By Kevin Skole, MD
Living with inflammatory bowel (IBD) disease can be a real pain both physically and mentally and unfortunately there is no cure.
But while people with this condition may require a lifetime of medical care, it does not mean they are sentenced to a lifetime of misery. By working with their doctor to manage IBD and reduce its symptoms, people with the condition can live full and rewarding lives.
Understanding IBD
Inflammatory bowel disease refers to an autoimmune condition that leads to chronic inflammation in the gastrointestinal (GI) tract. Crohn’s disease and ulcerative colitis are the two most common inflammatory bowel diseases. Although they may affect different parts of the body, both Crohn’s and colitis result from an improperly functioning immune system, leading to your body perceiving parts of itself as the enemy. Confused by otherwise harmless bacteria, and maybe even food, the immune system attacks the body itself, leading to intestinal inflammation and other complications.
IBD can occur in anyone at any time, although in most cases it first starts between the ages of 18 and 30. The disease may have a genetic component, so it often runs in families, and is influenced though not caused by certain lifestyle factors such as smoking and eating a diet that is high in fat and processed food.
The Centers for Disease Control and Prevention estimate that as many as 1.4 million Americans suffer from IBD.
Symptoms
Symptoms of IBD vary depending on where the inflammation occurs and may include: Diarrhea, cramping, blood in the stool, joint pain, fatigue, lack of appetite, weight loss.
Symptoms may vanish for periods of time (remission) and then flare up. The reasons for the flare-ups are not always clear, but some possible triggers include:
Stress; not taking medication properly; conflicting medications, smoking; certain foods; infections.
Symptoms can also become quite severe and result in complications, such as a blocked intestine, ulcers, fistulas and malnutrition. Additionally, people with IBD are at greater risk for colon cancer and for developing other conditions such as osteoporosis, arthritis, kidney stones and gallstones. Moreover, because their immune system is suppressed, people with IBD are at greater risk for infections, including hepatitis, meningitis and pneumonia.
Medical Treatment
Treatment for IBD is different for everyone. Different therapies are available based on the type of the condition and the severity.
Medications such as anti-inflammatories (aminosalicylates), steroids, and modulators of the immune system are commonly prescribed for IBD. Many of the medications do have side effects, but they can reduce the risk of flare-ups and keep your IBD in a state of remission. The doctor’s goal in prescribing medication is to get the inflammatory bowel disease in remission to try to prevent complications from occurring.
For people who do not respond to medication, surgery is a viable treatment option. Numerous types of surgeries are possible depending on the type of the condition severity. Each carries with it varying pros and cons. If your doctor recommends surgery, be sure to discuss the pros and cons.
Living with IBD:
Diet
Despite medication and surgery, the reality is that IBD is usually a lifelong condition that requires coping. Diet can play an important role in that coping. Various diets have been shown to reduce IBD symptoms in certain populations, especially if people have coexisting conditions such as lactose intolerance and Celiac disease. While a limited diet will probably not “cure” IBD, it can be an important factor, and sticking to a nutritious menu and avoiding any personal “trigger” foods can help prevent flare-ups.
During a flare-up, doctors may advise you to avoid fatty foods, spicy foods, caffeine, dairy products, and high-fiber foods. Instead, applesauce, bananas, and small portions of bland, cooked foods are recommended to lower irritation. No single diet will work for everyone, so speak to your doctor, and recognize that diet modification should not be used in place of standard medical treatment.
Vitamins and supplements can also be welcome additions. In people with IBD, the body does not always get the nutrients it needs, nor can it always absorb vitamins and nutrients properly. You can make up for this by taking vitamin and mineral supplements to address deficiencies.
Living with IBD:
Day-to-Day
IBD can complicate day-to-day living, but by planning ahead and being open with people, you can lower your level of discomfort. Know where bathrooms are when you are out and about.
Bring extra undergarments with you.
Consider moist wipes instead of toilet paper to reduce irritation.
Take medication as directed, even if you are not having a flare-up.
Moreover, to help keep flare-ups at bay, be sure to exercise regularly, keep your stress levels down and if you smoke, stop.
IBD can be a delicate subject, and many people feel some form of embarrassment in bringing it up. You don’t have to be ashamed talk to people, and keep your family and friends informed and in the loop. Additionally, many people find comfort in in-person support groups and online communities.
Though living with IBD is not always easy, it is possible to manage the condition so you can live a healthy life.
To find a physician with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
Kevin S. Skole, M.D. is a board certified gastroenterologist and a member of the medical staff at University Medical Center of Princeton at Plainsboro.
