What is inflammatory bowel disease (IBD)? - By Dr Vishal Khurana (Senior Gastroenterologist, Faridabad)

 

What is inflammatory bowel disease (IBD)?

Inflammatory bowel disease (IBD) is a group of inflammatory conditions of large and small intestines. The major types of IBD are Crohn`s Disease, CD and Ulcerative Colitis, UC. IBD is a condition in which the swelling develops in the digestive system (also called gastric intestinal tract or intestine). Ulcerative colitis affects only the large intestine (colon). Inflammation in Crohn Disease can affect any part of the digestive tract, from the mouth to the anal, but in general it is in the final part of the small intestine (ileum) or large intestine (colon).

This condition occurs when your body's immune system attacks and destroys the healthy tissues of the body in error (auto antibody disorder). Crohn's disease and ulcerative colitis present extraintestinal manifestations (such as liver problems, arthritis, skin manifestations and eye problems) in different ratios.

How common is this disease?

In recent reports, IBD is growing in Asia, though it is much lower than in Europe.

Increasing incidence and spread of inflammatory bowel disease (IBD) in India is growing in South East Asian countries (SEA).

In January 1986, in the house survey in Haryana, 21921 people were included in 4796 households in a house, in which 10 cases (5 out of every gender) came forward, which meant spread of 45.5 per lakh population.

In 1999, neighboring Punjab, where cluster sampling was used, the prevalance of ulcerative colitis (UC) was found to be 44.8 per lakh population, which was the highest in Asia but still less than North America and Europe.

What are the symptoms of this disease?

Although there are many different diseases, both of them can present any of the following symptoms:

• Stomachache
• Vomiting,
• Diarrhea
• Bleeding from the intestines
• Exhaustion and weakness.
• Unhealthyness.
• Hip in the mouth
• Lack of appetite and weight loss
• Anemia (decrease in levels of red blood cells)
• fever and chills
• continuous diarrhea.
• Sweat in the night.

Investigations

After doing physical examination and taking medical history, doctors can advise any of the following to know the severity of the infection:

Colonoscopy or Flexible Sigmoidoscopy.

Biopsy

Stool testing.

CT scan/MRI

When should a person contact the doctor?

Contact the doctor if the person with fever, nausea and vomiting, wounds and scars on the skin and bleeding from the intestine, with or without severe abdominal pain, diarrhea, tremor etc. In case of pus or fluid coming out of the anus, fistula and anal pain, there is a need for immediate medical assistance.

What are its other problems?

• In Crohn`s Disease, 1.2% of patients get perforation, usually these holes of the small intestine can reach the toxic level. Peritonitis of the free perforation, especially the large intestine, can be deadly. In 10.30% of patients in Crohn`s Disease, wounds occur within the stomach and in the pelvic region at any time during the disease. Other problems include obstruction of the intestine, excessive bleeding, improper absorption, and serious diseases surrounding the anus.

What are its remedies?

• The optimal treatment of inflammatory bowel disease (IBD) depends on what its appearance is. For example, Mesalamine is more useful in ulcerative colitis compared to Crohn's disease. Generally, on the basis of the level of severity, IBD may require immunosuppression to control symptoms, such as Mesalamine, prednisone, TNF blocking agent, azathioprine, etc.

Precaution

• Due to the pain, vomiting, diarrhea and other socially unacceptable symptoms IBD can limit the quality of life, it is rarely fatal in itself. Dangerous results are rare due to complications like toxic, metabolic and surgical complications.

Dr Vishal Khurana

MBBS, MD, DM (Gastro), MNAMS, Mem.WEO, Mem.ACG

Senior Gastroenterologist

Mobile: 7289840710