INFLAMMATORY BOWEL

DISEASES
 What’s IBD?

Inflammatory bowel disease (IBD): an umbrella

term used to describe disorders that are
characterized by chronic inflammation of the
digestive tract.

The inflammation occurs due to the attack of body’s

own immune system to parts of the digestive system.
 IBD

Types of IBD include: Ulcerative colitis and

Crohn's disease.
Ulcerative colitis and Crohn's disease are not the
same in the medical condition, although both are
inflammatory bowel diseases.
In ulcerative colitis, inflammation affects only the
large intestine and sores (ulcers) develop along the
innermost lining of the colon and rectum.
 TYPES OF IBD
Crohn's disease is characterized by inflammation of
the lining of any part of the GI tract (from the
mouth to the anus). Most often it affects the last
part of the small intestine (ileum) and the large
intestine (colon).
There can be healthy patches of tissue in between
diseased areas. Ongoing inflammation causes the
intestinal wall to become thick, and can lead to a
blockage called a stricture.
 SYMPTOMS
Smptoms of IBD vary, may range from mild to
severe.
 Diarrhea
 Fever and fatigue
 Abdominal pain and cramping
 Blood in your stool
 Reduced appetite
 Unintended weight loss
 Nausea, vomiting
 A feeling that the bowels are not empty after a bowel
movement
 CAUSES

The exact cause of inflammatory bowel disease

remains unknown. One possible cause is an
immune system malfunction.
Normally the immune system helps protect the
body from harmful organisms like bacteria,
viruses, and fungi.
 CAUSES

In IBD patients, the immune system can't tell the

difference between normal substances and foreign
invaders.
It gives abnormal/overactive immune response
(autoimmune disorder) causing it to attack the cells
in the digestive tract, that leads to the chronic
inflammation.
The genetic factor also seems to play a role in IBD,
and it is more common in people who have family
members with the disease.
 RISK FACTORS
 Family history. You're at higher risk if you have a close
relative — such as a parent, sibling or child — with the
disease.
 Cigarette smoking. Cigarette smoking is the most
important controllable risk factor for developing Crohn's
disease.
 NSAIDs medications. These include ibuprofen,
naproxen sodium, diclofenac sodium, and others.
 Residence. If you live in an industrialized country,
you're more likely to develop IBD. Therefore, it may be
that environmental factors, including a diet high in fat or
refined foods, play a role.
 COMPLICATIONS

Complications found in both IBD conditions may

include:
 Colon cancer
 Skin, eye and joint inflammation. Certain
disorders, including arthritis, skin lesions and
eye inflammation (uveitis).
 Medication side effects. Corticosteroids can
be associated with a risk of osteoporosis and
other conditions.
 COMPLICATIONS

 Primary sclerosing cholangitis. In this

condition, inflammation causes scars within the
bile ducts, eventually making them narrow and
gradually causing liver damage.
 Blood clots. IBD increases the risk of blood clots
in veins and arteries.
 COMPLICATIONS
Specific complications of ulcerative colitis:
 Toxic megacolon. Ulcerative colitis may cause
the colon to rapidly widen and swell, a serious
condition known as toxic megacolon.
 A hole in the colon (perforated colon). A
perforated colon most commonly is caused by toxic
megacolon, but it may also occur on its own.
 Severe dehydration. Excessive diarrhea can
result in dehydration.
 COMPLICATIONS
Complications of Crohn's disease:
 Bowel obstruction. Over time, parts of the
bowel can thicken and narrow, which may block
the flow of digestive contents.
 Malnutrition. Diarrhea, abdominal pain and
cramping may make difficult for the patient to
eat or for intestine to absorb enough nutrients.
It's also common to develop anemia due to low
iron or vitamin B12 caused by the disease.
 COMPLICATIONS
 Ulcers. Chronic inflammation can lead to open
sores (ulcers) anywhere in your digestive tract.
 Fistulas. Sometimes ulcers can extend
completely through the intestinal wall, creating a
fistula — an abnormal connection between
different body parts, Fistulas near or around the
anal area are the most common kind.
 Anal fissure. This is a small tear in the tissue
that lines the anus or in the skin around the anus
where infections can occur.
 TREATMENT

 There is no cure for IBD. The goal of treatment is

to reduce symptoms, achieve and maintain
remission, and avoid associated complications.
 The most common available treatments are
medications and surgery.
 TREATMENT
Medication

 Aminosalicylate (e.g. sulfasalazine, mesalamine,

olsalazine and balsalazide). They reduce
inflammation in the lining of the intestine and
are used in mild to moderate cases.
 Corticosteroids (e.g. budesonide, prednisone,
prednisolone). They are only used in a short-
term treatment during flares. They act on the
immune system and suppress its ability to begin
and maintain inflammation.
 TREATMENT
 Immune suppressors (e.g. azathioprine,
methotrexate). These work by preventing the
immune system to attack the bowel cells, leading to
a reduction in inflammation. They are used in a
long-term treatment.

 Biologic therapies: Antibodies (e.g. infliximab,

adalimumab, certolizumab pegol, and
natalizumab), that target certain substances
responsible for inflammation in the body.
 TREATMENT

Other medications recommended include:

 Antibiotics
 Antidiarrheal drugs
 Laxatives
 Vitamin and mineral supplements, for cases of
nutritional deficiency because of IBD.
IRRITABLE BOWEL SYNDROME (IBS)

 Irritable bowel syndrome (IBS) is different with

IBD.
 IBS is not caused by inflammation and the
tissues of the bowel are not damaged like IBD.
Treatment is also different.
 It is important to remember that patients with
IBD can also have IBS.
IRRITABLE BOWEL SYNDROME (IBS)

 IBS is a condition that affects the function and

behavior of the intestines.
 Normally, the muscles lining the intestines
intermittently contract and relax to move food along
the digestive tract.
 In IBS, this pattern is disturbed, resulting in
uncomfortable symptoms.
 SYMTOMS
Symptoms can include:
 Cramping,
 Abdominal pain,
 Bloating,
 Gas,
 Mucus in the stool,
 Diarrhea and/or constipation.
 Unlike IBD, IBS does not cause inflammation,
permanent damage to the GI tract or an increased
risk of colorectal cancer.
 CAUSES
The exact cause of IBS is unknown. Potential
causes may include:
 Sensitivity of the GI tract to gas and bloating,
 Alteration of the fecal flora (bacteria) within the
intestines,
 Altered levels of specific endogenous chemicals
within the body, such as serotonin.
 Having a recent GI track infection and having a
history of IBD may also be a risk factor for IBS.
 CAUSES

 Hormones may also play a role. For example, many

women often report more symptoms when they are
menstruating.
 In addition, many people with IBS report more
symptoms after eating specific foods and beverages,
such as spicy foods, certain fruits and vegetables,
foods containing wheat, coffee, alcohol and milk.
 TREATMENT

Specific medication for the treatment of IBS.

 Alosetron hydrochloride, a serotonin 5 HT3
antagonist indicated for treatment of women with
severe diarrhea-predominant IBS (IBS-D)
 Lubiprostone (Amitiza), a chloride channel activator
indicated for treatment of IBS with constipation
(IBS-C) in women 18 years or older.
 TREATMENT
Treatment of Specific Symptoms:
 Laxatives (anti-constipation medications), such
as milk of magnesia, lactulose, miraLax and
linaclotide, are used to treat constipation.
 Anti-diarrheal agents, such as loperamide,
diphenoxylate and atropine, are used to treat
diarrhea.
 TREATMENT
 Antispasmodics, such as belladonna
alkaloids/phenobarbital, hyoscyamine, and
peppermint oil, are used to treat abdominal
cramps and associated diarrhea.
 Antidepressants, such as fluoxetine, citalopram,
sertraline, desipramine, amitriptyline,
venlafaxine and duloxetine, are used to relieve
gut pain and treat psychological distress (anxiety
and depression).
 TREATMENT
 Probiotics, dietary supplements that contain
certain beneficial bacteria, may help to balance
the intestinal track.
 Antibiotics, such as rifaximin, are used to treat
small bowel bacterial overgrowth, which may
occur concurrently with or contribute to IBS.
 Fiber supplements can ease the movement of
bowel contents, preventing constipation.