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Managing IBD: Medications and Treatment Options

The global rise of Inflammatory Bowel Disease: Examining its increasing prevalence over the past two decades.

Dr Suhail Malik

Inflammatory bowel disease (IBD) is a term for two conditions (Crohn’s disease and ulcerative colitis) that are characterized by chronic inflammation of the gastrointestinal (GI) tract.  Prolonged inflammation results in damage to the GI tract.   Is it IBD different from IBS? Yes , the two diseases are quite different .While  diarrhea is present in both weight loss is seen in IBD and not in IBSBleeding is not seen in IBS but is seen in IBDExtraintestinal manifestations like joint pain, eye involvement , itching SKIN involvement is not seen in IBSIBS troubles but doesn’t lead to cancerIBD can lead to fistulisationIBD patients may need surgery in the course of illness while IBS doesn’t lead to complications 
What are the common symptoms of IBD? Persistent diarrhea.Abdominal pain.Rectal bleeding/bloody stools.Weight loss.Fatigue. Managing IBD: Medications and Treatment Options
What causes  IBD?       
The exact cause of IBD is unknown, It is postulated that it could be due to  the result of a weakened immune system. Possible causes are: In a genetically predisposed person  immune system responds incorrectly to environmental triggers, such as a virus or bacteria, which causes inflammation of the gastrointestinal tract.There also appears to be a genetic component. Someone with a family of  history of IBD is more likely to develop this inappropriate immune response.
How is IBD diagnosed? A combination of endoscopy (for Crohn’s disease) or colonoscopy (for ulcerative colitis) and imaging studies, such as:Magnetic resonance imaging (MRI) of small bowelComputed tomography (CT).Stool samples. like fecal calprotectin Blood tests. which suggest inflammation like CRP The patient may develop low hemoglobinThe patient can have various extra intestinal manifestations like joint pains , eye involvement or deranged liver function tests.

How is IBD treated? Types of common medications to treat IBD:5-aminosalicyclic acids.Immunomodulators.Corticosteroids.Biologics.With newer modalities of treatment the disease can be controlled nicelyConsult your doctor for details
Do these patients require surgery ? The patients with severe colitis may require surgery The patient with Crohn’s disease may develop fever , pain abdomen and may require drainage of abscessesCrohn’s disease patients can develop fistulas which may require surgery
Managing IBD: Medications and Treatment Options


About 7 million people worldwide have IBD.1 Although it is not a common disease, an increasing number of people have been diagnosed over the last 20 years.

It is affecting people in their productive years and unfortunately IBD is a lifelong disease, with remitting and relapsing course. Do note delay colonoscopic examination when your doctor advises so . At times it can be very challenging to diagnose  IBD as it mimics many other diseases especially tuberculosis . So your doctor may advise you number of investigations .

Diagnosis is based on imaging (MRI bowel) colonoscopy , biopsy 

Some patients may have what is known as Indeterminate colitis where clinical condition , biopsy are not classical of IBD.   

When diagnosed with IBD , one   can adopt a healthy lifestyle to improve overall health.

Some tips are as under 

  • Keep up your IBD medication regimen. You may be started on step up regimen with biologics as the last resort  
  • Follow your doctor’s advice to manage pain.
  • Drug , dose and side effects need to monitored at regular intervals .Now with the help of non invasive markers the disease is monitored by CRP, Fecal tests without colonoscopy 
  • Once diagnosed  the patient should have  recommended vaccines on time.
  • Stop smoking if you currently smoke.
  • Engage in moderate physical activity.
  • Limit or stop alcohol drinking.
  • Get enough sleep.
  • Achieve and maintain a healthy body weight.
  • Have balanced diet . Avoid commercial , packed foods with preservatives .Vegetarian diet is always helpful. Keep a food diary as one can have secondary lactose intolerance or bile salt malabsorption .Your doctor can guide you   
  • Reduce stress. A positive approach can help to tackle the disease. Join IBD support groups of your locality .One can share with other patients and get confidence .Word of caution , however, is that all  patients do not have similar course and  complications .

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