Inflammatory Bowel Disease (IBD)

The two main types of IBD are Crohn’s disease and ulcerative colitis. Both are inflammatory bowel diseases, but they affect people differently.

Crohn’s disease

Crohn’s disease can occur anywhere in the gastrointestinal (GI) tract, from the mouth to the anus. It’s commonly found in the end of the small bowel (ileum) and the beginning of the colon. Crohn’s disease can damage the entire bowel wall, and the inflammation is usually patchy (some sections of the bowel are spared). Crohn’s disease can cause scarring and narrowing in the GI tract. In some cases, it leads to tunnels forming between the bowels and skin or other organs.

Ulcerative colitis

Ulcerative colitis occurs only in the large intestine (colon). The disease affects only the innermost lining of the colon. With ulcerative colitis, inflammation is usually continuous with no gaps of healthy tissue.

What are the symptoms of IBD?

IBD can cause a variety of symptoms that range from mild to severe. Symptoms of IBD may include:

• Abdominal pain and cramps
• Bloody stool (rectal bleeding)
• Bowel urgency
• Constipation
• Diarrhea (sometimes 10-20 times per day)
• Fatigue
• Fever
• Malnutrition
• Weight loss

IBD is sometimes confused with irritable bowel syndrome (IBS). While IBS has similar symptoms, they are not the same.

While the exact cause is unknown, experts believe several factors may be linked to IBD. Risk factors for developing inflammatory bowel disease include the following.

Diet

A diet high in processed food, fat and animal protein can increase the risk of developing IBD.

Family history

IBD may run in families; having a family member with the disease increases your risk.

Overactive immune response

IBD may begin as a response to viruses or bacteria, but the immune system never shuts off, causing chronic inflammation.

Age

IBD can occur at any age, but many people are diagnosed at age 30 or younger and age 60+.

Geographic area

IBD is more prevalent in developed countries, urban areas and northern climates.

Lifestyle

Smoking, poor diet, lack of exercise and use of certain medications can also raise your risk.

Early diagnosis and treatment are critical to minimizing the long-term complications of IBD. No single test can diagnose the disease. A physical exam and several tests are used to diagnose IBD. Tests may include:

• Blood tests to check for anemia (low blood counts), the severity of inflammation, and iron and vitamin levels
• Colonoscopy to examine the colon (the lower portion of your large intestine)
• Endoscopy to check the GI tract from the mouth to the first section of the small intestine
• Biopsy to collect a small piece of tissue from the inside of the intestine for further testing
• Imaging tests such as CT scans, MRIs and video capsule enteroscopy to examine areas that can’t be easily seen by endoscopy or colonoscopy

Mercy gastroenterologists offer treatments to help reduce inflammation, relieve IBD symptoms and minimize bowel damage. While there’s no cure for IBD, several effective treatment options are available.

IBD Medications

Medications used to treat IBD include:

• Antibiotics may be used to treat infections in the bowel that can complicate IBD
• Anti-inflammatory drugs may be used to reduce inflammation
• Biologics may be used to neutralize proteins that cause inflammation
• Immunomodulator drugs may be used to calm the overactive immune response that leads to the inflammation
• Janus kinase (JAK) inhibitors may be used to block signals from cytokines (proteins that promote inflammation)

Medical Nutrition Therapy

Mercy dietitians can assess the nutritional status of people with IBD and recommend dietary or lifestyle changes to improve their symptoms. A food diary can be used to identify foods that trigger IBD symptoms.

Total Parenteral Nutrition (TPN)

TPN is liquid nutrition delivered through a catheter that’s inserted into a vein. The nutrients go directly into the blood instead of the digestive tract. It may be needed if the digestive system isn’t functioning or needs complete rest.

IBD Pain Management

It’s common for people with IBD to have abdominal pain. Mercy gastroenterologists offer pain management options. Non-steroidal anti-inflammatory drugs like ibuprofen can worsen IBD symptoms. Acetaminophen (Tylenol) may be recommended. Sometimes medications are used to treat spasms and slow down the GI tract transit (the time it takes for food to leave your stomach and pass through the intestines). Opiates sometimes treat severe pain in the short term, but they’re used cautiously to avoid dependence or addiction.

IBD Surgery

Surgery may be required if medication and nutritional support aren’t effectively controlling IBD – or if complications like bowel obstruction or severe bleeding occur. Mercy offers a variety of IBD surgery options, including minimally invasive procedures to repair or remove damaged areas of the GI tract.