>> DR. JAMES GRAY: Getting a diagnosis
of inflammatory bowel disease or IBD can be life altering.
If you are a close friend or family member
have this disease,
you’ve probably got a lot of questions.
In this video I'm going to go over the basics
and address some of those concerns.
First of all what exactly is IBD?
The basic underlying feature of IBD is chronic inflammation
of a part of the digestive tract.
This inflammation can cause many painful and often
debilitating symptoms.
Because of this individuals with IBD
often have a lower quality of life.
However with proper treatment IBD will not affect
the length of your life and it can usually be
successfully managed although not cured.
There are multiple diseases that fall within
the IBD umbrella.
Most people with IBD have either Crohn's disease
or ulcerative colitis but there are many other types of IBD.
This video will primarily focus on Crohn's
disease and ulcerative colitis.
It is important to note that IBD is not the same thing as IBS.
While they have similar acronyms and both affect
the digestive system they have different underlying causes,
symptoms, experiences and treatment methods.
IBS stands for irritable bowel syndrome,
which is a functional gastrointestinal condition.
This means that its symptoms are a result of poor gut
function and motility rather than damage
or inflammation to the gut.
IBD on the other hand involves visible damage
to the gastrointestinal tract.
Please visit bad gut dot org for more
information regarding IBS.
Remember that every person is unique
so that while there are many symptoms
and experiences that are common in IBD
they might not apply to you.
If you ever have any questions or concerns about
your digestive health make sure you speak about them
with your health care provider.
If you received a diagnosis of IBD you might wonder why.
While we don't know for sure what causes IBD
research suggests that interactions
between environmental factors, intestinal bacteria,
immune dis —
regulation and genetic predisposition are responsible.
For example if you have a close family member
with IBD you have a higher chance of developing it yourself
than someone who does not.
IBD can affect anyone of any race, sex and age.
Most people experience symptoms in childhood
or early adulthood but some might not develop the disease
until they are much older.
Approximately zero point seven percent of Canadians
or about 270000 individuals in this country have IBD
with slightly more having Crohn's disease
than ulcerative colitis.
While Crohn's disease and ulcerative colitis
are both types of IBD,
there are quite a few differences between them.
To understand how they can have different
symptoms and treatments,
we need to look at how they affect the gut.
In ulcerative colitis,
inflammation only affects the colon also
called the large intestine.
It always begins at the anus and then progresses
upward affecting just the inner lining of the colon.
At its largest extent the inflammation can affect
the entire large intestine. In Crohn's disease,
inflammation can affect any part of the digestive system;
in multiple patches or one large section
and can penetrate the entire thickness of the bowel wall.
It often affects the small intestine especially
the lowest portion or Terminal Ielum
which is the part of the gut that absorbs most
of the nutrients from the food we eat.
The digestive tract is where we digest process
and absorb food and how we get all the energy
and nutrients that keep our bodies running.
Because of this disease in the gut can
cause many symptoms.
The most common symptom of IBD is diarrhea
which is often very watery.
This occurs because inflammation causes
food to pass through the digestive
system too quickly.
So the colon does not have enough time to absorb
water from waste.
Diarrhea can also be covered in mucus or be
bloody especially in those with ulcerative colitis
which can cause bleeding ulcerations
in the lower part of the colon.
Crohn's disease can affect the small intestine
and in doing so it may prevent the proper absorption
of food resulting in diarrhea that is fatty along
with nutritional deficiencies and weight loss.
These symptoms can be especially devastating in young
children who might not get enough nutrients
to grow properly.
If you have IBD you are likely familiar with the intense
abdominal pain that it can cause.
This is often due to spasms from the inflamed intestine
putting pressure on the nerve endings in the bowel wall.
Pain can vary in severity and tends to be cramping.
Sometimes pain can result from pressure building up
behind a narrowed portion of the intestine known
as a stricture which forms as a result of inflammation.
This typically requires immediate treatment
and sometimes surgical intervention.
Fever is quite common as is the feeling
of incomplete defecation.
You might also experience a sudden strong
urge to pass stool. Sometimes even false alarms.
There is also a chance that you could develop
iron deficiency anemia either from poor absorption
of iron or excessive iron loss through rectal bleeding.
Some less common symptoms of IBD include nausea,
vomiting, loss of appetite, and constipation.
Manifestations of inflammation outside of the gut are also
possible and include arthritis, skin problems, liver disease,
kidney stones and eye inflammation.
In Crohn's disease the formation of painful
inflamed slits in the skin and superficial tissues called
anal fissures can also occur.
You can develop abscesses which are very painful
and can cause fever or an abnormal tunnel
like connection between the intestine
and the skin called a fistula.
Fistula can also occur near the opening of the anus
and between loops of intestine within the abdomen or between
the intestine and the abdominal wall.
When you receive treatment for IBD the goal
is to reduce inflammation and improve
symptoms as much as possible.
Also known as remission if your symptoms
return especially if they are worse than before,
we call that a flare.
It is important to continue taking any
medications your doctor prescribes,
even if you feel better,
to give yourself the best chance at avoiding a flare.
Remember that medications are designed to control
and reduce inflammation but also to maintain
that control once obtained.
When you go to your doctor with digestive symptoms,
there are many possible causes that he or she will
need to investigate.
If you haven't been diagnosed with IBD
but are wondering if you might have it,
here are some of the steps your doctor will
take to find out.
First he or she will carefully evaluate your symptom history
and review factors such as when and how
your symptoms began,
what subsequent problems you experienced,
the nature of your diarrhea,
the type of abdominal pain as well as the characteristics
and quantity of rectal bleeding.
If your symptoms point to IBD your physician will use
diagnostic tools to look for signs of disease
in the digestive tract.
Stool studies are helpful at the outset to rule out
infections and to even measure inflammatory products within
the stool through a relatively new test
called fecal calprotectin.
Similarly blood test are used to indicate the degree
of inflammation and its effect on the body.
For ulcerative colitis the most useful diagnostic
tool is the sigmoidoscope;
a short instrument that allows visualization
of the inside of the lower bowel and demonstration
of inflammation.
If necessary during this procedure,
your physician can biopsy any suspected areas
for further investigation. If needed,
a longer flexible instrument called
a colonoscope can help your physician see
farther up into the colon.
Sometimes as far as the Terminal Ielum where
the small and large intestine,
meet which is a likely location for the formation
of Crohn's disease.
In some cases a gastro scope entering the body via
the mouth is useful to confirm Crohn's disease
in the upper part of the G.I. tract.
Other diagnostic tools include imaging by ultrasound,
C.T. or MRI, blood tests,
an examination of a stool sample for infectious agents.
Treatment for IBD typically involves lifelong
management with different types and doses of medication.
However diet and lifestyle factors can
also play an important role.
Some individuals might also require surgery.
Watch your other videos to learn more about
the treatment options for individuals with IBD.
The future of IBD lies in education and research.
Education of both the public and the medical profession,
to emphasize the importance of inflammatory
bowel disease research is vital.
A partnership between physicians and researchers
interested in the study of these diseases along
with those who have IBD their families and their friends
is the best hope toward finding the cause or causes and the cure
of inflammatory bowel disease. I'm Dr.
James Gray on behalf of the Medical Advisory Council
of the Gastrointestinal Society, thanks for watching.
Learn more about IBD and many other digestive and liver
conditions that bad gut dot org.