Chủ Nhật, 12 tháng 1, 2014

Inflammatory Bowel Disease

Inflammatory Bowel Disease Ulcerative colitis and Crohn’s disease together constitute inflammatory bowel disease. It causes inflammation on the entire region of digestive system. The symptoms of IBD can range from mild to severe and sometimes it can be life threatening. Symptoms of IBD will develop gradually and not overnight. Ulcerative colitis causes inflammation of the innermost lining of the rectum and colon but Crohn’s disease can cause inflammation on the entire digestive tract and spreads easily to neighboring tissues. Lymphocytic colitis and collagenous colitis also form part of IBD.


Symptoms :


The symptoms of inflammatory bowel disease vary with respect to the area of the digestive tract that has been affected. Ulcerative colitis is categorized into many types based on the portion of digestive tract it affects. When the area of the anus or rectum gets inflamed it can cause bleeding of rectum and bloody stool. This is an indication of ulcerative proctitis. The individual with this condition may get rectal pain and frequent bowel movements.


If the entire portion of the rectum and colon gets affected it is known as sigmoid colon. It will produce symptoms of bloody stool, cramps in the abdomen, inability to discharge bowel and this condition is called proctosigmoiditis. Left side colitis is the condition in which there is swelling from the rectum till the descending colon found in the left part of the stomach. It will cause symptoms like bloody diarrhea, cramps in the abdomen with pain on the left side of the stomach.


When the entire colon gets inflamed it is called pancolitis which may cause severe cramps in the abdomen, weight loss, and fatigue. The symptoms of ulcerative colitis are not the same all the time. It alternates between severe symptoms and remission periods.


Crohn’s Disease :


In this disorder, many parts of the digestive system are affected and the rate of inflammation is different in different people. Ileum and colon are the most affected areas in inflammatory bowel disease. For some people only the wall of the colon gets inflamed causing stenosis and for others the scarring of tissues will spread across the entire bowel wall called fistula.


Crohn’s disease will produce symptoms like diarrhea, abdominal pain and cramps. The scarring of tissues will produce large volumes of salt and water inside the intestine leading to diarrhea. For some people there may be bloody discharge in the stool which is due to the bleeding of tissues in large intestine. Ulcers are quite common for people with Crohn’s disease which is due to the formation of sores on the surface of intestine. In addition to the above, some people will have symptoms like fever, weight loss, arthritis, fatigue, inflammation of liver, and skin problems.


Causes :


What exactly cause inflammatory bowel disease is not known. Experts believe that it can be due to side effect of the response caused by the immune system to fight against the pathogens present inside the intestine. It can cause inflammation leading to abdominal pain, diarrhea and other symptoms.


Stress can play a role in causing inflammatory bowel disease since stressful events will directly affect your abdomen. It can also occur due to hereditary factor when the traits of IBD symptoms are passed on to the children by the parents.


Risk Factors :


Generally inflammatory bowel disease targets people of age group 30-35. But it can affect people of any age and any sex. Some scientists suggest that use of Accutane and isotretinoin products can cause inflammation of intestine. People who smoke have increased chance for developing Crohn’s disease. Repeated use of pain-killers can cause ulcers in the intestine.


Complications :


Inflammatory bowel disease causes ulcers and painful sores by affecting the intestine. It can lead to the formation of fistulas or pressure ulcers inside the intestinal wall. Fistulas may develop on any part of the intestine and if they form internally food may not be absorbed properly. If the fistulas develop externally there is chance for emptying the bowel contents into your skin causing infection. IBD can lead to anal fissure, colon cancer, malnutrition and various other health problems.


Diagnoses :


The doctor will check the symptoms for detecting the traits of inflammatory bowel disease. He may order for blood tests and stool analysis for determining the bowel infection. He may do colonoscopy test for viewing the entire colon through camera.


For some cases, sigmoidoscopy procedure is conducted for checking how far the colon has been infected. CT scan, MRI scan and imaging tests like X-ray are also done if he suspects any perforation in the colon. Now doctors use capsule endoscopy or double balloon endoscopy methods for confirming inflammatory bowel disease.


Treatment :


The treatment should be oriented in reducing the inflammation that has occurred in the colon. Ulcers and inflammation are either cured through drug therapy or surgical process.


Medications :


Anti inflammatory drugs like sulfasalazine, mesalamine, balasalazide and dipentum are prescribed for treating ulcers in colon. These drugs can either be used as oral pills or as topical creams to be applied on the rectum area. Corticosteroids are effective for reducing severe kinds of inflammation. Some doctors give immune system suppressors like Azasan, if the actual cause of ulcers is due to the tissue damage caused by immune system. It can cause some adverse effects and hence you need to follow the instructions of your doctor for taking these drugs.


Cyclosporine like Neoral or sandimmune and Infliximab with brand name Remicade is given for treating IBD where other drugs are not able to cure the symptoms. Antibiotics like Flagyl and Cipro are useful for decreasing the amount of drainage from fistulas. It is effective in fighting bacterial infection. Anti-diarrhea medications, laxatives and iron supplements are also prescribed depending on the symptoms and inflammation.


Surgery :


Surgical procedure gives the best relief for inflammatory bowel disease. During surgery the entire colon area is removed (proctocolectomy). Your surgeon will attack a small pouch on the opening of abdomen for collecting the stool. Alternatively he will construct a bag from the end of small intestine and attach it with your anus so that you can expel stool in normal method. Surgery is also done for removing fistulas and draining abscesses.


Lifestyle Changes :


Diet :


You should restrict taking milk and dairy products which can intensify the symptoms. Include fresh veggies and fruits in your diet that are rich in fiber. Avoid taking gas producing foods like beans, broccoli and raw juices. Drink lot of liquids and plan your diet schedule with your doctor.


Quit smoking if you have inflammatory bowel disease since it can worsen the symptoms. Practice yoga and meditation to avoid stress. Do regular exercises which can help you to overcome stress.


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