Understanding chronic inflammatory bowel disease, or IBD, can be tricky. The US Center for Disease Control and Prevention, (CDC), explains that it is an umbrella term for “a group of lifelong diseases affecting the intestines. IBD occurs when the body’s natural defense system mistakenly attacks healthy bowel cells. This causes inflammation (swelling) and other damage that does not go away on its own.”
There are two main types of IBD, Crohn’s disease and Ulcerative colitis. .05% of black people have been diagnosed with IBD but that number is steadily increasing, and it is being discovered that black populations have more severe disease outcomes. Common symptoms of both can easily be missed or assumed to be other things, but recognizing the symptoms as a group or related to one another could be the key to a proper diagnosis and getting relief sooner.
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IBD: Cause, Signs and Symptoms
The Mayo Clinic shares that “Inflammatory bowel disease symptoms vary depending on how bad the inflammation is and where it occurs. Symptoms may range from mild to severe. A person with IBD is likely to have periods of active illness followed by periods of remission.”
Common symptoms:
- Belly pain and cramping.
- Blood in the stool.
- Loss of appetite.
- Losing weight without trying.
- Feeling extremely tired.
Though we do not know the exact cause, it is believed to involve:
- Changes to one’s Immune system
- Certain genetic markers
- Environmental triggers like diet, stress, infections.
Chronic vs Inflammatory and the Damage IBD Can Cause
Chronic is defined as lasting a long time, often a lifetime, and Inflammatory is when the body’s immune system causes swelling and damage in the gut. These two factors together lead to the damage that can be caused by IBD. It mistakenly attacks your digestive system, causing:
- Ulcers (sores)
- Damage to the intestinal lining
One of Two Common Forms: Crohn’s Disease
The CDC says that Crohn’s disease “can affect any part of the digestive tract, from the mouth to the anus. It inflames areas of the intestine walls, causing patches of damage that can reach the outer lining.”
There are a few symptoms that set Crohn’s disease apart like diarrhea that is usually not bloody, malnutrition due to the digestive tract becoming inflamed and mouth sores. These symptoms usually come and go in cycles, and the severity depends on the level of damage the intestines have endured.
There are some common complications associated with this disease:
- Ulcers – open sores that result from inflammation. Crohn’s disease ulcers are deep lines that grow outward through the intestine wall.
- Anal fissures – this happens when inflammation creates small tears in the tissue lining the anus. This causes painful bowel movements and discomfort.
Common Ways to Diagnose Crohn’s Disease
There is no single test for Crohn’s Disease. Diagnosis begins with a full medical exam and a combination of tests. According to the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), these tests include:
- Blood and Stool Tests to check for changes in:
- Test for changes in red blood cells. If you have fewer than normal red blood cells, you may have anemia.
- White blood cells. When your white blood cell count is higher than normal, you may have inflammation or infection somewhere in your body.
- C-reactive protein. When your c-reactive protein level is high, you may have inflammation in your body.
- Inflammation and to rule out certain infections.
- Imaging Scans
- Computed tomography (CT) scans, which use a combination of x-rays and computer technology to create images
- Magnetic resonance imaging (MRI), which takes pictures of the body’s internal organs and soft tissues without using x-rays
- Upper GI series, which uses x-rays and a chalky liquid called barium to view the upper GI tract, including the small intestine
- Endoscopy is the most effective way to diagnose Crohn’s
- Colonoscopy, which doctors use to see inside your rectum, colon, and ileum
- Enteroscopy, which doctors use to see inside your small intestine
- Upper GI endoscopy, which doctors use to see inside your esophagus, stomach, and duodenum.
Because of the sometimes-common nature of the symptoms associated with Crohn’s disease, it is important for us to look at them as a group with our HCP, so that the collective test results can be evaluated to ensure a proper diagnosis.
Crohn’s Disease: Treatment and Care
Severity of disease and where in the digestive tract it is located, will determine a your treatment and subsequent care. Though there is no cure, treatment can significantly reduce symptoms and improve your quality of life.
The first and most effective line of defense is medication prescribed by a patient’s medical provider. The Crohn’s and Colitis Foundation shares that “treating Crohn’s disease is designed to suppress your immune system’s abnormal inflammatory response that is causing your symptoms. Suppressing inflammation not only offers relief from common symptoms like fever, diarrhea, and pain, it also allows your intestinal tissues to heal…medication can also be used to decrease the frequency of symptom flare ups (maintaining remission). With proper treatment over time, periods of remission can be extended, and periods of symptom flare ups can be reduced.”
With medication, one’s provider may also suggest nutrition therapy. This could be as simple as avoiding trigger foods (spicy, fatty, dairy for some) and eating smaller portions more frequently. Or it could mean a temporary liquid diet consumed via a feeding tube to help heal any inflammation within the digestive tract.
According to the Crohn’s and Colitis Foundation, “Crohn’s often reduces your appetite while increasing your body’s energy needs. Additionally, common Crohn’s symptoms like diarrhea can reduce your body’s ability to absorb protein, fat, carbohydrates, as well as water, vitamins, and minerals.”
Other times, depending on severity of symptoms, surgery may be necessary. “Surgery often involves removal of the diseased segment of bowel (resection), the two ends of the healthy bowel are then joined together (anastomosis). While these procedures may cause your symptoms to disappear for many years, Crohn’s frequently recurs later in life.”
Key things to know about Surgery:
- Over a span of 5 years, studies have shown that 18% of Crohn’s patients may eventually require surgery. This percentage has significantly declined within the last several years.
- Different types of procedures may be performed depending on the reason, severity of illness, and location of the disease.
- For Crohn’s disease patients, approximately 31% may require a second resection 10 years after their first resection.
It is important to know the signs and symptoms of chronic diseases like IBD and Crohn’s. They can easily be mistaken for more common conditions but understanding them as a collection of symptoms can lead to earlier diagnosis and less severe disease outcome for you or your loved one. Early detection lessens the chance for more long-term damage to the digestive system and intestines, potentially making one’s condition easier to treat over time.
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