Inflammatory Bowel Disease – The Food Medic

May 20, 2022

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This article was written by on of The Food Medic team; GP – Dr Nirja Joshi

Gut-related symptoms are very common and something that is often seen by GPs. There are a whole host of conditions which could contribute to these types of symptoms from thyroid disease, to food intolerances, pancreatic issues, and so many more.

It is important that if you have noticed changes to your bowel habit, your weight or have noticed blood in your stool, to seek medical advice from a healthcare professional. It is important with these symptoms to rule out conditions such as bowel cancer, you can read more about this in our article here.

What is inflammatory bowel disease?

Inflammatory bowel disease, otherwise known as IBD (1), describes two main conditions, Ulcerative Colitis and Crohn’s disease. These are both long term conditions which involve inflammation of the gut. Ulcerative Colitis (UC), only affects the large bowel, whereas Crohn’s disease can affect any area of the gut from mouth to anus. It is possible to develop IBD at any age, however, it is most commonly diagnosed in young adults (15-40 years old). Crohn’s is more likely in those who smoke, but also genetics are thought to play a role in who may develop the condition.

What are the main symptoms of IBD?

Common symptoms include abdominal pain, which can be quite severe, diarrhoea which can present with blood as well, weight loss and fatigue. Some patients have other symptoms in addition such as vomiting and low iron levels (anaemia). Other features can be associated with IBD (although they may relate to other conditions as well), such as jaundice (yellowing of the skin and eyes), erythema nodosum (a type of bumpy skin rash, commonly on the shins), red eyes (uveitis), and liver issues (primary sclerosing cholangitis) (1).

How can you treat IBD?

There is currently no cure for IBD. Treatments involve different agents to help to reduce the inflammation in the gut. These can be tablets, sometimes given rectally, or infusion therapy. Treatment aims to relieve the symptoms and achieve some remission. There may be other aspects to look at as well including a specific diet which would be guided by a dietician (1). Read more about IBD and nutrition here.

In some cases, surgery is required. This may mean removing a section, or in some cases, a significant portion of the bowel. In some cases, patients may require a stoma bag (2,3). Up to 75% of patients with Crohn’s disease may require a type of surgical intervention to repair the complications from having the condition (3).

Treatments may include steroids, anti-biotics and biologic agents (anti-TNF). Anti-TNF medication was a good breakthrough for sufferers of IBD, however, 40% of patients do not respond to these (4), there is new research about therapeutic targets which have been identified to help to develop innovative treatments for these patients in the future.

These conditions are also associated with a greater risk of bowel cancer. It is likely that patients will have regular screening to check for this (1).

IBD vs. IBS

These acronyms sound very similar and hence it may be easy to get confused.

IBS stands for Irritable Bowel Syndrome. This syndrome consists as symptoms such as change in bowel habit with looser stools or constipation, bloating and abdominal pain. Some patients with IBS may have bleeding from the rectum, however, this is less common (1).

IBS is generally triggered by certain foods or food groups and also has an association with stress. Weight loss should not be a symptom of IBS.

Although it is possible to feel fatigued.

A feeling of ‘incomplete evacuation’ is again more common with IBS, which is a feeling that you need to visit the toilet again straight after you have just been.

What to do if you have any of the symptoms listed?

Any symptoms such as change in bowel habit, weight loss, blood in your stool and unexplained fatigue should all be a sign that you should consult a healthcare professional.

It is likely that they will take a detailed history of the problem, as well as examine your abdomen, and if relevant, your back passage. They may then ask for tests such as blood tests or a stool sample to help to decipher what the diagnosis may be.

Help for those with IBD

Crohn’s and Colitis UK (5) are a charity set up to support those with the disease as well as family and caregivers. The charity help with live webinars to help those with the condition to discuss topics of interest, as well as using social media platforms to help patients to ask questions and gain valuable information .

The charity has an IBD helpline 0300 222 5700 to help with discussions around symptoms, wellbeing, tests, diagnosis and financial and employment support.

19th May 2022 is World IBD Day to help to raise awareness of the conditions.

References