Inflammatory Bowel Disease

Dr. Joseph Tharakan - Hadi Clinic

Wednesday, November 18, 2020

Inflammatory bowel disease( IBD ) is a term generally used to describe 2 conditions:
Ulcerative Colitis(UC) and Crohn's disease(CD)

These are long term conditions that involve the bowel and occasionally other organs like the joints ,eyes and skin.

While UC only affects the colon(large bowel) Crohn's can affect any part of the digestive tract from the mouth to the anus

While the condition is usually found between the ages of 15 and 45, any age can be affected.
The disease is more common in the northern hemisphere as compared to the southern but increasing prevalence is being noted all over the globe with better detection and awareness.

What causes it

Genetics
Changes in the gut flora
Problems with the immune system
Environmental factors like smoking

Symptoms

The main symptoms of IBD are
crampy pain in the abdomen
recurring or bloody diarrhea
weight loss
malaise and lethargy
In Crohn's disease you could also get arthritis like pains, painful red eyes, red skin nodules and occasionally jaundice
The course of the disease is fluctuant and can come and go. At times it can be severe(flare) followed by long periods of no symptoms(remission)


Diagnosis

The diagnosis is usually made with an endoscope (gastroscopy and colonoscopy).Biopsies can be taken of the inflamed areas and sent for examination.
Other supportive modalities for diagnosis include Ultrasound, CT scans and occasionally MRI of the abdomen
Blood tests may show a raised white cell count or a high C reactive protein or ESR and occasionally changes in liver and kidney function tests.

Treatment

There is currently no cure for IBD
Mild UC may need no or minimal treatment
Medicines used to treat IBD include
Aminosalicylates or Mesalazines
Immunosuppresants such as steroids, azathioprine or cyclosporine
Biologicals -antibody based treatments that target a specific part of the immune system
Occasionally antibiotics

Course of the disease

About 20% of patients with UC may need surgery at some point in their lives which involves removing all or part of the colon while the corresponding figure for Crohn's disease is 60-75%
There is also a slightly increased risk for bowel cancer as well in long standing cases of IBD for which

Dr. Joseph Tharakan
Consultant Internal Medicine
Hadi Clinic

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