What is Inflammatory Bowel Disease (IBD)?

Types of IBD
There are two main types of IBD:

• Ulcerative colitis: This condition causes inflammation in the large intestine (colon), leading to bloody diarrhea.

• Crohn's disease: This condition can cause inflammation in the small and/or the large intestine, leading to diarrhea, weight loss, and anemia.

Both ulcerative colitis and Crohn's disease can involve severe diarrhea, abdominal pain, fatigue and weight loss.  IBD can be debilitating and sometimes leads to life-threatening complications if untreated.

Symptoms
Signs and symptoms that are common to both Crohn's disease and ulcerative colitis can include:

• Diarrhea

• Fever and fatigue

• Abdominal pain and cramping

• Blood in your stool

• Reduced appetite

• Unintended weight loss

Diagnosis
Your doctor may perform one or more of the following procedures to diagnose IBD:

• Colonoscopy. This exam allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis. Sometimes a tissue sample can help confirm a diagnosis.

• Flexible sigmoidoscopy. Your doctor uses a slender, flexible, lighted tube to examine the rectum and sigmoid, the last portion of your colon. If your colon is severely inflamed, your doctor may perform this test instead of a full colonoscopy.

• Upper endoscopy. In this procedure, your doctor uses a slender, flexible, lighted tube to examine the esophagus, stomach and first part of the small intestine (duodenum). While it is rare for these areas to be involved with Crohn's disease, this test may be recommended if you are having nausea and vomiting, difficulty eating or upper abdominal pain.

• Capsule endoscopy. This test is sometimes used to help diagnose Crohn's disease involving your small intestine. You swallow a capsule that has a camera in it. The images are transmitted to a recorder you wear on your belt, after which the capsule exits your body painlessly in your stool. You may still need an endoscopy with a biopsy to confirm a diagnosis of Crohn's disease.

Treatment
The goal of inflammatory bowel disease treatment is to reduce the inflammation that triggers your signs and symptoms. The goal is to achieve not only to symptom relief, but also long-term remission and reduced risk of complications related to untreated IBD. IBD treatment usually involves either life-long medications or surgery. Your doctor will work with you to decide which treatment options are best for you.

Medications
Your doctor will often start you on a short-term steroid medication such as prednisone or budesonide to quickly shut down the inflammation in your intestine. People often start to feel better within days of starting these medications. You will then work with your doctor to decide which long-term medication is best for you. These may include anti-inflammatory drugs such as mesalamine (Asacol HD, Delzicol, Lialda, and others) or a stronger immune suppressant such as azathioprine, mercaptopurine, or methotrexate. In some cases, your doctor may recommend that you start an injection or IV immune suppressing medication. These may include adalimumab (Humira), infliximab (Remicade), vedolizumab (Entyvio), ustekinumab (Stelara), and others. For more information, you can read about these medications through the Crohn’s and Colitis Foundation.

Surgery
For some cases, surgery (removal of the colon or part of the small intestine) may be the best treatment option. This is often when people have not had a good response to multiple medications or for people with Ulcerative Colitis who do not want to be on life-long medication. Your doctor will discuss surgical options with you as well.

If you are concerned you have IBD, call your doctor.  You can also call us at 978-459-6737 to request an appointment.