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Inflammatory bowel disease (IBD)

Chronic Inflammatory Bowel Diseases (IBD) are very common and paradoxically not well known. They are generally characterised by recurrent abdominal pain and diarrhoea due to inflammation of the large intestine. How are they diagnosed? What are the causes, symptoms and possible treatments? Find out everything you need to know about IBD in this article.

Chronic Inflammatory Bowel Disease: What is it?

There are two main forms of chronic inflammatory bowel disease (IBD) : ulcerative colitis and Crohn’s disease. These two types of inflammation of the intestine share many similarities to the point where it is sometimes difficult to distinguish between them.

Hemorrhagic rectocolitis and Crohn’s disease: The similarities

Both diseases are characterised by inflammation of the lining of a part of the digestive tract. This is due to the dysregulation of the intestinal immune system. They also share epidemiological, therapeutic and clinical similarities.

Hemorrhagic rectocolitis and Crohn’s disease: The differences

The main difference lies in the location of the lesions.

Hemorrhagic rectocolitis can be recognised by lesions that are confined to the colon and rectum. Although these lesions are superficial, it is important to recognise that they lead to significant bleeding.

Crohn’s disease is localised in the whole digestive tract from the mouth to the anus. In this case, there are larger lesions. As a result, some fistulas, which are still called holes in the wall of the intestine, may appear.

What are the causes of these chronic diseases ?

The causes of IBD are not fully known. However, there are a number of factors that contribute to it.

IBD is unevenly distributed around the world. Compared to the southern hemisphere, the northern hemisphere has the highest frequency. This suggests ethnic or geographical factors. 

There are also genetic factors related to family history

In addition, environmental factors also increase the risk of developing IBD. These include, but are not limited to :

  • Tobacco,
  • appendectomy,
  • food,
  • the psyche (permanent stress),
  • taking aspirin or anti-inflammatory drugs,
  • low sunlight levels and vitamin D deficiency. 

What are the symptoms of IBD ?

The symptoms vary depending on the location of the disease. 

The onset of diarrhoea and chronic abdominal pain is observed in people with Crohn’s disease. In contrast, patients with ulcerative colitis usually have intermittent episodes of abdominal pain and bloody diarrhoea.

In addition, it should be noted that the diarrhoea that patients experience can lead to significant weight loss.

Exceptionally, IBD can attack other parts of the body such as the joints, eyes, mouth, liver, gallbladder and skin.

In addition, areas that have suffered from IBD are generally at risk of cancer.

How can they be diagnosed ?

Diagnosis is not easy, as there is an interference of symptoms between IBD and certain digestive inflammations, such as a parasitic or bacterial infection. 

To do this, two main examinations are carried out.

1 – Stool and blood tests

To identify a possible bacterial or parasitic infection, the doctor analyses the patient’s stool and blood samples. It should be noted that this infection can also be caused by antibiotic treatment.

In addition, the symptoms of sexually transmitted diseases can also be similar to Chronic Inflammatory Bowel Diseases. To avoid confusion of symptoms, the health professional screens the rectum for Sexually Transmitted Diseases (STDs): Gonorrhoea, Herpes virus infection and Chlamydia infection.

2 – Endoscopy with mucosal biopsy

In this case, the doctor uses an endoscopy probe to examine the colon and the end of the small intestine, from which fragments of the mucous membrane are removed and studied in the laboratory under a microscope.

How to treat Chronic Inflammatory Bowel Disease (CIBD) ?

In terms of treatment of IBD, there is no drug to prevent it. Similarly, it should be noted that there is no total cure for IBD. Nevertheless, relative treatment solutions are available and can be divided into three areas: Medication, surgery and a healthy lifestyle.

1 – Anti-inflammatory drugs

Inflammation is the main symptom of IBD. This means that, if left unchecked, the patient’s quality of life is greatly affected. Anti-inflammatory drugs will therefore help to relieve the pain for a time.

For ulcerative colitis, doctors generally prescribe 5-aminosalicylates (5-ASA) in the early stages of the disease and of varying degrees of severity.

2 – Corticosteroids

In the case of Crohn’s disease, health professionals prescribe corticosteroids instead. While the effectiveness is verifiable, there are medium- and long-term side effects, such as weight gain, increased blood pressure and endocrine and bone disorders.

This is why the use of corticosteroids is tending to be reduced in favour of short attack treatments.

3 – Immunomodulatory or immunosuppressive biotherapies

In cases of advanced or progressive disease, doctors prescribe immunomodulatory or immunosuppressive therapy. The aim is to regulate the patient’s immunity and reduce inflammation in the long term.

Moreover, when the various treatments have been ineffective, surgery is used as a last resort.

Furthermore, studies have shown that despite the various drug and surgical solutions, the secret to better treatment of IBD is and remains good nutrition, stress management and health maintenance.

However, it is important to know that IBD increases the risk of contracting other infections or severe bacteria. For this reason, patients are advised to keep up to date with their various vaccinations and to repeat the various diagnostic tests.

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