Inflammatory bowel disease (IBD) is a group of conditions wherein the intestines become inflamed. IBD is a collective term used for the diseases like Crohn’s disease, ulcerative colitis (UC) and indeterminate colitis. Patients who have inflammatory bowel disease may occasionally develop severe complications or emergency situations that require extra medical care.

How do you Diagnose Inflammatory Bowel Disease?

The following tests and procedures are adopted to help confirm a diagnosis of IBD, they are as follows:

Blood Tests – Various laboratory blood tests including hemoglobin, platelet count, Erythrocyte sedimentation rate (ESR), albumin and C reactive protein (CRP) are used as preliminary screening tests for IBD.

Screening for Anemia – Blood loss from chronically inflamed intestinal mucosa and micronutrient deficiency are the main mechanisms for the development of anemia in patients with IBD. So, screening of anemia is also regularly done.

Fecal Markers

The fecal excretion of Indium 111-labeled leukocytes is considered to be the standard fecal marker of inflammation. Fecal levels of Alpha1 1-antitrypsin, which is a protease inhibitor is also a useful indicator of IBD specifically CD activity.

Endoscopy

  • Sigmoidoscopy examines the lining of the lower part of the large intestine (the rectum and sigmoid colon).
  • Colonoscopy examines the lining of the entire large intestine (i.e. colon) and some part of small intestine (ileum). This exam can help determine the severity of ulcerative colitis and Crohn’s disease as well as colon cancer.
  • EGD (Esophagogastroduodenoscopy) – this technique involves examining the lining of the esophagus, stomach, and duodenum.
  • ERCP (Endoscopic retrograde cholangiopancreatography) examines the bile ducts in the liver and the pancreatic duct.

 

Leukocyte Scintigraphy-White blood cells get attracted to sites of bowel inflammation. In this test, blood is taken from the arm, and white blood cells in the sample are tagged with a specified amount of a radioactive substance. The blood is injected back into the patient’s body and a special camera is used to see where the radioactive white blood cells travel.

Imaging Technique – It is an alternative to endoscopy a barium follow-through procedure is a useful medical imaging technique for Crohn’s disease when only the small intestine is affected.

Other imaging techniques include computerized tomography (CT) scan and magnetic resonance imaging (MRI) scan to provide detailed images of the small bowel and colon.

 

How do you Treat Inflammatory Bowel Disease?

There is no known medical or surgical cure for IBD but following drugs are being used in the treatment of IBD for alleviation of symptoms. The chief goal of treatment is reduction of the inflammation that is responsible for the symptoms of IBD.

  1. Medical Treatment

Anti-inflammatory drugs- Certain 5-aminosalicylates — including mesalamine balsalazide and olsalazine are available in both oral and enema or suppository forms, which are used for the treatment.

Immunomodulators

Immunomodulators, such as azathioprine, cyclosporine, mercaptopurine, methotrexate, infliximab, adalimumab, certolizumab, and natalizumab are used. Corticosteroids

Steroids such as hydrocortisone and prednisolone are given in moderate to severe cases of ulcerative colitis or Crohn’s disease that have not responded to other drugs. Due to their numerous side effects, they are not given long-term.

Antibiotics

Antibiotics like metronidazole and Ciprofloxacin help control the infection and heal fistulas in case of CD and UC.

Anti-diarrheal agents

Fiber supplements such as methylcellulose and psyllium increase stool bulk and help to relieve symptoms of mild diarrhea. In severe diarrhea, drugs such as loperamide are administered.

Iron and vitamin supplements

Since most persons with IBD also have iron deficiency and vitamin B12 deficiency, iron supplements and B12 injections have to be taken.

2.Surgical Treatment

If the patient fails to respond to diet changes and medical treatment, surgery may become necessary.

Surgery involves removing damaged portions of the small intestine or colon and anastomosing the cut ends (eg ileoanal anastomosis).

How do you Prevent Inflammatory Bowel Disease?

  •         Maintain a well-balanced diet in order to prevent nutritional deficiencies occurring particularly in patients with Crohn’s disease.
  •         Smoking has a negative effect on patients with Crohn’s disease, and quitting smoking might alleviate symptoms.
  •         Preliminary studies demonstrate that moderate exercise can help prevent IBD. Physical activity improves quality of life which gets affected during IBD.
  •         Restrict foods high in fiber as these can aggravate symptoms.
  •         Avoid foods that can cause bloating such as beans, cabbage, broccoli, caffeine, and carbonated drinks.

Health Tips to manage IBD

  •         Limit dairy products
  •         Drink plenty of fluids
  •         Eat small quantities but frequently

-Dr.Bhavani Sagar Surampally

 

REFERENCES

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106026/

https://academic.oup.com/ibdjournal

https://onlinelibrary.wiley.com/journal/15364844

 

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