Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that involve chronic inflammation of your digestive tract. Types of IBD include:
- Ulcerative colitis: Involves inflammation and sores (ulcers) along the superficial lining of the large intestine (colon) and rectum.
- Crohn's disease: Characterized by inflammation of the lining of the digestive tract, often involving deeper layers of the intestinal wall.
Both ulcerative colitis and Crohn's disease are usually characterized by diarrhea, rectal bleeding, abdominal pain, fatigue, and weight loss. IBD can be debilitating and may sometimes lead to life-threatening complications.
Symptoms
IBD symptoms vary depending on inflammation severity and location. Symptoms may range from mild to severe and typically alternate between periods of active illness and remission. Common signs include:
- Diarrhea
- Fatigue
- Abdominal pain and cramping
- Blood in stool
- Reduced appetite
- Unintended weight loss
When to see a doctor
See your doctor if you experience persistent changes in bowel habits or any symptoms of IBD. Though not usually fatal, IBD can cause serious complications.
Causes
The exact cause of IBD is unknown. Diet and stress may aggravate symptoms but are not causes. One possible cause is an abnormal immune response where the immune system attacks digestive tract cells. Heredity also plays a role, though most IBD patients do not have a family history.
Risk factors
- Age: Most diagnosed before 30, though it can appear later.
- Race/Ethnicity: Highest risk among whites, but can affect any race.
- Family history: Higher risk if a close relative has IBD.
- Cigarette smoking: Major risk factor for Crohn's disease; may protect against ulcerative colitis but is harmful overall.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen, naproxen, and diclofenac may increase IBD risk or worsen disease.
Complications
IBD complications may be shared or condition-specific:
Common complications
- Colon cancer: Higher risk in extensive IBD; screening usually begins 8–10 years after diagnosis.
- Skin, eye, and joint inflammation: Includes arthritis, skin lesions, and uveitis.
- Medication side effects: Corticosteroids may cause osteoporosis, high blood pressure, and other conditions.
- Primary sclerosing cholangitis: Scarring of bile ducts leading to liver damage.
- Blood clots: Increased risk in veins and arteries.
Crohn's disease-specific complications
- Bowel obstruction: Thickening and narrowing of the bowel may require surgery.
- Malnutrition: Difficulty absorbing nutrients; anemia due to low iron or vitamin B12 is common.
- Fistulas: Abnormal connections between body parts, often perianal, may become infected and form abscesses.
- Anal fissure: Small tears in anal tissue, often causing pain and potential fistulas.
Ulcerative colitis-specific complications
- Toxic megacolon: Rapid widening and swelling of the colon, a serious condition.
- Perforated colon: May occur due to toxic megacolon or independently.
- Severe dehydration: Excessive diarrhea can lead to dehydration.