Inflammatory Bowel Disease (IBD) is a collection of autoimmune diseases that affect the gastrointestinal tract. The 2 main types of IBD are Crohn’s disease (CD) and ulcerative colitis (UC). In CD, inflammation occurs throughout the entire GI tract, anywhere between the mouth and anus. It typically affects the small intestine and the top part of the large intestine. Inflammation can occur in patches and can penetrate all layers of the GI tract. UC is mainly concentrated in the colon. In this disease, inflammation is a continuous thread that only affects the innermost lining of the colon. Inflammation occurs when the body’s immune system attacks the healthy tissue in the GI tract. While the inflammation patterns are different, the symptoms of both UC and CD are very similar According to a 2016 study, approximately 1.2 million adults and 57k children live with IBD in the U.S.
What are the signs and symptoms of IBD?
Individuals with IBD experience symptoms only when their disease is flaring, or active. So, in some cases, symptoms can come and go, making it difficult to diagnose early on. Some of the most common symptoms include:
- Abdominal pain
- Diarrhea, sometimes with blood
- Bowel urgency or fecal incontinence
- Rectal bleeding
- Weight loss
- Anemia
- Malnutrition
- Anxiety and depression
Other symptoms that may happen that are unrelated to digestion include:
- Arthritis or stiff joints
- Mouth sores and ulcers
- Fatty liver
- Eye inflammation and redness
- Poor blood circulation
If inflammation goes on for too long and it is not controlled, people can develop:
- abscesses, which happens when inflammation gets too deep and tears into intestinal wall,
- Strictures – or narrowing of the intestinal tract, or
- Fistulas – abnormal connections or tunnels form between 2 organs that should not be there.
How is it diagnosed
As with any autoimmune disease, getting an IBD diagnosis can be totally overwhelming and complicated. No single test will confirm these diseases, so your doctor will likely do a series of tests and evaluations. Your doctor will do a thorough medical history assessment, ask about your diet, lifestyle, and family history.
Getting a diagnosis of IBD requires multiple tests. The initial tests are typically the less invasive ones – blood tests and stool tests. Additional testing will include either a colonoscopy (UC) or an endoscopy (CD). Your doctor may also do additional imaging using an MRI or x-ray.
Some of the common blood tests include c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) – both are markers for inflammation. Stool tests look at calprotectin and lactoferrin, both are markers for GI inflammation.
Endoscopy or colonoscopies will take samples of your tissue and analyze them for mucosal or tissue damage, or abnormal cells.
It’s important to mention that there are 2 other forms of IBD. One is called microscopic colitis, where inflammation is only visible through a microscope. The other is indeterminate colitis. This condition has features of both UC and CD.
Getting a diagnosis of IBD requires multiple tests. The initial tests are typically the less invasive ones – blood tests and stool tests. Additional testing will include either a colonoscopy (UC) or an endoscopy (CD). Your doctor may also do additional imaging using an MRI or x-ray.
Some of the common blood tests include c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) – both are markers for inflammation. Stool tests look at calprotectin and lactoferrin, both are markers for GI inflammation.
Endoscopy or colonoscopies will take samples of your tissue and analyze them for mucosal or tissue damage, or abnormal cells.
It’s important to mention that there are 2 other forms of IBD. One is called microscopic colitis, where inflammation is only visible through a microscope. The other is indeterminate colitis. This condition has features of both UC and CD.
Medications and other treatment options
There are a few classes of drugs that are used to target inflammation in IBD patients. These include:
- Corticosteroids: these are powerful anti-inflammatory medications that are used on a short-term basis to stop symptoms. This includes prednisone.
- 5-Aminosalicylic Acid Medications (5-ASAs): these are used for mild to moderate IBD and are typically more effective for UC. They work on inflammation and help lessen diarrhea and abdominal pain.
- Immunomodulators: These medications suppress certain parts of the immune system so it stops attacking the GI tissues. These are usually taken after corticosteroids, and when symptoms are more manageable.
- Biologics: These medications also stop certain parts of the immune system from overreacting. These are often longer-term medications that may be combined with immunomodulators.
Along with or instead of medication, diet, and lifestyle can go a very long way to help relieve symptoms of IBD. In terms of diet, there are several options to choose from.
Mediterranean diet
The easiest diet to start off with is the Mediterranean diet, which is really great at reducing inflammation. This eating pattern includes fish, fruits, vegetables, whole grains, healthy fats from nuts and olive oil, and limited amounts of dairy and red meat.
Paleo diet
The next option is a paleo diet, with the more restrictive option as the autoimmune protocol elimination diet. Small studies have reported remission in just 6 weeks of following the AIP diet in patients with IBD.
Specific Carbohydrate diet
Lastly, there’s the specific carbohydrate diet. This diet removes hard to digest carbohydrates to improve digestion and reduce inflammation. There are smaller studies that show this diet is effective in IBD patients. This diet excludes foods like grains, starchy tubers, canola oil, all dairy products, candy, chocolate, some beans, and sugars. It includes foods like fish, meat, shellfish, eggs, certain legumes, certain cheeses, most vegetables, most nuts, honey, and most oils.
If you are living with IBD and are interested in trying a diet change, please reach out to me or other qualified health professionals to see what options are right for you. As always, you can find more information about IBD and other autoimmune diseases here, or on my social media channels – instagram, facebook and YouTube .
