Inflammatory bowel disease

Crohn's Disease and ulcerative colitis

Inflammatory bowel disease (IBD) refers to chronic conditions that cause inflammation of some part of the gastro-intestinal tract. The walls become inflamed which can cause discomfort and problems with digestion. Presentation of inflammatory bowel disease depends upon which part of the tract is affected.  Crohn's Disease is a type of inflammatory bowel disease that can affect any part of the digestive tract from the mouth to the back passage but most commonly affects the ileum or colon.  Inflammation may occur in patches and ulceration may occur deep into all layers of the bowel wall. Ulcerative colitis on the other hand is a type a inflammatory bowel disease that only involves the colon and rectum, usually the sigmoid colon. Inflammation is continuous throughout the affected area but ulceration does not often extend beyond the inner mucous lining

 

Symptoms of IBD

Whilst there is a lot of overlap in symptoms between Crohn's disease and ulcerative colitis, there are some differences in presentation which can largely be attributed to the different parts of the digestive tract that are affected.

Symptoms of Crohn's disease include the following:

Symptoms of ulcerative colitis include the following:

 

Drug treatment options

Treatment of IBD usually involves aminosalicyclates, corticosteroids and immunosuppressants. Biologics (including alimumab and infliximab) are the newest class of medicines used in the treatment of IBD but should only be considered in severe active disease where standard treatments have failed. Drug treatment options are discussed below:

1. Aminosalicylates (e.g. balsalazide, mesalazine, sulfasazine and olsalazine)

2. Corticosteroids (e.g. budesonide and prednisolone)

3. Immunosuppressants (e.g. azathioprine, ciclosporin, mercaptopurine and methotrexate)

 

Lifestyle changes

There are a number of lifestyle changes that patients can adopt to help control symptoms and minimise occurrence and severity of flare-ups

  1. Limit dairy products
  2. Drink plenty of liquids but limit alcoholic, caffeinated and carbonated drinks
  3. Try low-fat foods
  4. Avoid fibre-rich foods that may exaggerate symptoms of IBD
  5. Avoid foods that trigger symptoms
  6. Eat smaller meals
  7. Stop smoking
  8. Remove stress
  9. Consider multivitamins to combat the problem of reduced absorption of nutrients from diet