Monday, June 24, 2013

What Is Inflammatory Bowel Disease? Symptoms, Diagnosis and Treatment


Inflammatory bowel disease (IBD) refers to conditions wherein the intestines, either the small or large intestines, become red and swollen. Symptoms of IBD include acute or persistent abdominal pain, diarrhea with or without bleeding, sudden weight loss, rectal bleeding, skin problems, fever, and pain in the joints. The two most common forms of IBD are ulcerative colitis and Crohn's disease.

Ulcerative colitis affects the lining of the large intestines exposed to the stool. It is characterized by swelling and tiny open sores on this intestinal lining. If the ulcers worsen, they can lead to the formation of holes on the intestinal wall, which would lead to the leaking of the contents of the large intestine into the abdominal cavity or the blood. This would result to severe infection needing immediate surgery.

On the other hand, Crohn's disease usually affects the last and first parts of the small intestine, although it can appear anywhere on the digestive tract. The swollen portions appear in patches, interspersed among normal tissues. The swelling and the scar tissue produced by the swelling leads to a thickening of the intestinal wall, which then, results in the narrowing of the passageway for the food to be digested. Sometimes ulcers also form, just as in ulcerative colitis, and lead to holes in the intestinal wall.

The exact cause of IBD is not known. Scientists theorize that it may be caused by an overreaction of the immune system to the bacteria in the digestive tract. They have also seen significant genetic correlations among IBC cases.
While certain foods and stress appear to make the symptoms of IBD worse, there is no evidence that these are causative factors.

Complications from IBD can include anemia, arthritis, weak bones, eye problems, inflammation of the liver, skin ulcers, kidney stones, and among children, stunted growth and delayed puberty. These are largely due to the impaired functioning of the intestines in absorbing nutrients from ingested food. Arthritic pain is related to inflammation outside of the digestive tract.

Diagnosis of IBD is performed through varied tests. A blood test is used to determine incidence of anemia and inflammation. Stool samples are analyzed for the presence of blood and indications of infection. Both colonoscopy and sigmoidoscopy may be conducted. The former allows the inspection of the lining of the whole large intestine up to the end portions of the small intestines, while the latter focuses on just the lower part of the large intestine.

A physician might also call for x-rays with barium. Barium is taken as a drink or as an enema. It coats the lining of the digestive tract, making it visible on the x-ray film. Another imaging technology used is computerized tomography scan, or CT scan.

Treatment of IBD usually focuses on the management of its symptoms through medications. The drugs used for controlling inflammation include aminosalicylates, corticosteroids and immunomodulators. Antibiotics are usually prescribed to patients with Crohn's disease, but not to those with ulcerative colitis. If the symptoms do not respond to medications, then surgery may be performed to mend or remove damaged portions of the intestine.

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