Inflammatory Bowel Disease (IBD)
Inflammatory Bowel Disease (IBD) encompasses a group of chronic inflammatory conditions affecting the digestive tract, primarily including Crohn's disease and ulcerative colitis. These conditions involve immune system dysfunction where the body's immune system mistakenly attacks the digestive tract, causing inflammation, damage, and various symptoms. At Blume Health, our gastroenterology team offers comprehensive management strategies for IBD patients.
Causes
- Immune system malfunction where the body attacks its own digestive tract
- Genetic factors and family history of IBD
- Environmental triggers such as certain microbes, dietary factors, or medications
- Alterations in the gut microbiome (the bacteria that live in the digestive tract)
- Smoking (particularly a risk factor for Crohn's disease)
- Stress (may trigger or worsen symptoms, though not a primary cause)
- Certain medications like NSAIDs that may trigger flare-ups in susceptible individuals
- Age (most commonly diagnosed before age 30)
- Ethnicity (more common in Caucasians and people of Ashkenazi Jewish descent)
- Urban living environments
Signs and Symptoms
- Abdominal pain and cramping
- Persistent diarrhea, often with blood or mucus
- Fatigue and reduced energy levels
- Unintended weight loss
- Reduced appetite
- Rectal bleeding
- Urgent need to move bowels
- Feeling of incomplete bowel evacuation
- Fever during active inflammation
- Night sweats
- In Crohn's disease: mouth sores, anal fissures, or fistulas
- Extra-intestinal symptoms: joint pain, eye inflammation, skin disorders, liver problems
Diagnosis
Colonoscopy and Upper Endoscopy
Visual examination of the colon, rectum, and upper digestive tract using a flexible tube with a camera. Allows direct visualization of inflammation, ulcers, and other abnormalities, and enables tissue biopsies for confirmatory testing.
Capsule Endoscopy
A swallowed camera capsule that captures images throughout the digestive tract, particularly useful for examining parts of the small intestine that can't be reached by conventional endoscopy.
CT Enterography and MR Enterography
Specialized imaging tests that provide detailed pictures of the small intestine to identify inflammation, strictures, fistulas, and other complications of IBD.
Laboratory Tests
Blood tests to check for anemia, infection, inflammation markers (ESR, CRP), and nutritional deficiencies. Stool tests to rule out infections and measure calprotectin, a protein indicating intestinal inflammation.
Treatment Options
Medications
Various drug therapies can help control inflammation and symptoms, including anti-inflammatory drugs (5-ASA compounds, corticosteroids), immunosuppressants (azathioprine, methotrexate), biologics (anti-TNF agents, anti-integrins, IL-12/23 inhibitors), and JAK inhibitors. Treatment is personalized based on disease type, severity, and individual factors.
Dietary Therapy
Nutritional approaches such as exclusive enteral nutrition (EEN), specific carbohydrate diet (SCD), or low FODMAP diet may help manage symptoms and inflammation in some patients. Our dietitians work closely with gastroenterologists to develop individualized dietary plans.
Antibiotics
Used in specific situations like perianal Crohn's disease, bacterial overgrowth, or complications such as abscesses. Commonly used antibiotics include metronidazole and ciprofloxacin.
Home Remedies
Stress Management
While stress doesn't cause IBD, it can trigger flares and worsen symptoms. Techniques such as mindfulness meditation, deep breathing exercises, yoga, and regular physical activity can help manage stress levels.
Dietary Adjustments
Keeping a food diary to identify trigger foods, eating smaller, more frequent meals, staying hydrated, and avoiding problematic foods during flares (such as high-fiber foods, spicy foods, dairy if lactose intolerant, and carbonated beverages).
Probiotics
Some patients find relief with probiotic supplements that help restore beneficial gut bacteria. Effectiveness varies by individual, and it's important to discuss with your healthcare provider before starting any supplement.
Heat Therapy
Applying a heating pad or hot water bottle to the abdomen may help relieve cramping and pain during flare-ups.
Adequate Rest
Ensuring sufficient sleep and rest periods, especially during disease flares when fatigue is common, can help the body recover and may improve overall well-being.
Preventive Care
- Regular follow-up appointments with your gastroenterologist to monitor disease activity
- Adhering to prescribed medication regimens, even when feeling well
- Routine colonoscopy for cancer surveillance, especially for ulcerative colitis patients
- Proper vaccinations, as some IBD medications may affect immune function
- Smoking cessation (particularly important for Crohn's disease)
- Maintaining good nutrition and healthy weight
- Bone density screening if on long-term steroid therapy
- Mental health support and stress management
- Regular exercise appropriate to your energy levels and symptoms
- Prompt reporting of new or worsening symptoms to your healthcare provider
Surgical Options
Bowel Resection
Surgical removal of damaged portions of the intestine, typically performed when medication fails to control symptoms, or complications such as strictures, fistulas, or abscesses develop. For Crohn's disease, minimally invasive (laparoscopic) approaches are often used, preserving as much bowel as possible.
Colectomy for Ulcerative Colitis
Removal of the entire colon and rectum (proctocolectomy) which can effectively cure ulcerative colitis. This is typically followed by creation of an ileostomy (external pouch) or an internal pouch procedure (ileal pouch-anal anastomosis or IPAA) to collect waste.
Strictureplasty
A bowel-preserving procedure that widens narrowed sections (strictures) of the intestine without removing them. This is particularly important in Crohn's disease to preserve intestinal length and prevent short bowel syndrome.
Schedule a Consultation
If you're experiencing symptoms of inflammatory bowel disease (ibd), our expert team is here to help you find the right treatment approach for your specific needs.