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An umbrella term for inflammatory bowel diseases
The main ones are Ulcerative Colitis and Crohn’s disease, autoimmune diseases that are life long but relaxing and remitting
Mostly in the GI tract but you can get extraintestinal symptoms such as inflammation of joint or eyes.
Exact etiology is unknown but there are several factors:
Genetic factors: plays a part, 20% of IBD patients have a close relative with an IBD. Interestingly there is an increased occurrence in specific jewish populations and a decreased risk in asian populations.
Environmental factors: IBD is on the rise in developed countries and is more prevalent in urban areas
Diet and Lifestyle: Smoking leads to an increased risk of crohn’s disease but also suppresses the symptoms of ulcerative colitis in some patients
Immune System: an inappropriate immune response to gut microbes is a known factor
Stress: stress is a trigger for the development and relapses of the disease
There are 7 key symptoms with a lot of crossover with other conditions which can lead to late diagnosis/misdiagnosis
Frequent diarrhea – 5-20 times a day
Fatigue – partly related to diarrhea but also if the gut wall is compromised micronutrient deficiency can occur
Abdominal pain and bloating
Blood and mucus in stools are key symptoms, indicative of wounding to the gut wall
Eczema can be a sign
Mental health impact: can be quite unsupported
Where bowl is affected chronic constipation may be a symptom
One hypothesis is the hygiene hypothesis
Lack of sleep
Microbial diversity and the health of the gut, dysbiosis in the development of the disease
Eating a wide variety of plant foods and high fibre foods can have a positive effect on the gut
In IBD fibre can exacerbate symptoms in a flare up however the short chain fatty acids are an important part of maintaining a healthy gut lining. Avoid fibre when you’re in a flare up but consume it in remission
For patients in a flare up it’s necessary to increase your fluids and replenishing electrolyte loss
Consuming animal protein can cause a change in the microbiome
Dietary interventions need to be tailored to the client, there are specific triggers for specific patients but there isn’t a one size fits all diet.
An elimination diet is the clearest way to find out what your triggers are
Foods such as ginger and mint can be soothing for stomach pain and nausea
Emulsifier carrageenan has been linked to the development of IBD
Medical management is really important to decrease inflammation in the gut and suppress the immune system
Usually patients are started off on anti-inflammatory drugs such as 5ASAs
If those don’t work they are often layered with immunosuppressants such as corticosteroids but usually not for more than a few weeks at a time
There are a new type of drug called biologics however they do come with side effects so usually are more of a later intervention
Last resort is surgery where the bowel or part of the bowel is removed and recovery occurs either by stitching up the bowel or using a colostomy bag, more commonly in crohns.
Communicate your needs to those around you to get support, especially at work/school
Teleworking is a good option during flare ups
If fatigue is an issue for you it’s important to ask for flexibility with hours
IBD also effects parents who are caring for their children who may have IBD
Managing friends and families expectations can also be difficult, one of the best things you can do if your friend is suffering with IBD and cancels is to offer to go to them.
Be prepared: carry around a spare pair of trousers, underwear, wipes
Incontinence pants – can be a good temporary measure to prepare for accidents
Stress management tools can be great for long term management
You can always ask for referral to a different doctor
There are also tons of associations all over the world for support the main one is crohns and colitis UK which have loads of information online as well as phone lines for advice.
Some supplements can help some patients, check out Aliza’s supplements brand Inessa
Iron status due to blood loss, iron supplements can cause GI problems so ensure you are taking the right kind for you
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