Chronic inflammatory bowel disease – what is it?
Chronic inflammatory bowel disease (IBD) causes inflammation of the intestinal wall, which can affect various intestinal layers and areas. Periods of inflammation alternate with symptom-free intervals.
The two most common chronic inflammatory bowel diseases are ulcerative colitis and Crohn's disease. While Crohn's disease can cause inflammation of the entire digestive tract, ulcerative colitis only affects the large intestine. In Crohn's disease, inflamed and non-inflamed areas can alternate. The last section of the small bowel (terminal ileum) and the foremost area of the large bowel (proximal colon) are most commonly inflamed. In the case of ulcerative colitis, the affected bowel sections are next to each other. The inflammation begins in the rectum and can spread from there to the entire large bowel.
There are various possible causes of inflammatory bowel disease. It is assumed that there is no single cause for IBD, but rather that it is the interaction of various factors that causes the bowel to become inflamed repeatedly.
A disrupted intestinal barrier plays an important role in the development of IBD. Normally, the intestinal barrier forms a protective wall that protects the intestinal wall from germs and toxins. If this protective barrier is damaged, various intestinal problems can occur – including chronic inflammatory bowel disease or irritable bowel syndrome (IBS). Other factors that may be associated with intestinal inflammation include hereditary (genetic) predisposition and past intestinal infections.
Symptoms of inflammatory bowel disease include
- abdominal pain
- diarrhoea, sometimes with blood
- flatulence
- slightly raised body temperature
Sometimes, inflammatory bowel disease can also cause symptoms outside of the digestive tract, including
- skin changes
- inflammation of various layers of the eye, e.g. corneal inflammation
- Changes to the joints, e.g. joint inflammation
Recurrent intestinal inflammation can lead to a number of complications, for example
- Passages between different intestinal loops, to other organs or to the skin surface (fistulas)
- Abscesses
- Weight loss and malnutrition
- In children: delayed growth
- Bowel obstruction
Chronic inflammation of the bowel is treated with anti-inflammatory drugs (e.g. cortisone) and surgery, depending on the extent and spread of the inflammation. If the inflammation is widespread, the entire colon may need to be removed. This procedure can cure ulcerative colitis. Although Crohn's disease can be treated, there is currently no complete cure. An appropriate diet can support the treatment.