The main symptoms in inflammatory bowel disease
is diarrhea. This is often associated with blood, pus and mucus. Patients can get cramping
and abdominal pain. This is around the time they open their bowels. They can feel generally
tired and unwell. This could be due to the disease being active possibly as side effects
of the medication or just simply waking up in the middle of the night on a regular basis
to go to the toilet. They may lose the appetite and have weight loss. This could be because
they’re not eating enough or not absorbing enough nutrients from their food because the
inflammation in the bowel. They can just feel generally unwell and feel feverish. They may
develop anemia, especially if they are going to the toilet and having lots of bleeding. Occasionally,
some patients may have painful, tiny ulcers in their mouth called aphthous ulcers.
Inflammatory bowel disease can also affect other parts of their bodies. It can cause
arthritis especially in joints in their arms, legs, and back. It can cause rashes called
erythema nodosum and pyoderma gangrenosum. It can also affect your eyes, a very common
condition where episcleritis can occur which is when the outer lining of the eye becomes
inflamed, red, and painful. There are certain recognised risk factors
for inflammatory bowel disease. Living in a Western society is a risk factor. This could
be due to lifestyle choices such as diet, possibly environmental pollution. However,
recently, there has been an increase in incidences of inflammatory bowel disease especially in
Asia, again possibly related to lifestyle changes such as diet.
Being young is a risk factor. However, there is also increase incidence of inflammatory
bowel disease towards later stages of life. People don’t know exactly why this is. Having
a family history of inflammatory bowel disease significantly increase the risk of you developing
the condition. Smoking affects ulcerative colitis and Crohn’s disease differently.
It is a significant risk factor of Crohn’s disease and makes the symptoms much worse.
However, it is very protective for ulcerative colitis and ex-smokers are more likely to
develop the condition. Certain gut infections are told to trigger
inflammatory bowel disease such as campylobacter, salmonella, and E. coli. It is thought that
having the appendix taken out is protective against developing ulcerative colitis. It
is thought due to a change in the immune system but people don’t know exactly why this happened.
There are a range of drugs that I use to treat inflammatory bowel disease. Initially, the
treatment is given to heal the inflammation and to bring about remission so that the patient
feels better. Following this, the doctor will keep their treatment goings so that you won’t
get any more flare ups and the disease is under control. This is called maintenance
treatment. Obviously, lifestyle choices will also help
as well such as drinking a lot of fluids especially if you have lots of fecal loss, avoiding trigger
foods, and stressful situations. If you have nutritional deficiencies, then you may need
some supplementations such as vitamin D, iron supplementation if you’re anaemic. This is
the main stay of medical treatment. Occasionally, when patients have really bad disease such
as the developed stricture in Crohn’s disease, then they may need surgery.
The genetic causes of inflammatory bowel disease can be prevented. However, by making lifestyle
choices, you can release the risk of developing inflammatory bowel disease and also release
the chance of relapse. This can be done by eating healthily, exercising regularly, and
if you’ve got Crohn’s disease, then by stopping smoking.
There is no strict individualised plan that patients must follow. There are basic principles
that will help improve symptoms especially during a flare such as having smaller meals,
having them more frequently, eating in a nice, relaxed atmosphere, avoiding insoluble fiber
such as bran, vegetable, fruit, et cetera. Avoiding greasy foods and avoiding trigger
foods. Obviously, this can vary between individual to individual. It is also important to increase
the amount of food intake especially water. Try to avoid drinks that contain caffeine
because caffeine is a stimulant and it can rev up the bowel and make the diarrhea worse.