Inflammatory Bowel Disease (IBD)

Symptoms of IBD include:

• Pain, cramps and swelling in the tummy
• Recurring diarrhoea or bloody diarrhoea
• Weight loss
• Extreme tiredness

Not all IBD patients have all of these symptoms and if they do, not all at once. Some people may get additional symptoms including fever, vomiting, anaemia as well as painful joints, skin rashes and sore eyes.

The symptoms of IBD can come and go. There may be times where you get a ‘flare-up’ and symptoms are more severe, followed by long periods when there are few symptoms or none at all.

See here for more detail on the symptoms of ulcerative colitis and the symptoms of Crohn’s disease.

Despite much research, we still don’t know exactly what causes IBD. Current understanding is that is caused by a combination of genetics (the unique DNA instructions passed on to you from your parents which make you individual) and an altered immune system, which changes how your body handles microbes. Other factors such as diet, where you live, medications and stress may also play a role. People who smoke are twice as likely to get Crohn’s disease than non-smokers. Ulcerative colitis tends to be more common in non-smokers and ex-smokers than current smokers – but the risks of smoking clearly outweigh the benefits seen in colitis.

IBD is not the same as irritable bowel syndrome (IBS), which is a common condition that affects the digestive system, although the symptoms can be similar. IBS is a problem with how the bowel works, but there is no inflammation and it is not dangerous, although the symptoms can be troublesome and uncomfortable.

Typical IBS symptoms include:

• Bloating
• Stomach pain
• Constipation
• Diarrhoea

Three quarters of patients with IBS are able to manage their symptoms more effectively after learning more about their condition and trying a combination of changes to diet, lifestyle and medications suggested by their GP.

There is currently no cure for IBD. If you have only a small amount of mild inflammation, especially with ulcerative colitis, you may need minimal or no treatment and remain well for prolonged periods of time.

Treatment to manage and relieve symptoms of IBD includes lifestyle changes such as diet, medicines or possible surgery.

Medicines that are used to treat ulcerative colitis or Crohn’s disease include:

• Aminosalicylates (5-ASAs) – these drugs reduce inflammation in the lining of the gut and help prevent relapses. They are mostly used in mild-moderate ulcerative colitis, although sometimes they work for Crohn’s disease which is limited to the colon. They include mesalazine (Asacol, Ipocol, Octasa, Pentasa, and Salofalk), olsalazine (Dipentum), sulphasalazine (Salazopyrin) and balsalazide (Colazide).
• Corticosteroids (steroids) – work by blocking the substances that trigger inflammation. They include prednisolone, budesonide, hydrocortisone and methylprednisolone.
• Immunosuppressants – help reduce the activity of the immune system. They include azathioprine, mercaptopurine, methotrexate as well as less commonly used ciclosporin and tacrolimus.
• Biologics and small molecules – these drugs target specific parts of the processes which cause inflammation. Some are injected by patients, others given as infusions in hospitals and some come as oral tablets.

You can read more on the treatments available for ulcerative colitis and Crohn’s disease here.

People with ulcerative colitis and Crohn’s disease of the colon are also at a higher risk of developing bowel cancer – although this risk differs from patient to patient and depends also on family history, time since IBD diagnosis as well as other factors. Your hospital specialist will be able to recommend whether you need regular bowel check-ups (colonoscopies) to reduce the risk.

Click here to watch a video from NHS Choices detailing what happens during a colonoscopy.

Living with IBD | https://www.crohnsandcolitis.org.uk

Crohns & Colitis UK | published 22 August 2014

Schooling with Crohn’s disease | https://www.crohnsandcolitis.org.uk

Crohn’s & Colitis UK | published on 20 November 2017

Relationships with Crohn’s & Colitis | https://www.crohnsandcolitis.org.uk

Crohn’s & Colitis UK | published on 20 November 2017

It takes guts Fix on look around on ITV border | http://www.fixers.org.uk/

Fixers UK | published on 16 February 2016