through your intestines
Blood tests
Stool culture

Colonoscopy

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Lifestyle Changes

Eating a healthy diet that is low in fat and rich in fruits and vegetables can control IBD symptoms. Reducing fiber and dairy products in the diet is also recommended.

Reducing stress and getting plenty of rest can also reduce symptoms and flare-ups.

Medications

Most medicines for IBD focus on reducing the inflammation that causes symptoms. Medicines include:

Anti-inflammatory drugs
Corticosteroids
Immune system suppressors
Antibiotics to kill germs in the intestinal tract
Anti-diarrhea medicine
Laxatives
Pain relievers

Surgery

While surgery is not helpful for all types of IBD, surgery to remove the colon is an option for patients who suffer from very severe ulcerative colitis.

Prevention

Because IBD is often inherited, there are no known measures that can prevent getting the disease. To prevent flare-ups, it is important to maintain a healthy diet and reduce stress.

RESOURCES:

American Academy of Family Physicians http://www.aafp.org/
National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/index.htm

CANADIAN RESOURCES:

Canadian Family Physician http://www.cfpc.ca/cfp/
Health Canada http://www.hc-sc.gc.ca/

References:

American Gastroenterological Association website. Available at: http://www.gastro.org/wmspage.cfm?parm1=851 . Accessed June 25, 2007.
Botoman VA, Bonner GF, Botoman DA. Management of inflammatory bowel disease. American Family Physician website. Available at: http://www.aafp.org/afp/980101ap/botoman.html . Published 1998. Accessed June 27, 2007.
Brandt LJ, Steiner-Grossman P, eds. Treating IBD: A Patient’s Guide to the Medical and Surgical Management of Inflammatory Bowel Disease . New York, NY: Raven Press; 1989.
Carson-DeWitt R. Ulcerative colitis. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated September 30, 2009. Accessed December 2, 2009.
Crohn's disease. US National Library of Medicine, Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000249.htm . Accessed June 27, 2007.
Inflammatory bowel disease. American Academy of Family Physicians website. Available at: http://familydoctor.org/online/famdocen/home/common/digestive/disorders/252.html . Accessed June 27, 2007.
Irritable bowel syndrome (IBS). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed June 25, 2007.
Steiner-Grossman P, Banks PA, Present DH, eds. The New People Not Patients: A Source Book for Living With IBD . Dubuque, IA: Kendall/Hunt Publishing Company; 1992.
Ulcerative colitis. US National Library of Medicine, Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000250.htm . Accessed June 27, 2007.

Last reviewed November 2009 by Daus Mahnke, MD

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