IBD, The Symptoms, Treatment Options & Patient Impact

YOUR BTECH APPLIED SCIENCE ASSIGNMENT IBD, THE SYMPTOMS, TREATMENT OPTIONS & PATIENT IMPACT

INFLAMMATORY BOWEL DISEASE (IBD)

IBD is caused by overactivity of the immune system, resulting in it attacking its own body cells by mistake.

This is known as AUTOIMMUNITY.

There are two main types of IBD: Ulcerative Colitis (UC) and Crohn’s Disease (CD)

IBD Ulcerative Colitis

Crohn’s Disease

The exact cause of IBD is unknown, but IBD is the result of an altered immune response.

Possible causes are:

ï Genetics: you are more likely to get IBD if you have a close relative with the condition ï A problem with your immune system triggered by a past infection

Usually IBD is diagnosed in people in their late teens or early 20s, but it can appear at any age.

Image Courtesy of:Wagnerova, A., Gardlik, R. In vivo reprogramming in inflammatory bowel disease. Gene Ther 20, 1111–1118 (2013). https://doi.org/10.1038/gt.2013.43

CROHN’S DISEASE:

ULCERATIVE COLITIS:

Affected Location? Can affect any part of the Gastrointestinal tract (mouth to anus). Most often affects the portion of the small intestine before the large intestine/colon. Can also affect the skin & eyes. Damaged Areas? Damaged areas appear in patches that are next to areas of healthy tissue. Inflammation? Inflammation may reach through the multiple layers of the walls of the GI tract (Abscesses and fissures)

Affected Location? Occurs in the large intestine (colon) and the rectum. Damaged Areas? Damaged areas are continuous (not patchy) – usually starting at the rectum and spreading further into the colon. Inflammation? Inflammation is present only in the innermost layer of the lining of the colon.

WATCH THIS VIDEO TO FIND OUT MORE ABOUT IBD

THE GUT DOCTOR INFLAMMATORY BOWEL DISEASE (IBD) | 3D GUT ANIMATION)

COMMON SYMPTOMS OF IBD

Abdominal Pain and Cramping

Loss of Appetite

Diarrhoea / Constipation

Weight Loss

Nausea

Fever

Vomiting

Weakness / Fatigue

An IBD patient will typically experience:

Periods of symptoms (Flare ups, relapse) with periods of no symptoms in between (Remission).

SYMPTOMATIC DIFFERENCES

Crohn’s disease:

Ulcerative colitis:

Continuous abdominal pain is more common.

Intermittent pain coinciding with bowel movements.

Perianal problems such as fistulas, anal sores and skin tags, can occur and are more common.

Bleeding from the rectum is much more common.

SIMILAR SYMPTOMS CAN BE DIFFICULT TO TELL APART

CROHN’S AND COLITIS UK: WHAT ARE CROHN’S AND COLITIS?

IBD AND MALNUTRITION Inflammatory bowel disease is often associated with malnutrition due to damage to the gut lining preventing absorption, and loss of nutrition through diarrhoea.

ï Poor digestion

ï Malabsorption of nutrients including protein, fat, carbohydrates, water, vitamins and minerals

ï Increased calorific needs of the body, especially during disease flares. More nutrient dense foods need to be consumed, which can be difficult when symptoms are active

ï Often associated with food intolerance

TREATMENTS AND DIET TO HELP MANAGE IBD

Treatment aims to relieve the symptoms of IBD and prevent them returning.

You may want to research further to find more information about the following treatments:

DIET

There is no one diet fits all for IBD. The best diet is one that meets individual nutritional needs and helps manage individual IBD symptoms.

ï Anti-inflammatory Diet (IBD-AID) ï Autoimmune Protocol Diet (AIP) ï Crohn’s Disease Exclusion Diet (CDED)

MEDICINES

ï Aminosalicylates or Mesalazines - reduce inflammation in the gut ï Immunosuppressants - such as steroids or azathioprine - reduce the activity of the immune response ï Biological and Biosimilar medicines – antibody-based treatments given by injection that target a specific part of the immune response ï Antibiotics

LIFESTYLE

ï Avoid foods that trigger attacks ï Take nutritional supplements when needed ï Manage stress: support from family and friends, support groups, and therapists ï Exercise and relaxation methods like meditation can also help

SURGERY

ï Ulcerative Colitis: For 1 in 5 people surgery may be necessary to remove an inflamed section of large bowel (colon).

ï Crohn’s Disease: 60 to 75% will need surgery to repair damage to their digestive system and treat complications.

If a large portion of bowel needs to be removed, a Stoma may be required.

This is a surgically made hole in the abdomen that allows body waste to be removed from the body directly through the end of the bowel into a collection bag.

IMPACT ON THE PATIENT

We have listed some of the main impacts below. You may want to explore further the effect on Well-being, Lifestyle and Mental Health.

ï Dealing with Symptoms: Pain, increased use of the bathroom & tiredness

ï Taking medications & side effects

ï Social / Family life & relationships

ï Regular appointments & tests

ï School / Work

ï Sticking to an appropriate diet & avoiding malnutrition

ï Surgery & living with a stoma

ï Reduced exercise & general activity

This concludes the ‘What is IBD?’ section.

If you haven’t already, read the ‘Testing for IBD’ e-book which is available on the bookshelf.

Testing for IBD

When you’ve read all three e-books, take a look through the website links that are listed in the ‘Introduction & Resources’ e-book for further reading.

Introduction & Resources