What to know about inflammatory bowel disease.
Inflammatory bowel disease is often confused with irritable bowel syndrome because the symptoms can be similar: persistent diarrhea, rectal bleeding, abdominal pain and unexplained weight loss. However, the two are not the same, and that distinction can change everything for patients.
“IBS is a symptomatic condition, and the GI tract looks normal. With IBS, once you fix the trigger, whether it’s food or medication, people feel better,” says Dr. Nitin Gupta, a gastroenterologist with Atlanta Gastroenterology Associates at the Sandy Springs location who specializes in Crohn’s disease and ulcerative colitis, which make up the two main forms of IBD. “With IBD, there is real, visible inflammation in the digestive tract. You don’t feel better until the inflammation is treated.”
Diagnosing IBD
An IBD diagnosis is confirmed with a colonoscopy, sometimes combined with an upper endoscopy, that can reveal ulcers, swelling or narrowing of the intestinal tract. The chronic disease can appear at any age, from infancy to the 90s, but most commonly presents in people in their 20s to 30s, or 60s. “The exact cause remains unknown, but we know risk factors include a family history of IBD and being of Ashkenazi Jewish descent. Antibiotic exposure and diet may also play a role,” Gupta says. He adds that it is likely multifactorial, genetics plus environmental triggers.
Treatment and Remission
While Crohn’s disease (most commonly in the small intestine) and ulcerative colitis (most commonly in colon and rectum) may affect different areas of the gut, Gupta says the treatments are usually the same. “Almost every medication is approved for both.” Patients may take oral medications or get injections to control inflammation.
Once diagnosed, treatment is ongoing throughout life. “When we say someone with IBD is in ‘remission,’ we mean the ulcers and inflammation are gone,” Gupta says. “The symptoms improve, labs look good, and the bowel heals.” Follow-up appointments typically happen annually with repeat endoscopic exams every one to two years, depending on the individual.
Even with regular treatment, IBD flares can still happen and should be expected once or twice a year. “These can be triggered by stress, illness or certain foods. They’re usually short-lived and resolve in a week or two,” Gupta says.
IBD no longer prevents people from living normal lives. “We have so many better therapies than we did 15 years ago,” Gupta says. Living in Atlanta, IBD patients are at an advantage, thanks to access to specialists, surgeons and large medical systems focused on digestive disease.
Lifestyle Matters
Stress, poor sleep, unhealthy diet and anxiety don’t cause IBD, but they can worsen symptoms. “It’s cumulative,” Gupta says. “The gut is already sensitive.” So daily habits can make a noticeable difference. He often recommends a Mediterranean- style diet: more fruits, vegetables, fiber and lean proteins, and less red meat and processed food. “These are things that are good for the body as a whole,” he says.
ATLANTA GASTROENTEROLOGY ASSOCIATES
(several locations)
uniteddigestive.com/provider/nitin-k-gupta-md
@united.digestive
