Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is a chronic condition that causes inflammation of the gastrointestinal tract. The two main types of IBD are Crohn's disease and Ulcerative colitis.

IBD is different from irritable bowel syndrome (IBS). IBD involves ongoing inflammation within the bowel and can lead to complications affecting both the digestive tract and other parts of the body.

The exact cause of IBD is not fully understood, but it is thought to result from an abnormal immune response occurring in genetically susceptible individuals.

Crohn’s Disease

Crohn’s disease can affect any part of the gastrointestinal tract from the mouth to the anus, although it most commonly affects the small bowel and colon. Inflammation can involve the full thickness of the bowel wall and may occur in patches with normal bowel in between.

Crohn’s disease may lead to complications including:

  • Strictures (narrowing of the bowel)

  • Fistulas

  • Abscesses

  • Perianal disease

Ulcerative Colitis

Ulcerative colitis affects the large bowel (colon and rectum). Inflammation involves the inner lining of the bowel and usually begins in the rectum before extending further into the colon.

Symptoms are often related to inflammation of the rectum and colon lining.

Symptoms of IBD

Symptoms can vary depending on the severity and location of inflammation and may include:

  • Abdominal pain

  • Diarrhoea

  • Rectal bleeding

  • Urgency to open the bowels

  • Weight loss

  • Fatigue

  • Loss of appetite

  • Fevers

Some patients experience periods of active disease (flares) alternating with periods of remission.

IBD can also affect other parts of the body and may be associated with:

  • Joint pain

  • Skin conditions

  • Eye inflammation

  • Liver disorders

Diagnosis

Diagnosis of IBD involves a combination of clinical assessment, blood tests, stool tests, imaging, and endoscopic procedures.

Investigations may include:

  • Colonoscopy

  • Gastroscopy

  • MRI or CT scans

  • Capsule endoscopy

  • Biopsies of the bowel lining

These tests help determine the type, extent, and severity of inflammation.

Treatment

Treatment aims to control inflammation, improve symptoms, and maintain long-term remission.

Management may include:

  • Dietary and nutritional support

  • Anti-inflammatory medications

  • Immunosuppressive medications

  • Biologic therapies

  • Steroids during flares

Many patients with IBD can be managed successfully with medication alone.

Surgery

Surgery may be required for complications of IBD or when medical treatment is no longer effective.

Reasons for surgery may include:

  • Strictures causing bowel obstruction

  • Fistulas or abscesses

  • Severe colitis

  • Dysplasia or cancer

  • Poor symptom control despite medical therapy

Surgical treatment depends on the type and extent of disease and is tailored to the individual patient.

Long-Term Care

IBD is a chronic condition that requires ongoing monitoring and follow-up. Management is often coordinated through a multidisciplinary team including gastroenterologists, colorectal surgeons, dietitians, specialist nurses, and other healthcare professionals.

With modern medical and surgical treatments, many people with IBD are able to achieve good long-term symptom control and maintain a high quality of life