Inflammatory Bowel Disease

More than 1.5 million Americansnearly one in every 250 people – are currently living with inflammatory bowel disease (IBD). IBD refers to two related but different diseases: Ulcerative Colitis and Crohn’s disease, which cause chronic inflammation of the intestinal tract. By increasing awareness about these conditions, research into new treatment options may be advanced, improving the lives of individuals with IBD.


Though the exact cause of the condition is not known, inflammatory bowel disease is thought to occur when the body’s immune cells attack the intestine. According to experts, there may be an initial trigger, such as an infection or something taken in from the diet or environment, that activates this immune response. IBD is frequently viewed a spectrum, as some patients exhibit symptoms associated with both UC and Crohn’s disease. The inflammation seen in Ulcerative Colitis (UC) occurs only in the large intestine (colon) and is limited to the inner lining of the intestinal wall. In contrast, Crohn’s disease can involve any portion of the intestinal tract from the mouth to the anus but is frequently confined to the terminal portion of the small intestine (ileum). While Crohn’s and UC affect different areas of the digestive system, both are marked by diarrhea, rectal bleeding, urgency to have bowel movements, abdominal cramps and pain, fever, and weight loss. In addition to painful and frequently debilitating symptoms, individuals with IBD can experience complications of their condition including bowel obstruction, ulcers, and malnutrition.

Treatment options for Crohn’s and UC are frequently limited to anti-inflammatory, immunosuppressant, and steroid-based medications. These medications are used to control acute attacks or “flare ups”, prevent repeated attacks, and help the colon and intestinal tract to heal. In addition, UC can sometimes be treated through surgical removal of the affected portion of the bowel, after which patients may require an ileostomy to allow waste to leave the body. Because Crohn’s disease frequently spreads deep into the layers of affected bowel and intestinal tissue, surgical removal of the affected regions is often not possible.

Experts continue to strive to identify new treatment options for individuals with IBD. New research suggests that while UC and Crohn’s affect a relatively high rate of individuals in the U.S., the conditions are extremely rare in the developing world. According to some experts, there may be a correlation between parasitic worm (helminth) infection – which is common in the developing world but not in the United States – and the number of patients presenting with UC. Though the practice is not recommended, Dr. Joel Weinstock, chief of gastroenterology at Tufts University Medical School, notes that some UC patients have seen relief from symptoms after ingesting the trichuris suis worm, a parasite that lives in the intestines of pigs. Researchers are also investigating the use of live bacterial cultures (probiotics), including a genetically altered version of the common bacteria Lactobacills acidophilus, which have been found to nearly eliminate colon inflammation in rodent studies.

While experts work to develop new treatments, individuals with IBD can manage their condition using medications and monitoring their diet to avoid foods that exacerbate their symptoms. Participating in support groups, either online or in person, can help some individuals with IBD learn more about their condition, ways to cope with it, and available treatment options.

 

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