What is Inflammatory Bowel Disease?

Inflammatory Bowel Disease (IBD) is the term used for a collection of disorders where the intestines become red and swollen (inflamed). This happens when an immune reaction of the body is against its own intestinal tissue.

In a more personal tone, Inflammatory Bowel Disease (IBD) is the term used for a collection of disorders where the intestines become red and swollen (inflamed). This happens when an immune reaction of the body is against its own intestinal tissue. IBD includes Crohn's disease and ulcerative colitis.

Types Of Inflammatory Bowel

Inflammatory bowel disease can be chronic, lifelong conditions that cause recurring inflammation in the digestive tract. The two major types of inflammatory bowel disease are ulcerative colitis and Crohn’s disease. The diseases cause sores (ulcers) in the digestive tract and inflammation which results in extreme pain in the patient.

• Ulcerative Colitis:Ulcerative colitis is a type of an inflammatory bowel disease that causes long lasting inflammation in a part of digestive tract. Ulcerative colitis involves the innermost lining of large intestine (colon) and rectum. It occurs only through continuous stretches of colon and may lead to bleeding, infections and scarring of the area involved.
• Crohn’s Disease:Crohn's disease is an inflammatory bowel disease that causes inflammation along the lining of the digestive tract. This can lead to abdominal pain, severe diarrhea, and malnutrition. It can affect any area of the intestines, from mouth to anus. Collagenous colitis and lymphocytic colitis are also considered inflammatory bowel diseases, but they are usually regarded separately from classic inflammatory bowel disease.

Signs And Symptoms

When IBD flares up in the case of chronic diseases, it can lead to different symptoms that can sometimes disappear or decrease and a person can return to their normal health. The main signs and symptoms for both the type of inflammatory bowel are same. Some of the symptoms are as:

• Symptoms related to inflammation of the GI tract
• General symptoms that may also be associated with IBD

Diagnosis For Inflammatory Bowel Treatment

• If a patient has severe bleeding then hemoglobin level may drop and the count of the red blood cells decrease.
• An inflammation in the body occurs when there is an increase in the count of white blood cells.

The tests depend on the symptoms of IBD that include:

• Blood test:Blood tests are done to know the presence of certain antibodies that can sometimes help diagnose which type of inflammatory bowel disease you have, but these tests cannot make the diagnosis.
• Colonoscopy:Colonoscopy is a safe, non-invasive procedure where a thin, flexible lighted tube is gently inserted into the rectum and slowly advanced until it reaches the entire length of the colon. This exam allows your doctor to view the inside of your entire colon using a thin, flexible lighted tube with an attached camera. During the procedure, small samples of tissue (biopsy) for laboratory analysis are sometimes taken to further investigate any suspicious areas found during your exam.
• X-Ray:A standard X-ray of abdominal area will rule out toxic mega colon or a perforation of the colon if these conditions are suspected because of severe symptoms.
• Flexible sigmoidoscopy:It is a procedure in which a doctor uses a slender, flexible, lighted tube to examine the last portion of colon. The doctor inserts the tube through the rectum and into the lower part (sigmoid colon) of the large intestine.
• Barium enema:A barium enema is a medical test that allows doctors to examine the inside of the large intestine using X-rays. It may also be called a barium swallow or a barium contrast enema. A barium enema combines barium sulfate, a contrast agent and water into an instant, thickened liquid called a suspension. This suspension is given to you either orally or through an enema. Once in your colon, it coats the walls of your colon with a white coating, creating an X-ray image for doctors to review.
• Computerized tomography (CT) scan:If your doctor suspects a complication from ulcerative colitis or inflammation of the small intestine that might suggest Crohn’s disease, you may need a CT scan. A CT scan is also used to find out how much of your colon is inflamed.
• Stool sample: The presence of white blood cells in the stool may indicate an inflammatory disease, including IBD. This stool sample can be used to rule out other disorders, including those caused by bacteria, viruses, and parasites.
• Magnetic resonance imaging (MRI): MRI is short for magnetic resonance imaging. The MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. During the test, the patient lies on a movable table inside the MRI machine. This test is helpful in diagnosing and managing Crohn’s disease. Its biggest advantage is that there is no radiation exposure. Its particularly useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MRI enterography).
• Capsule endoscopy: The doctor may perform capsule endoscopy. For this test patient needs to swallow a capsule that has a tiny camera in it. The camera takes pictures as it moves through the digestive tract, and the images are transmitted to a computer. The doctor can see the images, which are then displayed on a monitor and checked for signs of Crohn’s disease. Once it has made the trip through the digestive system, the camera exits the body painlessly in stool
• Double-balloon endoscopy: Double-balloon endoscopy is a procedure used in specialized endoscopy centers. For this test, a longer scope is used where standard endoscopes do not reach. It allows for biopsy of the abnormal area

Causes Of Inflammatory Bowel

IBD is an inflammatory disease of the gastrointestinal tract, which can lead to ulcerative colitis and Crohn’s disease. The exact cause of IBD is unknown. However, researchers believe that it could be due to a malfunctioning immune system and there are various triggers that can set off the symptoms. This includes faulty immune system, genetic make-up, environment, and emotional stress.

Treatment

Your treatment will depend on how severe the symptoms are, and how much of your gut is affected. Your doctor may prescribe medications that reduce inflammation in the gut and bring relief from symptoms. These anti-inflammatory drugs include steroids, 5ASA drugs and immunosuppressants such as azathioprine, methotrexate and ciclosporin. More commonly, treatment of IBD is through mesalazine. If your condition does not improve with medicines, then you may be required to undergo surgery. Some IBD

Surgery may be used to treat Crohn’s disease that is not responding to medications. Some people may need surgery to remove a damaged or diseased part of the intestine. In some cases, the entire large intestine is removed, with or without the rectum. People who have Crohn’s disease that does not respond to medications may need surgery to treat problems such as:

• Bleeding
• Failure to grow (in children)
• Fistulas (abnormal connections between the intestines and another area of the body)
• Infections
• Narrowing of the intestine

Surgeries that may be done include:

• Ileostomy
• Removal of part of the large bowel or small bowel (link to surgery)
• Removal of the large intestine to the rectum
• Removal of the large intestine and most of rectum
• Bowel resection
• Strictureplasty
• Temporary or permanent colostomy or ileostomy.

IBD Treatment Cost in India

Inflammatory Bowel Disease is a chronic disease without treatment. Patients have to spend a huge amount for the treatment of IBD. In India, usually IBD treatment cost around USD 1500 to 25225 (INR 118956 to 2000000). Additional costs are required for consultation fees, various diagnostic tests, etc.

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