Inflammatory Bowel Diseases (IBD) refers to chronic conditions that cause inflammation of the gastrointestinal tract. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease.
Both illnesses are marked by an abnormal response by the body’s immune system. Normally, the immune cells protect the body from infection. In people with IBD, however, the immune system mistakes food, bacteria and other materials in the intestine for foreign substances and it attacks the cells of the intestines. In the process, the body sends white blood cells into the lining of the intestines where they produce chronic inflammation. When this happens, the patient experiences the symptoms of IBD, including diarrhea, abdominal pain and blood in the stool.
IBD affects 1.4 million adults in the U.S. and is typically diagnosed in people ages 15 to 30. The incidence has grown approximately 20 percent in the last decade. A genetic condition, IBD expresses itself when exposed to something in the environment. “No one’s been able to really figure out what that environmental exposure is” that’s causing the increase in incidence,” says Dr. David Schwartz, director of the Inflammatory Bowel Disease Center at VanderbiltUniversity Medical Center in Nashville, Tenn.
Because symptoms mimic the more-common and less-serious irritable bowel syndrome (IBS)—and because the embarrassing nature of symptoms may make patients less likely to seek medical advice—there is typically a 3- to 5-year delay in diagnosing the disease. The wait can have devastating affects beyond a young person’s physical health, Schwartz says. “This is a disease that affects people right at the point when they should be kind of taking off and enjoying life and figuring out who they are, and they’re having to deal with these symptoms which can be terribly debilitating,” he says. “You need to tell your doctor exactly what’s going on so they can be better able to make a diagnosis. And if
If doctors suspect IBD, they typically recommend a colonoscopy, in which the colon and intestines are examined for inflammation and ulcers in the colon, for ulcerative colitis, or in the colon or small intestine for Crohn’s disease.
New technology is helping research get closer to finding out what causes IBD. “One of the things that may lead to IBD is differences in the types of bacteria one person has versus another,” Schwartz says. Technological advances now allow researchers to study and map bacteria in individuals. “There are twin studies now where one twin will have IBD and one will not, and we’re looking to see their bacterial differences.”
Current treatments include medications to keep the immune system from attacking the intestines and to control the inflammation in the bowel. Researchers are exploring complementary treatments including fish oil supplements, probiotics (the beneficial bacteria found in yogurt), and acupuncture.
“This is an incredibly exciting time to be taking care of people with IBD because in the last five years, we have more and more therapeutic options and our understanding of the disease has improved so much,” Schwartz says. “We’re getting better at identifying people that may or may not respond to certain therapies, and also predicting who’s going to have more aggressive disease over their lifetime.”