Inflammatory bowel disease (IBD)

If you frequently have digestive problems like pain, cramps and diarrhea, you may have inflammatory bowel disease (IBD). You’re not alone. IBD refers to a group of chronic conditions that cause the digestive tract to become inflamed, leading to pain and reduced quality of life.

The gastrointestinal tract (digestive tract) is made up of the mouth, esophagus, stomach, small intestine, large intestine and rectum.

Most common types of inflammatory bowel disease

The two most common types of inflammatory bowel disease are Crohn’s disease and ulcerative colitis.

Crohn’s disease is a form of IBD that affects the lining of the digestive tract and can spread to your bowel tissue. It can affect any part of the gastrointestinal tract from the mouth to the rectum, but it usually causes chronic inflammation in the last part of small intestine, the large intestine (colon) or in both.

Ulcerative colitis also causes chronic inflammation in the digestive tract, usually limited to the inner lining of the large intestine and rectum.

Inflammatory bowel disease symptoms

Symptoms of IBD may be mild or severe. They differ depending on where the condition occurs and how severe it is. IBD often occurs in a pattern where you have symptoms for a while and then have a period with no symptoms.

Symptoms of both Crohn’s disease and ulcerative colitis may include:

• Severe diarrhea, constipation
• Alternating constipation and diarrhea
• Abdominal pain and cramps
• Fever and fatigue
• Blood in stools (poop)
• Weight loss

When women have inflammatory bowel disease, they sometimes have more premenstrual symptoms or their IBD symptoms may be more severe during their periods. They are also at higher risk of iron-deficiency anemia due to blood loss and may have trouble getting pregnant.

Is IBD serious?

Inflammatory bowel disease is serious and can sometimes be life-threatening. Symptoms can spread to other parts of the body and complications may occur.

Other body systems that can be affected by IBD

• Skeleton – arthritis (most common)
• Skin conditions and mouth sores
• Eye inflammation
• Liver and kidney disorders
• Bone loss
• Delayed growth and puberty in teens and children

Joint, eye and skin symptoms often happen together.

Although IBD doesn’t cause depression or anxiety, people who have it are more likely to have anxiety and depression – particularly when they are having an episode of symptoms. Make sure to tell your doctor or counselor if you are having these mood disorders.

Complications of IBD

Dehydration and malnutrition may happen when diarrhea makes it harder to eat or harder for your body to absorb nutrients from food.

Inflammatory bowel disease can cause narrowing of the small intestine or large intestine. Sometimes this can lead to a bowel blockage because contents can’t make it through the narrowed part (stricture) easily. You may feel bloating and abdominal pain, and have decreased appetite, nausea and vomiting.

Fistulas are another possible complication of IBD (more common with Crohn’s disease). A fistula is an abnormal opening that can form between two parts of the body. For example, an abscess in a section of the intestines that touches the bladder can gradually cause openings in both organs. This can cause repeated bladder infections when bacteria from the intestines invade the bladder.

Differences between IBD and irritable bowel syndrome (IBS)

Although they share symptoms like diarrhea, abdominal pain and cramping, inflammatory bowel disease (IBD) is more serious than irritable bowel syndrome (IBS). IBD can cause destructive inflammation and permanent harm to the intestines and the effects can be seen on diagnostic imaging. Complications such as those listed above may require surgery to remove or repair the damaged parts of your body. And IBD increases your risk for colon cancer (particularly ulcerative colitis).

In contrast, irritable bowel syndrome is defined as a group of symptoms rather than as a disease. It rarely requires hospitalization or surgery and it doesn’t increase the risk for colon cancer or inflammatory bowel disease.

Inflammatory bowel disease causes

IBD usually begins between the ages of 15 and 35. We don’t know what causes it. Current research suggests these risk factors:

• Genetics
• Immune system problems
• Environment
• Gut microbiome (balance of bacteria, fungi, viruses and parasites in intestines)

Inflammatory bowel disease is more common among White people and people of Jewish descent, particularly Ashkenazi Jews.

Inflammatory bowel disease diagnosis

To diagnose IBD, your doctor may order tests such as:

• Blood tests
• Stool testing to find out if you have blood in your stool – and find any viral, bacterial or parasitic infections
• Sigmoidoscopy to examine the lower colon and rectum using a flexible tube with a tiny camera inserted into the anus
• Colonoscopy: Your provider uses a small, flexible tube to examine the entire length of the colon, looking for polyps or other abnormalities. Tissue samples can also be taken.
• Capsule endoscopy in which you swallow a capsule containing a tiny camera that takes pictures of your digestive tract
• MRI and CT scans
• Barium enema X-ray to show the rectum, colon and part of the intestine on X-rays using dye
• Double balloon endoscopy using a long tube with a tiny camera on the end inserted down the throat to see from the esophagus to the colon

To treat dehydration and malnutrition, you may receive nutrition through an IV or a feeding tube. This kind of feeding also lets your intestines rest and heal.

If medications don’t alleviate your symptoms or if you have some kinds of complications, your doctor may recommend surgery.

You don’t have to avoid all these foods. Chances are that some of them won’t cause problems for you. It helps to keep a record of what you’ve eaten and whether or not your symptoms get worse. That way you can know what works for you and what doesn’t.