A Pain in the Gut

A Pain In The Gut

What's the worst physical pain you have ever experienced? Now imagine that pain times ten. This is the type of stomach/digestive pain experienced on a daily basis by sufferers of Inflammatory Bowel Disease, also referred to as IBD.

There are two main types of IBD. Ulcerative colitis (UC) and Crohn's disease (CD), both with very similar symptoms, and both with varying levels of severity from mild to very severe. Although there is no cure, IBD can be treated and the sooner you reach a diagnosis the better.

Crohn's disease is a chronic inflammatory disorder of the intestines which can affect any area of the gastrointestinal tract, from the mouth to the anus. This inflammation often results in a wide array of symptoms as the swelling extends deep into the lining of the affected organ causing pain, vomiting, diarrhea, and in some cases, constipation due to internal strictures. Among the internal, symptoms can come complications outside the GI tract. Problems such as skin rashes, tiredness, arthritis, and inflammation of the eye can also arise.

As the symptoms of Crohn's disease are similar to other intestinal disorders such as Irritable Bowel Syndrome, Celiac Disease and Ulcerative Colitis, it can be very difficult to diagnose. Ulcerative Colitis results in ulcers and inflammation within the top layer of the lining of the large intestine, whereas, in Crohn's disease, all layers of the intestine may be affected, and in-between areas of diseased bowel normal healthy sections can be found.

Crohn's disease can appear in any age group, but is most commonly diagnosed between the ages of 20 to 30 years old. It's considered to be an autoimmune disease and like with any autoimmune disease, genetic factors are thought to play a role in a person's susceptibility to developing the disease. Up to 5% of those with Crohn's have one or more affected relatives and Crohn's now affects seven out of every 100,000 people and is thought to be two to three times more common in those of Jewish descent. The number of genes linked to the predisposition of Crohn's disease has gone from 21 to 32, but a defect in these genes alone does not cause the disease; this means genetics is just one factor that plays a role in determining whether or not someone may have Crohn's.

A number of different procedures ranging from colonoscopies and gastroscopies, CT and MRI scans, Barium X-rays and blood tests may be needed to aid in making an official diagnosis. Even with an extensive amount of tests, it may not be ever be possible diagnose Crohn's with 100% certainty. Disease in the small bowel is particularly difficult to diagnose as a colonoscopy only permits access to the colon and lower parts of the small intestines. In this case a capsule endoscopy procedure may be required. This involves a patient swallowing a tiny pill with a micro mini camera attached to it. As the pill travels down the GI tract, it is able to snap pictures of the digestive system and examine areas of the small bowel that cannot be reached by other internal procedures.

When it comes to treatment options, as their symptoms can offer mimic each other, it's important to distinguish between UC and CD. The course of these diseases and treatments may differ and in some instances, it's not always possible to tell the difference. In this case the disease is given the term indeterminate colitis.

As Crohn's cannot be cured, sufferers will have 'flare ups' followed by periods of remission that can last for days, weeks, months, sometimes even years. Remission may not always be possible or prolonged if achieved. Relapse can be prevented and symptoms can be managed with medication, lifestyle changes and for some, surgery may be necessary, not an option.

Treatment for Crohn's disease first involves treating the acute problem, then maintaining remission. Acute treatment involves medication to treat any infection (antibiotics) and to reduce inflammation (aminosalicylates, anti-inflammatory drugs and/or corticosteroids). As corticosteroids usually have significant side effects they are generally not used as a long-term treatment option. When symptoms subside, maintenance of remission through treatment without symptoms reoccurring is the goal. Doctors and specialists will work out treatment plans based on a patient's symptoms and the severity of their disease. It's quite common for people with IBD to require a mixture of medications to achieve the best results.

Along with medication, lifestyle changes can also help to reduce symptoms. Regular exercise with a healthy diet and enough sleep will all contribute to helping sufferers gain back some of the control lost over their health. Even though this can be a debilitating disease, people with IBD can and do go on to lead normal, healthy and active lives.

Karli