All You Need to Know About Inflammatory Bowel Disease (IBD)

What is inflammatory bowel diseases?

Inflammatory bowel disease (IBD) is a condition that exists in two different forms. The first, Crohn's disease is the result of inflammation in all the layers of our intestine. Ulcerative colitis occurs when inflammation irritates the inner lining of the large intestine or colon. Both, however, inflict pain and discomfort in millions of people across the world. There can also be cases where the source of inflammation is a mix of the two sub-conditions. Although rare, this is referred to as indeterminate colitis.

Those living with IBD can have any of the following, all with varying degrees of severity. Reduced appetite, unplanned weight loss, extreme tiredness, diarrhoea, abdominal pain and blood in their stool. When symptoms persist, it is commonly called a flare.

In worst case scenarios, IBD will last for decades, making it a chronic disease. Reassuringly, the condition can be managed with medication aimed at turning down the bodies immune response. In roughly 25% of cases, IBD is diagnosed before turning twenty years old, although some people are not diagnosed until their fifties. Given the prevalence of the condition in children, it can be incredibly impactful on their ability to live a normal teenage life.

Many people assume that IBD is the result of a poor diet. One laden with junk foods and sugary treats. While those types of food are certainly not beneficial to a healthy lifestyle, the cause of IBD is actually an over-enthusiastic immune system.

In a typical scenario, our immune system would spring into action whenever infection or bacteria is detected. An inflammatory response from our immune system is a natural and necessary part of human survival. Inflammatory bowel disease occurs when our immune system stays over-activated despite there being little to no infection or bacteria.

One of the most significant challenges of IBD is not knowing how it starts or what causes it to develop in the first place. Therefore, the primary goal of treatments will be to reduce inflammation, thus reducing symptoms, and restoring a healthy quality of life for patients.

Our immune system is involved

The difficulty in treating IBD comes from its links to the immune system. Our immune system is integrated with some many other areas of our body, that pinpointing the exact trigger has proven a significant challenge for modern medicine. Because we don’t know what causes the condition to develop, we also don’t (yet) have a cure for inflammatory bowel disease. Even though IBD may be challenging to treat, that doesn't mean we cannot learn more about what is happening inside our bodies when the condition occurs.

Preliminary research points to two types of problem with our immune system. The first, “immune-mediated” is much like the example we used above. Our immune system is working around the clock, trying to deal with infections even when they have passed. The second, “autoimmune”, is when our immune system becomes confused. It can see the healthy bacteria in our digestive system as a threat, rather than a benefit, and start attacking it. Generally speaking, Crohn’s disease is linked to immune-mediated conditions, while UC is closely aligned with autoimmune issues.

Two types of IBD - Crohn's disease and ulcerative colitis

Crohn’s disease

Despite being linked by issues with our immune system, there is some difference between the two conditions. The inflammation from Crohn’s can occur anywhere from the lips to the anus. Imagine the path food would need to take through your body when you eat. At any point in that journey, a built up of inflammation will irritate and lead to the symptoms we mentioned above.

Complications from Crohn’s include the development of fistulas. This is when an ulcer connects two parts of the intestinal wall. The narrow passageway created is prone to infections and the formation of an abscess.

Ulcerative colitis

Ulcerative colitis is more typically more localised. It tends to cause excess inflammation in the colon, rather than throughout the digestive system. Symptoms remain very similar to Crohn’s, but onset is typically more acute rather than the chronic discomfort associated with Crohn’s. Ulcerative colitis is still severe though, creating long-lasting inflammation. A perforated colon is one of several risks linked to UC. Often the perforation is caused by a rapid widening and swelling of the colon.