Forbes India 15th Anniversary Special

Inflammatory bowel disorders

Dr. C.R. Panda talks in detail about — Inflammatory bowel disorders, also signifying the importance of early detection

Published: Mar 31, 2023 01:28:51 PM IST
Updated: Mar 31, 2023 04:55:45 PM IST

Inflammatory bowel disease is a group of intestinal disorders that cause prolonged inflammation of the digestive tract. It includes Ulcerative colitis or Crohn’s disease.   

  • Ulcerative colitis (UC). This involves inflammation of the large intestine — but only in the digestive tract. It can lead to other non-digestive issues.
  • Crohn’s disease. This can cause inflammation in any part of the digestive tract. However, it mostly affects the tail end of the small intestine. 
Symptoms of IBD vary depending on the location and severity of inflammation, but they may include diarrhea, bleeding ulcers, stomach pain, cramping, and bloating due to bowel obstruction, weight loss and anemia, which can cause delayed physical growth or development in children.   

The immune system may also play a role in IBD. The immune system normally defends the body from pathogens, which are organisms that cause diseases and infections. A bacterial or viral infection of the digestive tract can trigger an immune response. The digestive tract becomes inflamed as the body tries to create an immune response against the invaders. In a healthy immune response, the inflammation goes away when the infection is gone.

In people with IBD, however, digestive tract inflammation can occur even when there’s no infection. The immune system attacks the body’s own cells instead. This is known as an autoimmune response. IBD can also occur when the inflammation doesn’t go away after the infection is cured. The inflammation may continue for months or even years.  

Smoking is one of the main risk factors for developing Crohn’s disease. Smoking also aggravates the pain and other symptoms associated with Crohn’s disease. It increases the risk for complications too.   

Possible complications of IBD include malnutrition, colorectal cancer, fistulas, or tunnels that go through the bowel wall, creating a hole between different parts of the digestive tract, intestinal rupture, which is also known as perforation, bowel obstruction.  

A physical exam may then be followed by one or more diagnostic tests. 

Stool sample and blood test
Stool samples and blood tests can be used to look for infections and other diseases.
Blood tests can also sometimes be used to distinguish between UC and Crohn’s disease. However, blood tests alone cannot be used to diagnose IBD.

Barium enema
A barium enema is an X-ray exam of the colon and small intestine. In the past, this type of test was often used, but now, other tests have largely replaced it.

Flexible sigmoidoscopy and colonoscopy
These procedures use a camera on the end of a thin, flexible probe to look at the colon. The camera is inserted through the anus. It allows your doctor to look for ulcers, fistulas, and other damage or abnormalities in the rectum and colon.

A colonoscopy can examine the entire length of the large intestine. A sigmoidoscopy examines only the last 20 inches of the large intestine — the sigmoid colon.

During these procedures, a small sample of the tissue inside the intestine will sometimes be taken. This is called a biopsy. This sample can be examined under a microscope and used to diagnose IBD.

Capsule endoscopy
This test inspects the small intestine, which is much harder to examine than the large intestine. For the test, you swallow a small capsule containing a camera. The camera takes pictures as it moves through your small intestine. Once you’ve passed the camera in your stool, the pictures can be seen on a computer.
This test is only used when other tests have failed to find the cause of Crohn’s disease symptoms.

Plain film or X-ray
A plain abdominal X-ray is used in emergency situations where intestinal rupture is suspected. 

CT and MRI scans
CT scans are basically computerized X-rays. They create a more detailed image than a standard X-ray. This makes them useful for examining the small intestine. They can also detect complications of IBD.

MRIs use magnetic fields to form images of the body. Since they don’t require radiation, they’re safer than X-rays. MRIs are especially helpful in examining soft tissues and detecting fistulas. Both CT scans and MRIs can be used to determine how IBD affects much of the intestine.

Issued in Public Interest by Dr.Reddy's Laboratories LTD

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