Inflammatory bowel disease describes a group of gastrointestinal disorders that primarily involves inflammation to the gut wall lining.

By Dr Y.L.M.

Gut feeling: Crohn’s disease can involve any part of the gastrointestinal tract, from the mouth to the anus.

I HAVE had to go to the toilet very frequently for several months now. My stools have been bloody as well, and at first, I thought I had piles. But I was diagnosed as having inflammatory bowel disease. What is it?

This is a group of diseases where your intestine becomes red and swollen (inflamed). The two main types of inflammatory bowel disease (IBD) are ulcerative colitis and Crohn’s disease.

Ulcerative colitis involves your colon or large intestine. Crohn’s disease can involve any part of your gastrointestinal tract, from your mouth to your anus. But it usually affects your small intestine and/or your colon.

Most people get IBD from age 15 to 30.

What causes the disease?

No one knows for sure. There is an unknown agent or several agents that trigger off your body’s own immune response to produce inflammation in your gastrointestinal tract.

This results in damage to the intestinal wall, hence ulcers, bloody diarrhoea and abdominal pain.

Scientists have postulated a genetic predisposition to IBD. But the triggering factor has never been uncovered.

How will I know if I have inflammatory bowel disease?

It’s not a diagnosis easily made by the layman. If you have bloody stools, there’s a common tendency to wonder if it’s piles or a gut infection. Some people even worry about colorectal cancer.

Bloody diarrhoea is a feature of IBD. You should always go to a doctor if you have bloody stools. Sometimes, you can have bleeding through your rectum.

IBD lasts for a long time. There will be weeks or months when the disease flares up, and other periods when the symptoms disappear or decrease. The latter is called remission.

Your symptoms will depend on which part of your gastrointestinal tract is involved. If your large bowel is involved, you may have bloody diarrhoea or a constant urge to go to the toilet most of the time.

You may have abdominal cramps or pain, fever, loss of appetite, loss or weight or even anaemia due to chronic blood loss.

IBD is also associated with arthritis and inflammation in other organs such as your liver or your eye.

Is inflammatory bowel disease dangerous?

There are several complications that can arise that makes it dangerous if untreated.

You can have a lot of bleeding from ulcers in the gastrointestinal tract (for ulcerative colitis). The ulcers may erode until they actually penetrate through to the other side of the bowel, causing it to rupture. This then constitutes a medical emergency.

The inflammation itself leads to healing and the formation of strictures, leading to intestinal obstruction.

In Crohn’s disease, the strictures do often resolve with treatment, but in ulcerative colitis, colonic strictures may become cancerous. In fact, having ulcerative colitis and Crohn’s disease itself makes your colon and intestinal cancer risk rise significantly.

The inflammation may lead to the formation of abnormal passages called fistulae.

Ulcerative colitis can also lead to a condition called toxic megacolon, which is a dilatation of your colon that is very dangerous.

Does inflammatory bowel disease interfere with digestion?

In Crohn’s disease, the small intestine becomes inflamed. Therefore, it becomes less able to absorb food and nutrients. This undigested food dumps into your large bowel, thus causing diarrhoea.

In ulcerative colitis, the large intestine is inflamed, but does not interfere with the absorption of nutrients, which is the function of your small intestine.

The large intestine, however, absorbs water, and interference with this function causes diarrhoea.

Are Malaysians prone to getting inflammatory bowel disease?

Luckily, we’re not. Westerners are more prone to it. But it is more common amongst people who live in cities, especially in developed countries. A family member who has it predisposes you to getting it too, as does smoking – which is a risk factor for Crohn’s disease.

Can IBD be treated?

Yes. There are plenty of anti-inflammatory medicines available, such as salicylates, steroids, immunomodulators, and biologic therapies. Then there is surgery to fix or remove damaged parts/strictures of your intestine.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.