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Inflammatory Bowel Disease

Dr. Joseph Tharakan - Hadi Clinic
Wednesday, November 18, 2020
Inflammatory Bowel Disease

Inflammatory bowel disease( IBD ) is a term generally used to describe 2 conditions:

Ulcerative Colitis(UC) and Crohn's disease(CD)

These are long term conditions that involve the bowel and occasionally other organs like the joints ,eyes and skin.

While UC only affects the colon(large bowel) Crohn's can affect any part of the digestive tract from the mouth to the anus

While the condition is usually found between the ages of 15 and 45, any age can be affected.

The disease is more common in the northern hemisphere as compared to the southern but increasing prevalence is being noted all over the globe with better detection and awareness.

What causes it

Genetics

Changes in the gut flora

Problems with the immune system

Environmental factors like smoking

Symptoms

The main symptoms of IBD are

crampy pain in the abdomen

recurring or bloody diarrhea

weight loss

malaise and lethargy

In Crohn's disease you could also get arthritis like pains, painful red eyes, red skin nodules and occasionally jaundice

The course of the disease is fluctuant and can come and go. At times it can be severe(flare) followed by long periods of no symptoms(remission)

Diagnosis

The diagnosis is usually made with an endoscope (gastroscopy and colonoscopy).Biopsies can be taken of the inflamed areas and sent for examination.

Other supportive modalities for diagnosis include Ultrasound, CT scans and occasionally MRI of the abdomen

Blood tests may show a raised white cell count or a high C reactive protein or ESR and occasionally changes in liver and kidney function tests.

Treatment

There is currently no cure for IBD

Mild UC may need no or minimal treatment

Medicines used to treat IBD include

Aminosalicylates or Mesalazines

Immunosuppresants such as steroids, azathioprine or cyclosporine

Biologicals -antibody based treatments that target a specific part of the immune system

Occasionally antibiotics

Course of the disease

About 20% of patients with UC may need surgery at some point in their lives which involves removing all or part of the colon while the corresponding figure for Crohn's disease is 60-75%

There is also a slightly increased risk for bowel cancer as well in long standing cases of IBD for which

Dr. Joseph Tharakan

Consultant Internal Medicine

Hadi Clinic

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