If you’re among the more than three million adults in the US suffering from inflammatory bowel disease, you know all too well the pain and frustration that accompanies the chronic condition. Inflammatory bowel disease is a term used to describe Crohn’s disease and ulcerative colitis, both characterized by chronic inflammation of the gastrointestinal tract. Thanks to better treatments and increased awareness, I see countless men, women and children with inflammatory bowel disease going on to live normal, healthy lives.
Often manifested by ulcers, Crohn’s most commonly affects the end of the small bowel, but may affect any part of the gastrointestinal tract, from the mouth to the anus. Crohn’s disease manifests with abdominal pain and changes in bowel habits, including chronic diarrhea (often with blood), weight loss from excessive bowel movements and low-grade fever. Patients also may experience anemia, increased heart rate and an elevated white blood cell count – a sign of inflammation somewhere in the body. According to the Crohn’s and Colitis Foundation of America, Crohn’s disease may affect as many as 780,000 Americans. Men and women are equally likely to be affected, and Crohn’s is more prevalent among adolescents and young adults between the ages of 15 and 35.
Unlike Crohn’s disease, which can affect the entire GI tract, ulcerative colitis only impacts the lining of the colon. When the lining becomes inflamed it develops tiny open sores, or ulcers, that produce pus and mucous. The combination of inflammation and ulceration can cause abdominal discomfort and frequent bowel movements. Patients also experience loose, urgent bowel movements and blood in the stool. Symptoms can come and go, with long periods of remission in between flare-ups. The CCFA estimates ulcerative colitis may affect as many as 907,000 Americans. Men and women are equally likely to be affected, and most people are diagnosed in their mid-30s. The disease can occur at any age and older men are more likely to be diagnosed than older women.
Who’s at risk?
Both diseases are the result of an abnormal response by the body’s immune system, and exact causes are unknown. However, we do know that in people with inflammatory bowel disease, the immune system mistakes food, bacteria and other materials in the intestine for foreign or invading substances. When this happens, the body sends white blood cells into the lining of the intestines, where they produce chronic inflammation and ulcerations. Smoking is a risk factor for Crohn’s disease and can exacerbate ulcerations and impair healing. While every inflammatory bowel disease patient has different food triggers, low fiber diets seem to produce less stomach pain and diarrhea overall. Stress can trigger symptoms as well.
By the time patients arrive in my office, symptoms have often been present for months or even years. In fact, a recent study showed it took patients three years to bring up GI complaints to their primary care provider and even longer to make it to a gastroenterologist’s office, often from embarrassment of discussing bowel movements or discomfort. I also see patients with misconceptions about medication risks or side effects. In reality, innovation in personalized medicine means today’s inflammatory bowel disease patients are far more likely to experience complications from the disease itself than from the medication.
Following an evaluation of blood work, colonoscopy allows us to look at the small bowel and colon and make an accurate diagnosis. For patients with upper GI symptoms, an upper endoscopy allows us to examine the esophagus, stomach and as far as the duodenum, the first part of the small intestine which can be affected by Crohn’s disease as well.
For most patients, adhering to a regular medication schedule – regardless of how healthy one feels at the time – can help prevent worsening symptoms or surgery.
And while bowel surgery is sometimes necessary for more severe inflammatory bowel disease cases, regular scopes play a crucial role in tracking a patient’s progress and response to medications in an attempt to prevent an operation.
Talk to your doctor
Like all chronic illnesses, inflammatory bowel disease requires an open, lifelong relationship with your primary care provider and gastroenterologist. If you’re having inflammatory bowel disease symptoms, talk to your doctor immediately. Bowel habits are an important reflection of a person’s overall health, and your doctor should be alerted of any changes. Early detection also helps prevent infections and potentially dangerous bowel obstructions, which can result in surgery. Early detection and treatment also help improve the chance of successful medication therapy, which can offer patients healthier, normal lives.
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