Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) represents a group of gastrointestinal disorders which may cause long term inflammation of the gastrointestinal tract (the digestive tract or gut). The gastrointestinal tract consists of the mouth, oesophagus, stomach, small intestine and large intestine. It is responsible for breaking down food, extracting nutrients and removing any residual material and waste products. Therefore, the occurrence of inflammation anywhere along the gastrointestinal tract disrupts the normal process of digesting food. IBD can be very painful and disruptive and may indeed become life-threatening.

There are different types of inflammatory bowel disease, including:

• Ulcerative colitis:
  This is a medical condition which causes inflammation in the large intestine, also called the colon. There are different types of ulcerative colitis depending on the location and severity. These include total/universal colitis, also known as pancolitis, left-sided colitis, proctosigmoiditis and ulcerative proctitis. Signs and symptoms of ulcerative colitis include diarrhoea, bloody stools, abdominal cramps/pain, fever and rectal pain.
• Crohn's disease:
  This type of IBD causes any part of the digestive tract to be inflamed. However, it normally affects the last section of the small intestine and colon. Symptoms of Crohn's disease normally develop gradually and may become worse over time. Symptoms may include diarrhoea, fever, frequent need for bowel movements, loss of appetite and abdominal cramps.

Inflammatory bowel disease's cause is unknown; however, genetics and problems with the immune system may aggravate but are not the cause of IBD. IBD symptoms include diarrhoea, blood in your stool, unintended weight loss and abdominal pain and cramping. To diagnose IBD, Dr Wright will take a detailed history of your symptoms, followed by diagnostic tests, possibly including stool samples and blood tests to check for infections and other diseases. Inevitably you will need an examination of the digestive tract by gastroscopy, sigmoidoscopy, colonoscopy and/or capsule video endoscopy to examine the intestine in order to diagnose IBD. The actual tests done depend on the type and extent of the IBD.

Inflammatory bowel disease treatment involves the prescription of medications such as anti-inflammatory drugs to reduce the digestive tract's inflammation, immune suppressants to prevent the immune system from attacking the bowel and increasingly biological agents aimed at the chemicals that drive the inflammation without the immune-suppression of the older drugs. These new biologicals have almost removed the need for surgery. It may occasionally be needed to remove a narrowed segment of bowel, closure or removal of fistulas, and very rarely in a life-threatening attack to remove a portion or even the entire colon and rectum.