What is IBD?
IBD stands for inflammatory Bowel Disease. This is an umbrella term for a group of auto-immune conditions that can occur throughout the digestive system. IBD is a physical problem, which affects the lining of the gut wall, as opposed to IBS, or irritable bowel syndrome, which is a functional problem.
There are two main types of IBD:
- Ulcerative colitis – which is confined to the rectum and colon
- Crohn’s disease – which can occur anywhere along the digestive tract (although it is most often found close to the junction of the small and large intestine)
How common is IBD?
There are estimated to be around 300,000 people in the UK with IBD, with around 1 in every 250 people affected, split roughly equally between ulcerative colitis and Crohn’s disease. It is slightly more common in women, white Europeans and people of Jewish decent. 20% of IBD sufferers have a close family member with the condition.
What causes IBD?
The causes of IBD are unknown, although it is thought to be either an auto-immune condition, where the body’s defences attack its own tissue, or an over-reaction to naturally occurring bacteria in the gut. IBD is rare in the poorest communities in the world, suggesting that the sanitised Western environment does not expose us to enough germs to learn healthy immune responses.
What are the symptoms of IBD?
The symptoms of IBD can be inconvenient, embarrassing and exhausting and include:
- Abdominal pain and cramps
- Tiredness and fatigue
- Blood in the stools
- Weight loss
Fortunately, these symptoms only occur during flare-ups, with weeks or even months of remission in between where the bowel functions normally.
How is IBD diagnosed?
Following blood tests for inflammatory markers, IBD will normally be confirmed by a direct examination of the lining of the gut. This can be done using:
- Colonoscopy – in which a camera is inserted via the rectum to examine the colon up to the point where it meets the small bowel (used mainly for ulcerative colitis, but may show Crohn’s disease)
- Gastroscopy – in which a camera is inserted via the throat to examine the upper digestive system and small intestine
- Capsule endoscopy – in which a small camera is swallowed allowing the whole of the digestive system to be examined
How is IBD treated?
There is no cure for either of the main forms of IBD, and treatment focuses on bringing the symptoms into remission and then retaining that remission for as long as possible.
Treatments include anti-inflammatories, steroids and immunosuppressants, along with cutting edge biological treatments that target the proteins involved in the inflammation. The initial dosage is reduced to a smaller maintenance dose once remission is achieved.
Surgery for IBD
One in five people with ulcerative colitis and three out of four people with Crohn’s will need surgery, either to remove a blockage, repair a perforation or to remove damaged parts of the digestive tract. Surgery for ulcerative colitis normally involves the removal of the colon, which will prevent the disease returning. Surgery for Crohn’s usually involves the removal of just a short length of bowel but the disease always returns.
Surgery can also be used to rest the gut by forming a temporary stoma on the skin surface while the gut recovers, then reconnecting it again at a later date.
Living with IBD
Living with IBD is tough, especially during flare-ups. However, there are steps you can take to improve your health, such as:
- Low residue diet – to reduce the strain on your gut
- Eating a little and often – to reduce the volume of food in your gut
- Drinking plenty of water – to avoid dehydration due to diarrhoea
- Taking supplements – to avoid aneamia and low vitamin levels
Can colonics help?
Unfortunately not. Since IBD weakens the bowel wall, the condition is contra-indicated for colonics. That means that your therapist will not perform the treatment if your consultation leads them to suspect you may have IBD.