IBD — What is Inflammatory Bowel Disease?

 

IBD is an umbrella term for life-long disorders caused by chronic inflammation of your gastrointestinal tract. Be informed about causes and triggers!

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IBD — What is Inflammatory Bowel Disease?

IBD stands for inflammatory bowel disease, which is an umbrella term used to describe disorders that cause chronic inflammation of your gastrointestinal tract.

The two most common forms of IBD are Crohn’s disease and ulcerative colitis.

Ulcerative colitis involves the inner lining of the colon. Crohn’s disease involves all layers of the intestine and can occur in both the small intestine, colon, and sometimes even the mouth.

Cause of IBD: A mistake of the immune system

IBD conditions were rarely seen before the 20th century and emerged when hygiene standards and urbanization changed the way we live our lives. After intense research it is now believed that it a combination of factors including environmental triggers and an abnormal immune system reaction result in IBD. The body’s own immune system mistakenly identifies a harmless trigger such as food or bacteria usually living in our intestines as ‘foreign’ and attacks it. The attack response involves filling the gut with white blood cells, which normally fight infections, and cause inflammation. Genetics may also play a part, particularly in ulcerative colitis.

Environmental triggers could include:

• Viruses
• Bacteria
• Stress
• Diet
• Smoking

Symptoms of IBD: Intestines in Uproar

Symptoms range from mild to severe and even life-threatening. They can also change over time: Periods with few or no symptoms are known as remission. They can be followed by times when symptoms are worse and harder to manage, known as an active phase or a flare up. Symptoms can also vary depending on how much of the digestive system is affected.

Symptoms and may include any or all the following:

• Abdominal pain and cramps
• Persistent diarrhea
• Rectal bleeding and bloody stools.
• Losing weight without intention
• Fever
• Feeling tired all the time
• Irritation of joint, skin, or eye
• delayed growth in children due to malabsorption

The onset of IBD can occur at any age, but it is most often diagnosed in adolescents and adults between the ages of 20 and 30. IBD is diagnosed by a combination of stool samples, blood tests, endoscopy (for Crohn’s disease) or colonoscopy (for ulcerative colitis), and radiology imaging.

IBS or IBD: Both the same?

No! Irritable Bowel Syndrome and Inflammatory Bowel Disease sound similar, have similar abbreviations and even similar symptoms. But IBS is a brain-gut-interaction disease which results in disturbance of the bowel function (see also IBS in our Blog). IBD has different reasons, is characterized by inflammation in the gut and can have life-threatening complications.

Don´t mix up! Inflammatory bowel disease (IBD) is different to irritable bowel syndrome (IBS), even though some of the symptoms may be similar.

Rising IBD as result of “Westernization”

Western countries have been historically observed as the populations where IBD is prevalent and continues to rise, whereas the general impression is that countries in the Middle East (ME) experience a lower incidence of IBD. Nonetheless, recent trends have shown a significant rise in the incidence of IBD in middle east countries, especially in Kuwait and KSA. In UAE, around 2–4 out of 100 people are suffering from IBD.

The rise of IBD in the middle east may be associated with the “westernization” in lifestyle, including dietary habits in these countries.

Another important factor to consider is consanguinity: Research has described families with a high number of IBD affected family members. In addition, a person with a first-degree relative (parents, siblings, or children) suffering from IBD is 10-fold more likely to develop IBD than a person with no IBD history in the family. Genetic variations which rise the susceptibility for IBD seem to be the reasons for these inherited traits. Therefore, if a family member suffers from IBD, you should be aware of the potential inheritance and directly consult a doctor when you discover any of the symptoms described above.

Are we UpToDate in IBD Treatment?

Crohn’s disease and ulcerative colitis are known as lifelong chronic conditions. While there is no cure for IBD up to now, there is medication, or if necessary, surgery, that can provide relief from the symptoms.

Crohn´s disease treatment strategies and outcome in the Arab world was jointly analyzed in 2021 by research groups from Rashid Hospital in Dubai, Kuwait University, King Abdulaziz University Hospital in Saudi Arabia, Lebanese University Hadath, and Humanitas University in Milan, Italy. Most patients were receiving aminosalicylates or corticosteroids alone or in combination. Immunomodulators were used the least. In all studies, few patients received antibody medication such as the anti–tumor necrosis factor (anti-TNFα).

While corticosteroids can be effectively used in an acute flare to calm down the symptoms, they are limited by important side effects. Additionally, long-term use of corticosteroids does not prevent disease relapse. Therefore, modern treatment involves immunomodulators like azathioprine and biologics, particularly anti–tumor necrosis factor. Recent treatment guidelines from the American Gastroenterology Association (AGA) recommend their early use. In moderate to severe Crohn’s disease use of immunomodulators or biologics should not be delayed until after failure of corticosteroids.

Let´s talk about it!

Crohn’s disease and ulcerative colitis can cause symptoms which are often not talked about. They can be awkward and cause embarrassment. Diarrhea and pain can often be mistaken for other conditions, such as IBS, which can delay an accurate diagnosis.

Always take note of your symptoms, their frequency and severity and any patterns you have noticed. Discuss them with you doctor! Awareness around the symptoms of IBD is important to support an early diagnosis and an appropriate therapy. Your health matters!

TheKnowHow Independent Second Opinion Service

Are you or a loved one suffering from gastrointestinal issues and are unsure about the exact diagnosis?

Have you been diagnosed with Crohn’s disease, colitis ulcerosa, or another IBD and are concerned about your current treatment choices?

The KnowHow Independent Second Opinion Service is not intended to take you away from your existing doctor, but rather provide an extra level of competence. Our impartial specialists conduct a record-based assessment of your current health state and all available treatment options, including their advantages and potential hazards.

Get an unbiased assessment from an international expert without having to travel or schedule appointments.
Read more on PATIENTS and SECOND OPINION REQUEST page.