Inflammatory bowel disease (IBD) is a chronic condition that affects the digestive tract, causing inflammation and various symptoms. This blog post aims to provide you with an introduction to IBD, including its types, causes, symptoms, diagnosis, and treatment options. Whether you have been recently diagnosed with IBD or are seeking to understand the condition better, this guide will equip you with essential knowledge to navigate your journey
What is Inflammatory Bowel Disease
Inflammatory bowel disease or IBD, is a term used to describe a group of chronic inflammatory conditions that affect the digestive tract. There are two main types of IBD. Both conditions involve chronic inflammation of the digestive tract, but they are different in terms of where the inflammation is and what it is like. (1)
The most common types of IBD are Crohn’s Disease and Ulcerative Colitis (2).
Crohn's Disease
Crohn’s disease can affect any part of the digestive tract from the mouth to the anus. The inflammation tends to be patchy with healthy tissue in between. It can spread through many layers of the walls of the digestive tract and also involve other parts of the body such as the joints, skin and eyes (3).
Ulcerative Colitis
Ulcerative Colitis (UC) is different from Crohn’s Disease as it only affects the large bowel and the rectum. It causes continuous inflammation and sores (ulcers). Where Crohn’s Disease affects many layers of the walls of the digestive tract, UC occurs in the inner lining of the large bowel and rectum (1). In severe cases, it can cause ulcers, bleeding and a higher risk of colon cancer. (4)
What cause IBD?
We don’t know exactly what causes IBD, but it is probably a mix of things you get from your family and things in the environment around you. If someone related to you, like a parent or sibling, has IBD, then you are more likely to get it too.
Eating a lot of processed foods, high in fat and sugar, and not getting enough fibre can increase your risk. Smoking (which can also make Crohn’s disease worse), certain medicines, infections, stress, and changes to the beneficial bacteria and other organisms living in our large bowel (called the gut microbiome) can increase our risk of developing IBD (5,6,7)
The gut microbiome plays an important role in maintaining our gut health and immune function and disturbance in the delicate balance between the immune system and the gut microbiome can lead to chronic inflammation. There is a lot of research currently into the role of the gut bacteria and how the immune system responds to outside factors (8)
Common symptoms of IBD
The symptoms depend on where the inflammation in the gut is. Some common symptoms are:
- Abdominal pain
- Ongoing diarrhoea (can have mucuc or puss)
- Blood in poo
- Sudden urgency to use the toilet
- A constant sensation of needing a poo
- Unplanned weight loss
- Tiredness (fatigue)
Some people may not experience any of these symptoms and may end up with a high temperature, vomiting or anaemia instead (9).
Getting Diagnosed
IBD is usually diagnosed by a different tests
Blood tests and stool samples are routinely taken as these can help detect inflammation in the body (10). These tests can also be helpful to find out whether there are any other reasons for the symptoms, such as a parasites or infections.
The most common tests used to diagnose IBD tends to be a colonoscopy and biopsy (11). A colonoscopy is where a doctor puts a tiny camera up someone’s bottom so they can have a look inside the large bowel. During this procedure, the doctor may cut off small samples of the bowel (biopsy) and send it off to the lab to be tested.
Another test used to diagnose IBD is an endoscopy. This also involves a tiny camera, however, this time the camera is placed through your mouth, down your food pipe (oesophagus) into your stomach and into the first part of your small intestines (duodenum). This helps doctors get a better view of the upper part of the digestive tract. The colonoscopy and endoscopy can help doctors tell the difference between CD and UC.
Finally, scans such as X-rays, MRIs, and CT scans are used to assess the extent of the disease, and to see whether there have been any complications, such as narrowing of the tract (strictures), ruptures (perforation), or inappropriate joining of two organs (fistula) (12).
What is the treatment?
For people with IBD, treatment options include medicine, surgery or changing their diet. But because IBD is a complicated condition, the way someone manages it can be different from person to person.
Diet
If you have IBD, what you eat is important. A good diet can help you stay healthy when your condition changes or gets better. There are different ways to improve your diet, like changing what you eat or adding vitamins. Sometimes, you might need feeding through a feeding tube to heal your gut. Along with medicine or surgery, a special diet can help your body get better when you have IBD. Speak to your doctor, IBD nurse or Dietitian about your options.
There’s no single diet plan that works for everyone with IBD, but some strategies can help relieve symptoms, reduce inflammation, and keep your gut healthy. Remember the type and severity of IBD varies, so dietary advice can differ for each person. It is recommended that you talk to an IBD team and registered dietitian who specializes in IBD to get personalized guidance.
Here are some things to keep in mind about your diet:
- Eat a balanced diet: Focus on eating a variety of nutrient-dense foods, including fruit, vegetables, whole grains, lean protein and healthy fats.
- Identify trigger food: Keep a food diary to help identify any foods that may worsen your symptoms or trigger flare-ups. Trigger foods are different for everyone, but spicy food, high fat foods, dairy products, caffeine, alcohol and high fibre food may be problematic for some people.
- Consider a low residue or low-fibre diet during flare ups or when experiencing symptoms such as abdominal pain, diarrhoea or bowel urgency. Food that may be difficult to digest during these flare ups are nuts, seeds, raw fruit and vegetables, whole grains and even tough meat.
- Try smaller, more frequent meals to help manage symptoms
- Stay hydrated and drink plenty of fluids throughout the day.
- If nothing else has helped, consider specific dietary changes such as the low FODMAP diet or a Mediterranean style diet. The low FODMAP diet should be followed under the guidance of a Dietitian trained in the low FODMAP diet.(10,13)
It is important to remember that dietary recommendations should be tailored to individual needs and what works for one person, may not work for another. Always consult your specialist doctor and ask for a referral to specialist Dietitian.
Is IBS and IBD the same thing?
IBD and IBS are both digestive conditions with similar symptoms, but they affect the body differently and need different treatments.
IBD causes inflammation in the digestive tract, which can harm the gut and other organs if not treated.
IBS is a common digestive disorder that causes recurring pain and changes in bowel habits, but it doesn’t cause damage to the body.
You can have both IBS and IBD, so it’s important to check with your doctor before changing your diet.
Check out this blog to learn more about IBS.
Conclusion
Inflammatory bowel disease is a complex condition that can significantly impact someone’s quality of life. If you have been diagnosed with IBS and you understand the difference between the types of IBD, the causes, the symptoms and the treatment options, you can take an active part in the management of your condition.
Useful websites for further information
Disclaimer: This post is for information purposes only and is not intended to replace or provide medical advice. Always consult with a healthcare professional for an accurate diagnosis and personalised treatment plan.
Written by Registered Dietitian, Eleanor Sinclair and edited and reviewed by Christel Lyell (Registered Dietitian)
My name is Christel. I am a Registered Dietitian with over 25 years experience. I specialise in gut health and Irritable Bowel Syndrome. My mission is to help people with digestive issues get their gut back on track so they can live with confidence again.
References
- Centers for Disease Control and Prevention (2022) Inflammatory bowel disease (IBD) [Online] USA: CDC. Available from: <https://www.cdc.gov/ibd/what-is-IBD.htm#:~:text=Inflammatory%20bowel%20disease%20(IBD)%20is,damage%20to%20the%20GI%20tract> [Accessed 13 May 2023].
Silverberg, M. S., Satsangi, J., Ahmad, T., et al. (2005) Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can. J. Gastroenterol, 19 (A): pp. 5-36.
NIDDK (2017) Definition & Facts for Crohn’s Disease [Online] USA: NIDDK. Available from: <https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease/definition-facts#:~:text=Crohn’s%20disease%20is%20a%20chronic,your%20mouth%20to%20your%20anus.> [Accessed 18 May 2023].
Jess T, Rungoe C, Peyrin-Biroulet L. Risk of colorectal cancer in patients with ulcerative colitis: a meta-analysis of population-based cohort studies. CLin Gastroenterol Hepatol. 2012 oct;10(10):639-45.doi:10.1016/j.cgh.2012.02.006. Epub 2012 Feb15. PMID:22343004.
Pearsson P. G., Ahlbom, A. and Hellers G. (1992) Diet and inflammatory bowel disease: a case control study. Epidemiology, 3, pp. 47-52.
- Amre, D. K., D’Souza, S. Morgan, K., et al. (2007) Imbalances in dietary consumption of fatty acids, vegetables and fruits are associated with risk for Crohn’s disease in children. Am. J. Gastroenterol, 102: pp. 2016-2025.
- Ye, Y., Pang, Z., Chen, W., Ju, S. and Zhou, C. (The epidemiology and risk factors of inflammatory bowel disease. International Journal of Clinical and Experimental Medicine, 8 (12), pp. 22529-22542.
- Xavier, R. J. and Podolsky, D. K. (2007) Unravelling the pathogenesis of inflammatory bowel disease. Nature, 448, pp. 427-434.
- National Health Service (2023) Inflammatory bowel disease [Online] UK: NHS. Available from: <https://www.nhs.uk/conditions/inflammatory-bowel-disease/> [Accessed 18 May 2023].
- NICE (2013) Faecal calprotectin diagnostic tests for inflammatory diseases of the bowel. [Online] UK: NICE. Available at <https://www.nice.org.uk/guidance/dg11> [Accessed 18 May 2023].
- Spiceland, C. M. & Lodhia, N. (2018) Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment. World J Gastroenterol, 24 (35) Sept, pp. 4014-4020.
- Gandy, J. ed. (2019) Manual of Dietetic Practice. 6th ed. Oxford. John Wiley and Sons.
- Crohn’s & Colitis Foundation (2022) IBS vs IBD [Online] UK. Available from: <https://www.crohnscolitisfoundation.org/what-is-ibd/ibs-vs-ibd> [Accessed 18 May 2023].
