Inflammatory bowel disease (IBD) involves the chronic inflammation of the gastrointestinal tract. It may affect the whole GI tract or only parts of it. Symptoms of IBD vary and depend on the severity and location of the inflammation. Patients usually experience periods of active disease followed by periods without any symptoms. The cause of IBD remains unknown. Some of the possible causes include an abnormal immune response that attacks the GI tract and heredity.
Forms of Inflammatory Bowel Disease:
- Ulcerative colitis causes inflammation and ulcer formation in the innermost linings of the large intestine and/or rectum. It has different types depending on the location and severity of the inflammation.
- Crohn’s disease affects the linings of the different areas of the GI tract. The inflammation can spread into the deeper tissues. The most common parts of the GI tract affected include the last part of the small intestine and the large intestine. Inflammation of the tissues can lead to the narrowing or scarring leading to blockage of the GI tract. In some cases, ulcers extend through the intestinal wall and create a connection with the skin or another body organ known as fistula.
Diagnosis of IBD involves several tests and elimination of other possible conditions. Colonoscopy allows the physician to see inside the large intestine. Crohn’s disease is confirmed with the presence of clusters of inflammatory cells. An alternative is capsule endoscopy which is done by swallowing a capsule containing a camera. CT scan is also used as an imaging test on the entire bowel and outside the bowel.
Commonly Prescribed Drugs
- Anti-inflammatory drugs are the first line of treatment for IBD.
o Aminosalicylates include sulfasalazine, mesalamine, balsalazide, and olsalazine. Sulfasalazine is shown to be an effective treatment for treating inflammation of the large intestine and rectum. Some anti-inflammatory drugs are available in oral, enema, and suppository forms. Side effects: headache, digestive distress
o Corticosteroids are used to treat unresponsive forms of IBD. These include prednisone and hydrocortisone. Corticosteroids are not always used due to its numerous side effects. Side effects: excessive facial hair, night sweats, insomnia
- Immunosuppressant drugs reduce the inflammation by inhibiting the release of chemicals that cause inflammation in the linings of the GI tract. Azathioprine and mercaptopurine are the most widely used immunosuppressants. Cyclosporine is the reserved drug for unresponsive ulcerative colitis. Infliximab, adalimumab, and golimumab are tumor necrosis factor-α inhibitors effective for patients with moderate to severe IBD. Complications: increased risk of infection, risk for cancer
- Antibiotics are given to patients who show signs of infection like fever. In some cases, these drugs reduce bad intestinal bacteria and act as immunosuppressants in the GI tract. Commonly used antibiotics for IBD are metronidazole and ciprofloxacin. Side effects: tingling of hands and feet, muscle weakness, muscle pain