Inflammatory Bowel Disease (IBD)

What are the symptoms of IBD?

Chronic inflammatory bowel diseases don’t have clear causes yet, but a bad balance of things in the digestive tract, like the intestinal flora, immune cells, and the way intestinal cells work, seems to be important. Environmental factors and smoking also play a role, but smoking seems to make Crohn’s disease more likely than ulcerative colitis.

Characteristic symptoms  of inflammatory bowel disease include:

• diarrhea
• stomach pain
• nausea
• general feeling of illness
• Fever
• weight loss

However, there can also be complaints outside the gastrointestinal tract, the so-called extra-intestinal manifestations. These include:

• joint inflammation
• inflammation of the eyes
• skin changes
• liver inflammation
• kidney and gallstones

IBD usually has a relapsing course, which means that there are times when the disease is very active, meaning that you have a lot of symptoms, and times when you don’t have any symptoms (remission). In ulcerative colitis, the inflammation is only in the colon. It may be limited to the lower part of the colon or it may spread to the whole colon, starting at the bottom. In Crohn’s disease, the spots of inflammation are not as deep. The main signs are bloody diarrhoea, stomach cramps, a strong need to go to the toilet, and pain when you do. Crohn’s disease can affect the whole digestive system, from the mouth to the anus. Here, there are spots of inflammation and healthy tissue. The inflammation is deeper than in ulcerative colitis, and fistulas can also form. Typical signs are crampy stomach pain and diarrhoea that isn’t bloody.

How is IBD diagnosed? 

A combination of endoscopic, histological, imaging, and laboratory tests, as well as how the disease looks and moves, are used to make the diagnosis. 

At the beginning of the diagnosis, the doctor and patient have a detailed conversation during which a full anamnesis is written and a thorough physical exam is done. 

The C-reactive protein (CRP), the number of white blood cells (leukocytes), and the blood sedimentation rate are then checked in the lab (ESR). A stool exam, in which the amount of faecal calprotectin is measured, can also show if there is inflammation in the intestinal tract.

Imaging procedures, such as gastroscopy and colonoscopy, are used to make a final diagnosis. Biopsies are another way to get tissue samples that can show what kind of inflammation it is and how bad it is. Sonography, computed tomography, and magnetic resonance imaging are all other imaging methods that can be used to help make a diagnosis.tomography,

Can IBD be treated?

At the moment, neither Crohn’s disease nor ulcerative colitis can be treated directly. They are treated in different ways based on the type of disease and how bad the inflammation is. Also, there is a difference between treating acute attacks and stopping them from happening again. 

The main goal of therapy is to quickly achieve and keep clinical remission (freedom from symptoms) until the endoscopically visible signs of inflammation have gone away completely. Other goals include keeping the affected parts of the intestines working and giving people with Crohn’s disease the best quality of life possible.

In addition to drugs, surgeries are also used to treat the disease. If you have ulcerative colitis, you can be completely cured, but you will have to give up your large intestine. 

Glucocorticoids, immunosuppressants, and drugs that stop inflammation are used in drug therapy. Biologicals like TNF- inhibitors and anti-integrin molecules have been around for a long time, and so-called small molecules like Janus kinase inhibitors have been around for ulcerative colitis for a relatively short time. 

These are specific molecules that get in the way of inflammation and stop certain pro-inflammatory signals from being sent. If therapy works well, there is a good chance that the person will have a better quality of life and go for long periods without symptoms.