What is Inflammatory Bowel Disease?

Inflammatory bowel disease (IBD) is defined as a group of autoimmune diseases that are characterized by chronic intestinal inflammation or bowel obstruction resulting from host-microbial interactions or environmental factors.

The two major diseases of this inflammatory condition are ulcerative colitis (UC) and Crohn’s disease (CD).

Causes of Inflammatory Bowel Disease:

The exact cause of IBD is unknown but diet, sleep, environmental factors, and immunoregulatory factors have been associated with IBD.

  • Immune system malfunction – One possible cause of IBD is an immune system dysfunction. Gastrointestinal (GI) disorders are reported to be present in 5-50% of patients with primary immunodeficiencies. Dysfunction of the regulatory mechanisms (T-cells) maintaining the balance between active immunity and tolerance in the gut may lead to mucosal inflammation.
  • Heredity – An individual is more likely to develop IBD if he has family members with the disease.
  • Environmental factors – Factors like hygiene, smoking, oral contraceptives and breastfeeding have been reported to the probable causes of IBD.
  • Sleep – Studies show that IBS is prevalent in those with self-reported sleep disturbance. Sleep deprivation can lead to increased levels of inflammatory cytokines, tumor necrosis factor-á and C-reactive protein, leading to further activation of the inflammatory response.
  • Diet – Although there are not many studies reported for the influence of diet on IBD but in some cases dietary fiber intake has been associated with a lower risk of developing Crohn’s disease (CD). Also, patients who had a high intake of meat, eggs, protein and alcohol were more likely to have a relapse of Ulcerative Colitis (UC).

Risk Factors of Inflammatory Bowel Disease:

The risk factors or environmental triggers for IBD are as follows:

  1. Age – Although Crohn’s disease and ulcerative colitis can occur at any age but, people are more frequently diagnosed between the ages of 15 and 35.
  2. Smoking – According to a study, active smokers are more than twice as likely as non-smokers to develop Crohn’s disease.
  3. Oral Contraceptive Pills (OCPs) – The risk of CD is increased with the prolonged use of OCPs.
  4. Non-Steroidal Anti-inflammatory Drugs – NSAIDs may cause damage to the intestinal mucosa of the stomach, small bowel, and colon. They also increase intestinal permeability by inhibiting cyclooxygenase, thus, prostaglandin production. Inhibition of prostaglandins has been implicated in IBD due to immunoregulatory effects.
  5. Appendicitis – Children undergoing an appendectomy before 10 years of age are less likely to develop ulcerative colitis later in life, but are at a higher risk of developing Crohn’s disease.

Clinical Signs and Symptoms of Inflammatory Bowel Disease:

With IBD, inflamed bowel including redness and swelling are the most common symptoms. Both Ulcerative Colitis and Crohn’s disease almost have common symptoms. Related symptoms, which can range from mild or severe, include:

  • ·         Severe or chronic abdominal pain
  • ·         Diarrhea
  • ·         Rectal bleeding
  • ·         Constipation
  • ·         Sudden weight loss
  • ·         Loss of appetite
  • ·         Rectal bleeding

Other symptoms unrelated to the gastrointestinal tract may include:

  • ·         Fever
  • ·         Skin rashes
  • ·         Night sweats
  • ·         Mouth sores
  • ·         Joint pain
  • ·         Weight loss

Complications of Inflammatory Bowel Disease:

Complications include:

  • Anemia due to blood loss
  • Ischemic colitis Blood flow to part of the large intestine is reduced
  • Fistula formation occurs when the inflammation extends through the bowel wall and forms an abnormal tract between the intestines and skin or other organs
  • Abdominal abscesses – Abscesses may occur when a fistula becomes infected
  • Small bowel obstruction – Inflammation and scarring of the intestine leads to narrowing of bowel lumen and obstruction.
  • Malignancy – Risk of colonic malignancy is increased in inflammatory bowel disease. Persons suffering from IBD should undergo regular colonoscopy.
  • Malnutrition – Diarrhea and abdominal pain make it difficult to follow a regular and well-balanced diet, leading to malnutrition
  • Primary sclerosing cholangitis (biliary tract inflammation) and uveitis (inflammation of iris and ciliary body in the eyes) are some of the extraintestinal complications of IBD.

If you see any of the symptoms it is advised to meet a general physician or gastroenterologist near by to avoid complications.

-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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