Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is the name given to diseases that cause the bowel wall to become inflamed. IBD can have several different terms such as ulcerative colitis or Crohn’s disease. These diseases differ and effect different areas of the digestive system but are both grouped under the collective term of IBD.

Crohn’s disease is charactised by inflammation that spreads deep into the bowel wall and is usually confined to one or more segments of the small intestine, especially the ileum. In about 50 per cent of cases, it includes both the ileum and the first part of the large intestine, the colon. About 20 per cent of cases involve only the colon.

Ulcerative colitis (UC) is an IBD with ulcers, open sores and inflammation of the large intestine. It almost always causes bloody, watery stools and involves the rectum. Ulcerative colitis can involve most of the large intestine beginning at the anus. When the entire organ is involved, there are seldom any areas that aren’t inflamed and ulcerated. Plain colitis doesn’t involve ulcerations and seems to be confined more to the upper part of the large intestine. When it’s found adjacent to the ileum (the lower portion of the small intestine) it is sometimes called Crohn’s Colitis.

UC is characterised by recurrent attacks interspersed among periods of low or no activity. In some cases the attacks are very frequent with very few periods of inactivity of the disease. The cause is unknown, it is thought to be due to a combination of genetic, environmental and dietary factors. At least until the very late stages of the disease the inflammation is confined to the inner mucosal layer of the colon.

The rectum is always diseased or inflamed but the extent of the inflammation within the colon varies from person to person. It may also vary within an individual over the course of the illness. When the inflammation extends upwards above the rectum, it usually does so in continuous fashion. In some cases only the rectum is inflamed.

When the disease is extensive and severe and extends into the deeper layers of the colon, complications such as toxic megacolon, massive haemorrhage and perforation are likely to occur.

If the inflammation can be controlled then the bowel is able to heal itself and return to normal or relatively normal function between flare ups of the disease.

There are surgical and medical methods of managing UC. There are also dietary recommendations for treating the disease but these are not all scientifically proven and may benefit some people more than others.

Symptoms of IBD

  • Rectal bleeding
  • Rectal urgency
  • False urges
  • Diarrhoea
  • Abdominal pain
  • Intestinal gas
  • Fatigue
  • Depression
  • Weight loss

The inflammation in the inner lining of the colon typically results in blood and mucus in the stools, abdominal cramps, diarrhoea, frequent trips to the toilet and an urgent need to move the bowels which often can’t be delayed. Due to these symptoms patients with ulcerative colitis often feel the need to stay close to a bathroom when their disease is active. Chronic inflammation of the intestinal lining, found in some cases of ulcerative colitis, can result in an increased risk of cancer of the colon and rectum.

IDB produces diarrhoea and serious abdominal pain whether it involves the large or small intestine. Both Crohn’s disease and colitis frequently causes rectal bleeding, while ulcerative colitis often causes serious bleeding. Persistent loss of blood can lead to anaemia, or a shortage of red blood cells, because red blood cells are last faster than your body can make them.

Intestinal inflammation can result in poor absorption of nutrients and the diarrhoea causes an actual loss of nutrients, especially minerals through the stools. Together, these symptoms can cause weight loss and poor nutrition; in young people this can cause growth problems.

Information gathered from:

Thompson, W.G. M.D. 1993. The Angry Gut. Perseus Books. Reading, Massachusettes.

Scala, J. 2000. The New Eating Right For a Bad Gut. Plume. Penguin Putnam Inc. Harmondsworth.

Steinhart, A.H. and Cepo J. 2008. Crohn’s & Colitis Diet Guide. Robert Rose Inc. Toronto.

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