What Is Inflammatory Bowel Disease?

Inflammatory bowel disease (IBD) is a condition that causes parts of the intestine (bowel) to get red and swollen. It's a chronic condition, which means it lasts a long time or constantly comes and goes.

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There are two kinds of IBD: Crohn's disease and ulcerative colitis. These diseases have many things in common, but there are important differences:

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• Crohn's disease can affect any part of the gastrointestinal tract from mouth to anus (where poop comes out). The inflammation of Crohn's disease damages the entire bowel wall.
• Ulcerative colitis happens only in the large intestine, or colon. It causes sores called ulcers that affect the inner lining of the colon.

What Are the Signs & Symptoms of Inflammatory Bowel Disease?

The most common symptoms of inflammatory bowel disease are belly pain and diarrhea. Other symptoms include:

• blood in the toilet, on toilet paper, or in the stool (poop)
• fever
• low energy
• weight loss

Inflammatory bowel disease can cause other problems, such as rashes, eye problems, joint pain and arthritis, and liver problems.

What Causes Inflammatory Bowel Disease?

The exact cause of IBD is not clear. It is probably a combination of genetics, the immune system, and something in the environment that triggers inflammation in the gastrointestinal tract. Diet and stress may make symptoms worse, but probably don't cause IBD.

Who Gets Inflammatory Bowel Disease?

IBD tends to run in families. But not everyone with IBD has a family history of the disease. Inflammatory bowel disease can happen at any age, but is usually diagnosed in teens and young adults.

How Is Inflammatory Bowel Disease Diagnosed?

If you have any of the symptoms of IBD, it's important to see your doctor. In addition to doing a physical exam, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medicines you take, any allergies, and other issues. This is called the medical history.

Inflammatory bowel disease is diagnosed with a combination of blood tests, stool (poop) tests, and X-rays. Medical imaging tests, such as CT scans and MRI, might be done too.

The doctor will check your stool for blood, and might look at your colon with an instrument called an endoscope, a long, thin tube attached to a TV monitor. In this procedure, called a colonoscopy, the tube is inserted through the anus to let the doctor see inflammation, bleeding, or ulcers on the wall of the colon. During the procedure, the doctor might do a biopsy (taking small tissue samples for further testing).

How Is Inflammatory Bowel Disease Treated?

IBD is treated with medicines, changes in diet and lifestyle, and sometimes surgery. The goal of treatment is to relieve symptoms, prevent other problems, and prevent future flare-ups.

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A doctor may recommend:

Medicines

Medicines are also used to treat IBD. Anti-inflammatory drugs, including corticosteroids, may be used to decrease the inflammation caused by IBD.

If your symptoms don't go away after taking anti-inflammatory drugs, your doctor may prescribe other medicines called immunosuppressants or immunomodulators to ease the inflammation. Biologic therapy, which is treatment to stop the body from developing inflammation, may also be used.

Doctors may prescribe antibiotics to prevent or treat bacterial infections associated with Crohn's disease, and antidiarrheal drugs may be prescribed for someone who has diarrhea a lot.

Nutrition Therapy

It is important for people with IBD to eat healthy foods and drink plenty of fluids to replace those lost through diarrhea. They should work with a doctor or a dietitian to come up with an eating plan that's best for their individual situation and symptoms.

For example, some people are told to cut down on the amount of fiber or dairy products in their diets, whereas others find that their symptoms improve if they cut back on foods that are high in fat or sugar. If you've been diagnosed with IBD, your doctor might ask you to keep a food diary so that you can find out which foods make your symptoms worse.

If you have trouble maintaining or gaining weight, your doctor may recommend that you take nutritional supplements or special drinks or shakes that contain needed vitamins, minerals, and calories.

Some people are placed on an elemental formula and restricted from eating regular food. It has been found that those who have mild Crohn's disease respond to this type of treatment because it removes some proteins in the diet that might cause inflammation of the intestine.

More Sleep and Less Stress

Besides watching the types of foods they eat, people with IBD need to get enough sleep. It's also helpful to manage stress in a positive way. When you get stressed out, your intestinal problems can flare. Some people find that learning breathing and relaxation exercises can help.

Surgery

Sometimes surgery is necessary to control the symptoms of IBD and to remove damaged sections of the intestines. For people with Crohn's disease, surgery may be needed more than once because the disease can involve other parts of the intestine over time.

Removal of the large intestine can cure the bowel problems in people with ulcerative colitis. However, this surgery is usually only done if medicines have failed or if a person develops a perforation (a hole in the intestine), uncontrollable bleeding, or has developed intestinal cancer.

Surgery also may be necessary if the bowel becomes blocked.

What Else Should I Know About IBD?

IBD may cause a delay in puberty or growth problems for some teens with the condition, because it can interfere with a person getting nutrients from the foods he or she eats. Some teens may need supplements, like calcium or vitamin D. Someone who's not growing well may need additional nutrition support.

Looking Ahead

Although it can be challenging to deal with the symptoms of IBD, many people find that they're able to feel well and have few symptoms for long periods of time. Talk to your doctor about ways that you can feel better during the times you have flares. If you feel sad or anxious about your symptoms, it may also help to talk to a therapist or other mental health professional.

As you get older, you can take on more responsibility for managing your health care. Getting treatment for IBD, managing your symptoms, and keeping a positive attitude can help get you back on track.

The Crohn's and Colitis Foundation is a good resource for more information and support.

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