INFLAMMATORY BOWEL DISEASES

Dr. Evelyn Angie M. Biomed

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.
SYMPTOMS

Smptoms of IBD vary, may range from mild to severe.

 Diarrhea
 Fever and fatigue
 Abdominal pain and cramping
 Blood in your stool
 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.
DIAGNOSIS

 Physical examination
 Endoscopy
 Biopsy
 Radiology
 Blood Test
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

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

S
Symptoms can include:
 Cramping,
 Abdominal pain,
 Bloating,
 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

 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.