We all sometimes eat things that don’t agree with us, resulting in some mild discomfort and other indications of minor gastrointestinal upset. But for people who live with inflammatory bowel disease (IBD), symptoms can be severe.
“Inflammatory bowel disease is a general term that includes two main types of diseases: Crohn’s disease and ulcerative colitis,” explains Dr. Ruben Aymerich, a gastroenterologist with SSM St. Mary’s Health Center and SSM St. Clare Health Center. “Patients with these have inflammation of different parts of the digestive tract, usually the colon and/or small bowel.
IBD tends to show up more often in urban areas and incidence is not significantly different between men and women, adds Dr. Alexandra Gutierrez, a gastroenterologist with Washington University Physicians. “Although IBD can occur at any age, most people are diagnosed between ages 15 and 35, but there is a second peak in the diagnosis for ulcerative colitis between 60 and 80 years.”
The symptoms depend on what part of the intestinal tract is affected, says Dr. Christine Hachem, a SLUCare gastroenterologist. “If it is Crohns of the upper intestinal tract, patients can have heartburn and oral ulcers. If it affects the small or large intestine, symptoms such as diarrhea are more common. Ulcerative colitis typically presents as bloody diarrhea and abdominal pain.”
Hachem adds that patients who have Crohns disease may experience vague gastrointestinal symptoms for years before diagnosis. Yet while these diseases require a significant amount of medical resources to manage, the cause is unknown. “That’s the multimillion-dollar question,” Hachem says. Genetics and environment are thought to play a role, but prevention is almost impossible, so people who have a family history of such diseases are urged to pay attention to potential symptoms in order to ‘take control of the disease before it takes control of you.’
“Dietary manipulation may help symptoms in persons with ulcerative colitis, and it actually may help reduce inflammation in Crohns disease,” Gutierrez says. “However, there is no evidence that consuming or avoiding any particular food item causes or avoids flare-ups of IBD.”
Treatment usually involves prescription medications, though in some cases, surgery may be necessary, Aymerich notes. “Because the treatment options have improved in the last 20 years, exposure to steroids and the need for surgery have significantly decreased. A great amount of research is underway, and so we should see more options available in the near future.”
Gutierrez offers an apt analogy: “The diagnosis of inflammatory bowel disease is best compared to a marathon and not a race. It takes persistence, patience and communication with your health care provider to obtain the goal of remission without steroids. Reaching the finish line isn’t easy, but is rewarding.”