INFLAMMATORY BOWEL DISEASE
Inflammatory Bowel Disease
Crohn’s disease: This disease can cause inflammation of any part of GI tract from mouth to anus. It affects all the layers of the bowel wall and hence often causes deeper lesions.
Ulcerative colitis: The inflammation in this disease is usually limited to the colon (large intestine). Also it affects only the inner layer of the colon.
The exact cause of IBD is not known. But experts believe that immune, genetic and environmental factors all combine to cause IBD. Genetically predisposed people may encounter an environmental trigger (an infection or an allergy) that activates the immune system to aggressively attack intestinal cells sustainably that leads to inflammation seen in the disease.
Symptoms:
Depending on the location of inflammation symptoms may vary. IBD is punctuated with remissions (decreased symptoms) and flare-ups (increased symptoms) during the course of illness. The following symptoms may be associated with IBD:
- Diarrhea
- Abdominal pain
- Blood in stools
- Weight loss
- Appetite loss
- Fever
- Fatigue
- Anemia
- Swollen joints
- Mouth ulcers
- Eye problems
- Skin problems
- Gallstones
- Kidney stones
Complications:
- Malnutrition
- Intestinal ulcers
- Fistula (abnormal connection between 2 body parts)
- Anal fissures
- Increased tendency to form blood clots
- Toxic megacolon: ulcerative colitis may cause the colon to rapidly swell and widen.
- Colon cancer
- Bowel obstruction and perforation (a hole in the intestine).
DIAGNOSIS:
- Blood tests: to look for anemia and infection.
- Stool routine and culture-to look for infection and occult blood
- Colonoscopy and biopsy-to visualize inflammatory changes of IBD Sigmoidoscopy
- Capsule endoscopy- to detect small intestinal lesions in Crohn’s disease.
- Barium studies-to delineate the inflammatory lesions CT abdomen
Treatment:
The treatment of IBD aims at inducing and maintaining symptom-free (remission) interval in the patients.
MEDICAL THERAPY:
Anti-inflammatory medications: This is usually the first line of treatment and includes steroids and aminosalicylates like mesalamine, sulfasalazine etc..
Antibiotics: ciprofloxacin and metronidazole are the commonly used antibiotics to treat the flare precipitating infection.
Immune system suppressants:These drugs suppress the immune system that releases chemicals causing inflammation. These include medications like azathioprine, methotrexate etc..
Biologics:Adalimumab, Infliximab etc..
Nutritional support: nutrition can be given through feeding tube (enteral) or through the vein (parenteral) that will help in repletion of nutrients and also helps in treatment of IBD.
Other adjunctive medications: These are given to reduce the signs and symptoms. These include antidiarrheal medications, pain relievers, iron, calcium and vitamin D supplements.
SURGERY: Surgery is usually done if medical therapy doesn’t relieve signs and symptoms of IBD. Here the diseased bowel is removed and normal ends are reconnected.
Surgery is also indicated in complications of IBD such as intra-abdominal abscess, toxic megacolon (enlarged bowel), fistula(abnormal connection between two body parts), stricture (narrowing of bowel) with obstructive symptoms, severe bleeding and cancer.
Diagnostic Indications & Treatment
- Symptoms
- Complications
- Treatment
Depending on the location of inflammation symptoms may vary. IBD is punctuated with remissions (decreased symptoms) and flare-ups (increased symptoms) during the course of illness. The following symptoms may be associated with IBD:
- Diarrhea
- Abdominal pain
- Blood in stools
- Weight loss
- Appetite loss
- Fever
- Fatigue
- Anemia
- Swollen joints
- Mouth ulcers
- Eye problems
- Skin problems
- Gallstones
- Kidney stones
- Malnutrition
- Intestinal ulcers
- Fistula (abnormal connection between 2 body parts)
- Anal fissures
- Increased tendency to form blood clots
- Toxic megacolon: ulcerative colitis may cause the colon to rapidly swell and widen.
- Colon cancer
- Bowel obstruction and perforation (a hole in the intestine).
The treatment of IBD aims at inducing and maintaining symptom-free (remission) interval in the patients.
MEDICAL THERAPY:
Anti-inflammatory medications: This is usually the first line of treatment and includes steroids and aminosalicylates like mesalamine, sulfasalazine etc..
Antibiotics: ciprofloxacin and metronidazole are the commonly used antibiotics to treat the flare precipitating infection.
Immune system suppressants:These drugs suppress the immune system that releases chemicals causing inflammation. These include medications like azathioprine, methotrexate etc..
Biologics:Adalimumab, Infliximab etc..
Nutritional support: nutrition can be given through feeding tube (enteral) or through the vein (parenteral) that will help in repletion of nutrients and also helps in treatment of IBD.
Other adjunctive medications: These are given to reduce the signs and symptoms. These include antidiarrheal medications, pain relievers, iron, calcium and vitamin D supplements.
SURGERY: Surgery is usually done if medical therapy doesn’t relieve signs and symptoms of IBD. Here the diseased bowel is removed and normal ends are reconnected.
Surgery is also indicated in complications of IBD such as intra-abdominal abscess, toxic megacolon (enlarged bowel), fistula(abnormal connection between two body parts), stricture (narrowing of bowel) with obstructive symptoms, severe bleeding and cancer.
A TIPPS Procedure was done at Kolhapur which gave patient immediate relief. This kind of procedure is done for the first time ever in this region.
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