Inflammatory bowel disease: what you need to know

When you or someone you love is diagnosed with inflammatory bowel disease (IBD), it can be scary. Here’s what you need to know about the condition.

​IBD and irritable bowel syndrome (IBS) are not the same​

IBS is a common gastrointestinal problem affecting approximately 20 percent of Australians at some point in their lives. It can cause fluctuating intestinal discomfort, bloating, constipation or diarrhoea. However, unlike IBD, IBS doesn’t result in damage to the digestive system.

Inflammatory bowel disease is a serious, chronic autoimmune disease

An autoimmune disease occurs when something goes wrong with your immune system. Instead of working to fight off foreign germs and injury, something triggers the immune system to attack your normal bodily tissues.

The disease belongs in the same category as other autoimmune diseases like lupus, rheumatoid arthritis, multiple sclerosis, and type 1 diabetes.

In IBD, the immune system is triggered to attack the tissues of the digestive system. These attacks cause inflammation and damage to the large and small intestines.

There are two major types of IBD: Crohn’s disease and ulcerative colitis (UC). While Crohn’s can impact any section of the digestive tract, UC impacts the large intestine.

Additionally, the disease can cause symptoms outside the gut, including joint pain and fatigue.

IBD risk factors

• Gender: Crohn’s disease is more common in women and UC is more common in men.
• Age: while IBD can develop at any age, you’re more likely to develop it prior to 35.
• Genetics and family history: inherited genes may increase the risk of developing Crohn’s disease.
• Location: IBD is more common in countries with a modern western lifestyle and least common in poorer part of the world, such as Africa.
• Smoking: smokers are twice as likely to develop the disease, and symptoms are usually more severe in smokers.

Interestingly, Australia has one of the highest prevalence of IBD in the world. More than 80,000 Australians experience the condition, and that number is anticipated to rise.

Signs and symptoms

You may decide to visit your doctor due to some of the following persistent symptoms:

• diarrhoea
• fever and fatigue
• abdominal pain and cramping
• blood in your stool
• reduced appetite
• unintended weight loss.

How is IBD diagnosed?

Your doctor will run some or all of the following tests:

• stool sample tests: to help rule out other causes
• blood tests: to check for anaemia, inflammation, and specialised markers for IBD
• endoscopy, capsule endoscopy, flexible sigmoidoscopy, and colonoscopy: to directly examine and potentially sample affected tissue.

Treating the disease

When treating IBD, several approaches are utilised.

If you have IBD, changes to your diet may help control symptoms – but there’s little evidence to prove this. Crohn’s and Colitis Australia recommends any dietary changes are made under the guidance of an  accredited dietitian.

Lifestyle changes you should consider are quitting smoking and limiting stress.

Medication is the foundation of IBD treatment. Medications often utilised for IBD include:

• anti-inflammatory drugs which work to decrease inflammation
• immunosuppressant drugs which turn down the immune system to lessen its attack on the digestive system
• biological agents, a newer type of immunosuppressant drug
• supportive drugs like antidiarrheals, pain relievers, and vitamin and mineral supplements
• In some cases, surgery is recommended to remove damaged areas of the intestinal tract.

The implications of living with the disease

There is no cure for IBD. Unfortunately, it is also a chronic condition that has implications not only for the patient but also for society in lost productivity, lost wages, and increased healthcare costs. It can lead to significant complications and disability. However, with good management it is possible to live comfortably and lessen the impact of the condition.

If you have been diagnosed with IBD, it’s important to be your own advocate. Research your condition, ask your doctor questions, take care of yourself physically and mentally, and find an in-person or online support group.

While a diagnosis of IBD is frightening, advances being made in medical and pharmaceutical research are making life with the disease more liveable.