Inflammatory Bowel Disease (IBD)


hi I’m dr. Mike Evans and this is a brief overview of a disease that attacks our guts called inflammatory bowel disease or IBD it is actually not a single disease but rather refers primarily to two related but distinct diseases one is called Crohn’s disease and the other is called ulcerative colitis or you see the key differences are firstly the location of the inflammation and secondly the extent of the information all sort of colitis only affects the colon or large intestine while Crohn’s disease can affect the entire digestive system from the mouth to the anus or as we say from gum dabomb and ulcerative colitis inflammation only involves the inner lining or what we call the mucosa while in Crohn’s disease inflammation can extend right through the entire thickness of the bowel wall to the outermost layer of the digestive tract these differences lead to different outcomes and different treatments which I’ll get to later the major symptoms of you seeing Crohn’s do however overlap these include stomach pain and a change in bowel habits almost always this means more urgent movements other symptoms include weight loss decreased appetite fever night sweats and extreme tiredness now these are trademarks symptoms but it’s very important to remember that IBD can play out quite differently in different people the symptoms of IBD can come and go over long periods of time now people may experience periods of severe symptoms or what we call flare-ups they also go through periods when they have few or no symptoms at all what we call remission IBD can occasionally effect or inflame other parts of your body such as your eyes your skin your liver your joints other symptoms can be more specific for example because you see only affects the inner lining of the bowel we tend to see mucus and blood in the stool whereas Crohn’s can inflame the whole bowel wall so there may be blood but also significant abdominal pain nausea and vomiting both diseases can lead to growth delay in children to investigate the cause of your symptoms or or gauge the extent of your disease your care team will listen to your story ask if there is any family history and then investigate with things like blood tests stool samples and then likely examination of your bow for x-rays scans and their scopes to look at the inside of your bowel IBD is usually diagnosed in young people say 15 to 25 but it can appear at any time they’re slightly increased risk for those who have a family member with the condition an IBD is more common in white people and more prevalent among Jewish people of European origin IBD affects about one in 350 people in most nations but its more common in northern regions here in Canada we actually have the highest rate in the world with IBD occurring in as many as 1 and 150 persons which translates to about 230,000 Canadians we’re not exactly sure why Crohn’s and you see happens it appears that some sort of environmental factor in susceptible individuals causes the immune system the body’s defense against infection to malfunction the immune system then starts attacking healthy tissue inside the digestive system leading to the information currently there is no cure for IBD but many of the treatments that are effective target the immune system so medications such as corticosteroids or 5a SAS which help reduce inflammation or immunosuppressants are often used medicines called biologics have become a key treatment option for those with moderate to severe inflammatory bowel disease they work by using specially developed antibodies to selectively block the effects of the molecules that are involved in the inflammation of the gut wall the idea here is that we can move from beyond just symptom management and heal the mucosal lining which can lead to remission and prevent relapses in Crohn’s disease mild attacks result in patches of information the lining of the intestine with groups of small ulcers similar to mouth ulcers that can occur anywhere in the digestive tract however and moderate or severe Crohn’s disease these ulcers become much larger and deeper with a lot of surrounding redness the inflammation can make the intestine become thickened blocking the passage of digested food in some cases deep ulcers break through the wall of the intestine causing infection outside the bowel what we call an abscess and this can actually spread to the skin or a nearby part of the body what we call a fistula about 3 out of 4 patients with Crohn’s will require surgery at one point move an inflamed section of the digestive system especially if the inflammation has caused a blockage fortunately now our surgical techniques have become much less invasive than in the past surgery is sometimes necessary and you see but with early treatment it can often be avoided things to think about with the diet are pretty common-sense and individualized there is considerable variation from person to person so self-awareness about what foods set you off or work for you can be very helpful as is staying hydrated self-awareness is also important when it comes to managing stress the unpredictability of IBD or dealing with symptoms at the same time you’re dealing with life’s other stressors can be incredibly tricky to navigate inflammatory bowel disease can have a profound effect on an individual’s life physically emotionally and socially both at home and at school or in the workplace having to go to the washroom more than 10 times a day or even talking about your bowels is you know I think it’s challenging at any age but perhaps especially as a young person when this disease commonly strikes it’s a disease that often impacts families not just individuals and it is a journey that requires no small amount of bravery problem-solving and optimism although there is no cure yet there are many treatment options available as one of my patients with IBD said to me with my ups and downs it was important for me to remember that things will return to normal it may be a new normal but normal just the same there are some fantastic IBD resources out there to educate learn and share with others that are where you are or have already been there thanks for listening and take care you you

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