If you, a family member or loved one, suffer from IBD (Inflammatory Bowel Disease) you know how debilitating it can be, and how it can control your life. However, while there is no known cure, there is help.
Well-Being explored the intricacies of this chronic, but treatable condition with Dr. Jane-Claire Williams, Gastroenterologist at GI Associates of Jackson, Madison and Vicksburg.
What is IBD?
First, it is important to understand that IBD does not refer to one specific disease, but is a general term used to describe several chronic, recurring immune response conditions, which involve inflammation of the gastrointestinal tract. Two of the most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease.
“Ulcerative colitis, which is more common in men, and Crohn’s disease, which is generally more common among women, are both serious conditions that can completely disrupt a person’s normal activities during flare-ups,” notes Dr. Williams. “They affect a person’s daily life, and involve extreme symptoms that are so severe they can wake you up from a sound sleep.”
Both illnesses have one strong factor in common. They 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.
What is Crohn’s disease and how does it affect the digestive tract?
Crohn’s disease is a condition of chronic inflammation potentially involving any location of the gastrointestinal tract, but frequently affecting the end of the small bowel and the beginning of the large bowel. In Crohn’s disease, all layers of the intestine may be involved and there can be normal healthy bowel between patches of diseased bowel.
Symptoms include persistent diarrhea (loose, watery, or frequent bowel movements), cramping abdominal pain, fever, and, at times, rectal bleeding. Loss of appetite and weight loss also may occur. Fatigue is another common complaint.
“The medications we use to treat Crohn’s disease include aminosalicylates (5-ASA), steroids, immune modifiers (azathioprine, 6-MP, and methotrexate), antibiotics (metronidazole, ampicillin, ciprofloxin, others), and biologic therapy (inflixamab),” adds Dr. Williams. “Sometimes it takes a little time to get just the right combination for a patient, but it is worth the effort when we can effectively treat flare-ups and maximize the times between, when patients can carry on their daily activities and enjoy a better quality of life.”
What is ulcerative colitis and how does it affect the digestive tract?
Ulcerative colitis affects the large bowel (the colon). The first symptom is a progressive loosening of the stool. The stool is generally bloody and may be associated with cramping abdominal pain and severe urgency to have a bowel movement. The diarrhea may begin slowly or quite suddenly. Loss of appetite and weight loss are common, as is fatigue. In cases of severe bleeding, anemia may also occur. Children with ulcerative colitis may fail to develop or grow properly.
Some patients with ulcerative colitis may have mild to moderate symptoms, but others may suffer from severe abdominal cramping, bloody diarrhea, nausea, and fever.
“As with Crohn’s disease, the symptoms of ulcerative colitis tend to be intermittent, with fairly long periods between flare-ups when patients may not experience any unpleasant symptoms, notes Dr. Williams. “Aminosalicylates, steroids, immune modifiers, and antibiotics also can be effective in the treatment of ulcerative colitis.”
Important steps for living with IBD
• Work with your healthcare provider to develop a treatment plan.
• Get help from your physician or a nutritionist to develop a dietary regimen that works for you.
• Follow your treatment plan carefully.
• Pay attention to your body. At the first sign of the onset of a flare-up, follow the steps your healthcare professional has recommended.
So what’s the take-away?
“Sometimes patients with IBD will eventually need to have surgery, but our options for treatment with medications are fairly extensive, so that is the first step,” Dr. Williams explains. “When we can treat a young person early on, and help them get on track, it makes a huge difference. For anyone who suffers from IBD, it is very important to see a specialist and start getting the proper treatment. I tell our patients that it takes patience and work to find the regimen that is most effective for them.”
Jane-Claire Williams, M.D., Gastoenterologist, received a Bachelor of Arts in Biology from the University of Mississippi. She received her Doctor of Medicine from the University of Mississippi Medical Center and she stayed there to complete her internship and residency in Internal Medicine. Dr. Williams was Chief Resident and Assistant Professor in the department of Internal Medicine at University of Mississippi Medical Center. She completed her fellowship in Gastroenterology at Baylor University Medical Center. She is board certified in Internal Medicine. Special thanks to the Centers for Disease Control and Prevention for additional information.