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Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD)

IBD is a group of chronic inflammatory conditions of the gastrointestinal tract, and it is often confused with Irritable Bowel Syndrome (IBS) or celiac disease, but they are not the same. While all these conditions may have similar symptoms, IBD is hallmarked by inflammation, which IBS is not. Celiac disease is an inflammatory reaction to gluten, which can be found in wheat and similar grains, requiring people with celiac disease to adopt a gluten-free diet.[1]


What is Inflammatory Bowel Disease (IBD)?

Inflammatory Bowel Disease (IBD) is the collective name for chronic inflammatory conditions of the gastrointestinal (GI) tract.

Your gastrointestinal tract (GI) are the organs through which food and liquids pass on their journey through your digestive system. The GI tract digests, absorbs, and eliminates everything you eat.

Crohn’s disease (CD) and ulcerative colitis (UC) are the most common forms of IBD.[2]

Crohn’s Disease[3]

  • Inflammation can affect any part of or the entire gastrointestinal tract
  • Inflamed areas appear in patches next to healthy areas
  • Inflammation affects all the layers of the bowel wall

Ulcerative Colitis[3]

  • Inflammation occurs in the large intestine and the rectum
  • Inflamed areas are continuous (not patchy)
  • Inflammation only affects the inner lining of the bowel wall

While the cause of IBD isn’t certain, several factors can play a role: genetics, an environmental trigger, or intestinal bacteria being out of balance, causing your immune system to have an unusual response to the other three factors.[4]

While your immune system is supposed to help you fight diseases, it can overreact, which causes inflammation.[1] In IBD, your immune system sees any food, bacteria, or other things that naturally exist in your intestines as harmful and therefore brings the cells of your bowels in defence mode, thinking it will help you when really, it’s only causing harm.


My IBD Journey

My IBD Journey

What are the symptoms of IBD?

IBD affects people in many different ways, and symptoms vary depending upon which part of the digestive system is inflamed.[3] However, the symptoms of both Crohn’s disease and ulcerative colitis are very similar and can include the following:[5]

  • Recurring diarrhoea
  • Swelling in parts of the GI tract
  • Unintentional weight loss
  • Extreme fatigue
  • Abdominal pain and cramping
  • Frequent bowel movements
  • Blood in stool
  • Anaemia
  • Fever

How common is IBD?

IBD affects both men and women equally and seems to be more common if you have a family history of the disease.[3] Around 4.3 million Europeans have IBD, and that number continues to grow.[6] 1.7 million of those with IBD have Crohn’s disease, while the other 2.6 million have ulcerative colitis.[6] IBD is usually diagnosed when a person is between the ages of 15 or 35, though it can occur at any time.[2] Also, you are more likely to develop Crohn’s disease if you smoke cigarettes.[2]


Treatment and Care

IBD is diagnosed using a combination of endoscopy (for Crohn’s disease) or colonoscopy (for ulcerative colitis) and imaging studies. In both of these procedures, your doctor will use a small tube with a camera attached to look inside your digestive tract for any signs of IBD. The difference between the two is that, for a colonoscopy, the doctor will use a specialised tube designed to take a detailed look at your rectum and colon.[7] Your doctor may also check stool samples to make sure symptoms are not being caused by an infection or run blood tests to help confirm the diagnosis.

For both ulcerative colitis and Crohn’s disease, the treatment options are similar. While there currently is no cure for IBD, symptoms may be reduced. For mild cases of IBD, it is possible for patients to manage their symptoms entirely through the right diet and lifestyle choices. For chronic, more stubborn cases of IBD, you can regain control of your life with the assistance of medication, such as immunosuppressants.

Severe IBD may require surgery to remove damaged portions of the gastrointestinal tract, but thanks to advances in medications, surgery is less common than it was a few decades ago. Since Crohn’s disease and ulcerative colitis affect different parts of the GI tract, the surgical procedures are different for the two conditions.[1]


Living with IBD

Living with IBD doesn’t mean that you can’t achieve your life goals, but it will require you to make some adjustments.

One of the most important steps you can take is adjusting your diet in order to find which foods trigger flare-ups and you’ll need to avoid. It’s important to avoid gassy foods, only eat a moderate amount of fibre, and avoid large meals.[8] You should also pay attention to what you eat before experiencing a flare-up so you can recognize your trigger foods. These will vary per person and will take some time to determine. Try keeping a journal of everything you eat.

If you feel comfortable doing so, let your workplace or school know about your IBD so they can try and accommodate your needs, and that you can continue your education or career. For example, you might need a longer time to take tests so you can use the restroom as needed, or you may need the option to work from home when you feel fatigued.

Discussing your IBD with romantic partners can be especially difficult but is vital to a successful relationship. Your partner needs to be aware of your limitations and any anxieties you may have.

One of the most prominent symptoms of IBD is fatigue. It is important to ensure you are getting enough sleep and making time to rest. Since fatigue isn’t visible, you’ll have to communicate with your friends and family about how you feel. Sometimes, you’ll need to leave gatherings early or decline invitations altogether. Over time you’ll learn how much you can handle and eventually, you’ll become an expert on budgeting your time.


What to ask your doctor?

The list below includes example questions to help start a conversation with your health care provider. There may be other relevant questions based on your symptoms, stage, and medical history that are not listed here.

  • Could any condition other than my IBD be causing my symptoms?
  • How will I know if my medication needs to be adjusted?
  • Approximately how long should it take to see some results, or to find out that this may not be the right medication for me?
  • If my medication doesn’t work, what are the other treatments available to me?
  • What are the potential side effects of the medication?
  • What symptoms are considered an emergency?
  • Should I change my diet or take nutritional supplements? If so, can you recommend a dietitian or any specific nutritional supplements?
  • Will I eventually need to get surgery?
  • Are there lifestyle changes I can make to help with my treatment?
  • What about my future? What will my condition be like when I’m older?
  • Does IBD affect pregnancy and my ability to have children?
  • ...

Glossary

  • Gastrointestinal tract: the tract from the mouth to the anus which includes all the organs of the digestive system, including mouth, oesophagus, stomach, small intestine, large intestine, anus, etc.
  • Endoscopy: a procedure in which an instrument is inserted into the body to give an internal view.
  • Colonoscopy: a procedure in which a flexible fibre-optic instrument is inserted through the anus in order to examine the colon.
  • Imaging studies: tests performed with a variety of techniques that produce pictures of the inside of a patient's body.
  • Immune System: a network of cells and proteins that defends the body against infection.
  • Inflammation: a physical condition in which a part of the body becomes reddened, swollen, hot, and often painful, especially as a reaction to injury or infection.
  • Remission: a decrease in the severity or intensity of disease or pain; a temporary recovery.
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