All About IBD

In today's episode of Life Without Leaks, we discuss Inflammatory Bowel Disease, or IBD. You'll get a detailed overview of the condition and the treatment options available to you, including lifestyle modifications, medications and surgery.

For more information about the condition, visit the National Association for Continence's page on IBD by clicking here. You can also download a free bowel diary by clicking here.

To learn more about the National Association for Continence, click here, and be sure to follow us on Facebook, Instagram, Twitter and Pinterest.

Music:
Rainbows Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/

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Transcript

Welcome back to another episode of Life Without Leaks. Today we’re going to talk about Inflammatory Bowel Disease, also known as IBD.

Unlike many other disorders, Inflammatory Bowel Disease is not a single condition. It’s actually a term for a family of conditions that involve inflammation of your gastrointestinal tract. When you have an IBD disorder, certain triggering events can cause your body to react in ways that produce unpleasant symptoms, including many that happen outside of your digestive tract.

It's classified as an autoimmune disorder because your immune system is producing an unhealthy response to your own cells, attacking them as if they were foreign invaders.  

The most common forms of IBD are Crohn’s disease and ulcerative colitis, also known as UC. Both of these often have similar symptoms, but they’re very different.

Most people tend to associate Crohn’s disease with an urgent need to empty the bowels, but it’s not limited to the lower parts of the digestive tract. It can actually affect you anywhere from mouth to anus, with symptoms that include severe diarrhea, abdominal pain, fever and fatigue. 

Outside of the digestive system, you can experience symptoms like anemia, arthritis, inflammation of the eye and skin rashes.

You may not have all of these, and the ones you do have may be mild or severe. They can even change from day to day or go into periods of complete remission. But that doesn’t mean that they can’t come back, so it’s important to stay under your doctor’s care and follow your treatment routine at all times. 

Unlike Crohn’s, which can occur anywhere along the digestive tract from entry to exit, UC occurs in your colon – that is, the large intestine – or your rectum. What happens is that the lining becomes inflamed, and this inflammation creates small ulcers. 

UC is usually categorized by where exactly it occurs in the bowel, and this is important because treatments may vary based on your particular condition.

Some of the most common symptoms include the frequent need to empty your bowels, loose stool, rectal bleeding, abdominal pain, fever and weight loss. And like Crohn’s disease, you can also experience symptoms outside of the intestine such as burning, redness, itching and other problems of the eyes; mouth ulcers and sores; skin conditions, including nodules or lesions formed on the legs; joint conditions, including various types of arthritis; liver conditions, like inflammation of the bile ducts, and more.

Symptoms can vary from person to person and from time to time, but even if you have mild symptoms – or none at all – it’s essential that you stay under a doctor’s care because UC is a progressive disease. It can worsen with age, and in advanced cases, UC can even lead to life-threatening situations.  

One thing that many people do is confuse IBD with irritable bowel syndrome – also known as IBS – but they’re entirely separate disorders.

IBS is the name we give to a group of symptoms that include abdominal pain, excess gas, changes in stool consistency and diarrhea or constipation, to name a few. It is not an inflammatory disease the way that IBD is, so the treatment path is often quite different. 

IBD is also NOT Celiac disease, which is a sensitivity to gluten that can produce troubling digestive symptoms. Celiac disease does happen to be an inflammatory disorder like IBD, but because it’s specifically linked to gluten, it’s treatment path is usually more straightforward: Eliminate gluten from your diet and you’re likely to reduce the number of episodes you experience. 

If you do have IBD, though, the condition can feel isolating, and many people suffer for years before they work up the nerve to seek help. But if this is something you’re living with, know that you’re not alone. According to the Centers for Disease Control, a little more than 3 million adults in the U.S. have IBD, which is enough to fill every NFL stadium one-and-a-half times. That’s a lot of people in going through the same thing as you. 

We aren’t entirely sure what causes either Crohn’s disease or UC, but many believe that a virus or bacteria may be the trigger. There does seem to be a genetic component to who comes down with it – both conditions are more common in people with a family history of the disorders. It’s most common to be diagnosed with Crohn’s disease or ulcerative colitis when you’re in your teens or 20s, though it can affect anyone at any time. 

And if you do have IBD, you should know that you may also be more likely to develop other chronic conditions like heart disease, cancer, diabetes and arthritis. Just one more reason to make sure that you’re under a doctor’s care!

So who should you turn to? In most cases, your first stop will be a gastroenterologist, a specialist who focuses on the digestive tract, and they’ll be the main coordinator of your care. But because of the broad range of symptoms that you can experience with IBD, there’s a good chance that you’ll actually have a team of physicians working to get you well.

For example, you may see a rheumatologist to address joint pain and skeletal symptoms, a dermatologist to treat skin issues, an ophthalmologist if you have eye problems, an endocrinologist to address issues with hormones, mental health professional to help you deal with the emotional challenges of IBD, and a dietician, since diet plays such an important role in the way your condition presents itself. 

Next, there’s your diagnosis. Because a whole range of bowel disorders and other diseases can have similar symptoms, and because those symptoms can vary significantly from one person to the next, your doctor will likely run a number of tests to diagnose your particular disorder and rule out other possibilities. 

Blood tests may be done to check for anemia or infection. Stool studies can help see if there are any irregularities in your stool. Flexible Sigmoidoscopy uses a thin, lighted instrument to examine your rectum and part of your colon. Colonoscopy examines your colon for signs of disease. An upper endoscopy examines your upper gastrointestinal tract, including the esophagus, stomach and first part of your small intestine. Balloon-assisted enteroscopy uses an instrument to examine portions of your small bowel that are usually hard to reach with other forms of examination. X-rays of your abdomen can help rule out serious conditions like a perforated colon. CT scans can capture a detailed picture of your entire bowel and surrounding tissue, and MRIs can examine organs and tissues around the anal area or in the small intestine. 

Once your testing has been done, you and your doctor can develop a treatment plan together. There’s no single treatment for IBD – the approach you take will depend on your particular condition, your symptoms and other factors. Fortunately, there are a number of time-tested, proven ways to address your problem, including many that you can begin on your own right away. 

Those treatments usually start with lifestyle modifications. Since we’re talking about a digestive disorder, you’ll definitely want to take a look at how changes to your diet and lifestyle may benefit you. Certain foods are known to trigger symptoms, and by avoiding them, you may be able to prevent flare-ups. 

For example, dairy products are notorious for causing diarrhea, abdominal pain and gas. Other culprits include high-fat foods, spicy foods, alcohol and caffeine, but that’s just the tip of the iceberg when it comes to food sensitivity. A good way to help identify those foods that set you off is to keep a food diary – there’s a free one available on the NAFC website at nafc.org – so you can track your diet and symptoms to see if there are any noticeable links. 

Multivitamins can also be helpful. When you suffer from a digestive disorder, you may not be absorbing all the nutrients you should, and supplementation can help make sure that you’re getting the building blocks you need to stay healthy – but do check with your doctor or dietician first to make sure that what you take is right for you. 

It shouldn’t be a surprise that it’s a good idea to quit smoking, too, because smoking can increase your risk of IBD or make your symptoms worse. 

There’s also a lot of evidence to suggest that stress can aggravate IBD, so it makes sense to do what you can to reduce it. Try exercise, meditation, mindfulness, hobbies, deep breathing or any other technique that you find helpful at lowering the anxiety and tension you feel. 

Then there’s medication. There are a variety of medications that are regularly used to treat IBD, and what your physician prescribes will depend on what form of IBD you have, what your symptoms are, how severe and frequent they are, your health profile and other factors. 

Immunosuppressants work on your immune system to reduce the inflammation that your body produces. Biologics neutralize the activity of certain proteins that cause inflammation. Aminosalicylates are used to fight inflammation in patients with mild-to-moderate UC. Small molecule medications are fairly new drugs for the treatment of moderate-to-severe UC. Rather than act on the immune system in general, they target specific areas, so they’re more focused on intestinal inflammation. Antibiotics may be prescribed in cases where there’s a concern about possible infection – particularly for some forms of UC. Anti-diarrheal medications are an obvious choice if diarrhea is one of your symptoms, and over-the-counter pain killers like Ibuprofen, naproxen sodium and diclofenac are all frequently recommended to help you deal with the discomfort of IBD. But do keep in mind that some of these medications can actually aggravate symptoms, so watch how you respond to them to make sure that you’re not inadvertently making things worse.

If lifestyle changes and medication aren’t enough, though, some patients may opt for surgery to treat their condition. The type of procedure you have will depend on whether you have Crohn’s or UC, how severe your condition is, where in the body it’s located and a number of other factors. 

Many patients have gotten excellent results from a procedure called a bowel resection, where a surgeon removes a damaged portion of the bowel and connects the healthy portions together. While it’s often successful, some patients may require a second procedure around 10 years after the first. 

The preferred surgery for UC today is something called the J-Pouch procedure, where the colon is removed and a pouch is created between the remaining intestine and the anus. This allows you to continue emptying your bowels the way you normally do.

In some cases, more extensive measures are required. A proctocolectomy is where the colon, rectum and sometimes the anus is removed. The surgeon will create a small opening in the abdomen called an “ostomy,” and a bag will be fit over this opening to collect waste. 

Keep in mind that these are only some of the treatments your doctor may recommend. In addition to other approaches that may work for you, new treatments are constantly in development, and there’s hope that there may be even more effective therapies in the near future.  

While you’re treating your physical symptoms, it’s important not to neglect your emotional ones. People living with digestive disorders can experience anxiety, worry, self-doubt and depression – in fact, they’re all common among those with IBD. That shouldn’t be too surprising. Between the discomfort of the symptoms themselves, fears over embarrassment, concerns over finding restrooms, and shame about sharing details with others, IBD has countless ways to make us feel down. 

The good news is that, just like your physical symptoms, there are a number of highly effective treatments for your emotional symptoms, as well. Many patients find that deep breathing exercises, meditation, yoga, acupuncture, acupressure, prayer and other methods for concentration, focus and stress reduction can be particularly helpful. Others find value in cognitive-behavioral therapy, since it’s a type of therapy that’s focused specifically on generating results and helping you develop real-world strategies to overcome your stressors. 

Of course, the best way to overcome all of your issues is by getting treatment that actually works, and that starts by talking with your doctor. That’s not always easy to do – issues around digestive disorders can be very difficult to talk about, which is why we like to remind people that There’s No Shame in Being Human. As we mentioned earlier, there are millions of people out there just like you living with IBD, and there are thousands of doctors across the country who deal with these issues every single day. You are not alone.

If you don’t know where to begin, a great way to start is to simply say to your doctor that you’d like to talk about IBD. Once the ice is broken, you’ll find that the rest of the consultation usually moves along like most any other discussion you have with your physician.  

And if you don’t even have a physician to talk with, you can visit the free Doctor Finder at nafc.org to locate a qualified specialist near you. IBD can be treated, and the sooner you start, the sooner you’ll be on your way to living the life you deserve.