Inflammatory bowel disease is really two chronic disorders, Crohn's disease and ulcerative colitis, both of which are caused by intestinal inflammation. About 10 in every 100,000 people in the United States have IBD, according to Dr. Jean-Paul Achkar of the Cleveland Clinic. IBD is characterized by remissions and relapses of varying intensity. Ulcerative colitis affects only the colon, while Crohn's disease can strike anywhere along the length of the gastrointestinal tract. But it tends to have a preference for the lowest part of the small intestine, the terminal ileum.
Cause
The exact cause of IBD is unknown, although some have linked it to genetics, environmental toxins, infections and autoimmune disorders. Current thinking is that one is genetically predisposed to IBD, and it is triggered by a toxin or infectious microorganism, according to the American College of Gastroenterology.
Symptoms
The most common symptoms during a flare-up include abdominal pain, bloody diarrhea, nausea and vomiting, frequent bowel movements, weight loss and rectal bleeding. IBD can affect other parts of the body in the form of arthritis, inflammation of the retina or cornea and osteoporosis. These symptoms are more common in children who may not experience abdominal pain or diarrhea, according to the Crohn's and Colitis Foundation of American.
Diagnosis
A physician seeing someone with these symptoms does a medical history and full examination. Because of the nutritional problems associated with IBD, blood tests usually show low albumin, iron-deficiency anemia and a high level of white blood cells indicating inflammation. To make a definitive diagnosis, an endoscopy, a tissue biopsy and a bowel X-ray are recommended.
Nutritional Concerns
In ulcerative colitis, only the large intestine is involved, so foods usually get absorbed normally. For as many as 80 percent of those with Crohn's disease, the small intestine, where most digestion and absorption takes place, is involved, according to a report in the May 2003 issue of Practical Gastroenterology. Therefore, nutritional problems are a major concern in Crohn's disease. These include fat and vitamin malabsorption. Iron deficiency is a common problem because of blood loss. Adding to the problem, someone with Crohn's disease may be afraid to eat for fear of worsening his symptoms.
Treatment
IBD is a chronic inflammatory illness. Therefore, the goals of treatment are to counter inflammation during a flare-up and to prevent further flare-ups. During an attack, corticosteroids are a powerful anti-inflammatory used orally at home or intravenously in severe cases. Other common medications include methotrexate and 6-mercaptopurine, which decrease the activity of the immune system and reduce inflammation. Surgery may be indicated in some cases in IBD. Because ulcerative colitis affects only the colon, removal of the colon provides a cure for the disease.
References
- The American College of Gastroenterology; Inflammatory Bowel Disease; Jean-Paul Achkar, MD. Cleveland Clinic Foundation.
- The American College of Gastroenterology; Common GI Problems: Volume 2; ACG PR Committee, Kulkarni A and Lacy BE; 2010
- Crohn's & Colitis Foundation of America; What is IBD: Possible Complications; Updated 12/5/08.
- "Practical Gastroenterology"; Nutrition Issue in Gastroenterology, Series #5,
- Nutrition Considerations in IBD; Kelly Anne Eiden, MS, RD, CNSD; May 2003.
