Definition of Inflammatory Bowel Disease: Inflammatory bowel diseases are a term used for diseases that result from chronic inflammation in the digestive system, primarily affecting the intestines. The two most common types of inflammatory bowel diseases are ulcerative colitis and Crohn’s disease.

Ulcerative Colitis: This condition primarily affects the colon and rectum. In ulcerative colitis, the superficial layer that lines the colon is affected, leading to the formation of ulcers on the intestinal surface.

Crohn’s Disease: Crohn’s disease can affect any part of the digestive system, but it most frequently involves the small intestine. While only the surface layer of the intestine is affected in ulcerative colitis, deeper tissues can be affected in Crohn’s disease.

The symptoms of inflammatory bowel diseases vary depending on the area affected and the severity of the inflammation. Some patients may exhibit milder symptoms, while others may experience severe indications. Inflammatory bowel diseases can manifest with flare-ups when symptoms intensify and remission periods when symptoms subside. Common symptoms in ulcerative colitis and Crohn’s disease include:

  • Diarrhea
  • Abdominal pain
  • Blood in stool
  • Abdominal cramps
  • Loss of appetite
  • Fatigue and weakness
  • Unintentional weight loss

Individuals showing one or more of these symptoms or noticing changes in their bowel movements recently should consult a doctor for necessary examinations. As inflammatory bowel diseases can lead to serious health issues, their diagnosis and treatment should not be overlooked.

What are the Complications of Inflammatory Bowel Diseases?
Inflammatory bowel diseases can lead to some undesirable effects in the body. Common complications that can occur in both ulcerative colitis and Crohn’s disease include:

  • Colon Cancer: Patients whose large intestine has been significantly affected by ulcerative colitis or Crohn’s disease have an increased risk of developing colon cancer. Patients diagnosed with inflammatory bowel cancer begin screening for colon cancer 8-10 years after diagnosis. The timing of the screening may vary based on the patient’s age, comorbidities, and family history, so diagnosed patients should discuss when to start screening with their doctor.
  • Skin, Eye, and Joint Inflammations: During flare-ups of inflammatory bowel diseases, conditions like arthritis (joint inflammation), skin lesions, and uveitis may occur.
  • Medication Side Effects: Some medications used to treat inflammatory bowel diseases may carry a slight risk of cancer development. Corticosteroids used in treatment can also lead to conditions such as osteoporosis and high blood pressure.
  • Primary Sclerosing Cholangitis: This condition, which involves the inflammation and narrowing of the bile ducts within the liver, can lead to impaired liver function. People with primary sclerosing cholangitis are likely to have inflammatory bowel disease.
  • Blood Clots: Inflammatory bowel diseases increase the risk of blood clot formation within blood vessels.

Undesirable Conditions Associated with Crohn’s Disease:

  • Intestinal Obstruction: Crohn’s disease can affect all layers of the intestinal wall, causing the affected segment to thicken and narrow, obstructing the passage of digestive materials through the intestine.
  • Malnutrition: Patients with Crohn’s may struggle to eat due to diarrhea, abdominal pain, and cramps. Additionally, absorption issues may occur in the intestine, leading to insufficient intake of essential nutrients. This can result in vitamin B12 and iron deficiency anemia.
  • Fistula Formation: A fistula refers to an abnormal connection between two different parts of the body. In Crohn’s disease, inflammation of the intestinal wall can lead to the formation of fistulas connecting to other organ walls, most commonly occurring in the anal region. A fistula may become infected and form an abscess.
  • Anal Fissure: Patients with Crohn’s may develop small tears in the skin around the anus, known as anal fissures.

Complications Seen in Ulcerative Colitis:

  • Toxic Megacolon: In patients with ulcerative colitis, the colon may suddenly swell and expand, leading to a condition called toxic megacolon.
  • Intestinal Perforation: Toxic megacolon can cause intestinal perforation, which can occur spontaneously.
  • Severe Fluid Loss: Excessive fluid loss due to diarrhea can lead to dehydration.

What Causes Inflammatory Bowel Diseases?
The exact causes of inflammatory bowel diseases remain unclear. Experts believe that various factors, including diet, genetics, stress, and environmental factors, may play a role in disease development.

The immune system also plays a role in the development of inflammatory bowel diseases. Under normal circumstances, the immune system recognizes and destroys harmful microorganisms such as bacteria, viruses, and parasites that enter the digestive system. During this process, inflammation occurs in the intestine to combat the infection. Once the infection is resolved, the inflammation subsides, and the intestine returns to its normal state. In healthy individuals, the infection process operates in this manner. However, in inflammatory bowel diseases, inflammation occurs in the absence of an infection. The immune system attacks the healthy intestinal cells, leading to organ damage.

Risk Factors for Inflammatory Bowel Diseases:

  • Age: Patients diagnosed with inflammatory bowel diseases are often under 30, though some may not develop the disease until their 50s.
  • Family History: Individuals with first-degree relatives (parents, siblings, children) who have inflammatory bowel diseases are at a higher risk.
  • Smoking: Smoking is the most significant controllable risk factor for developing Crohn’s disease.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications containing active ingredients like ibuprofen, naproxen sodium, and diclofenac sodium pose risks for both the development of the disease and the progression of existing conditions.

Diagnosis and Treatment of Inflammatory Bowel Diseases:
Diagnosis involves a comprehensive investigation considering other disorders that could cause similar symptoms and signs. Blood tests and stool tests are performed to evaluate potential diseases. Endoscopy and colonoscopy are used to assess the effects of ulcerative colitis or Crohn’s disease on the digestive organs. For patients with conditions like intestinal perforation where endoscopic methods cannot be applied, imaging methods such as X-ray, CT, or MRI may be utilized.

The primary goal in treating inflammatory bowel diseases is to reduce the inflammation causing the disorder. Reducing inflammation alleviates both symptoms and signs, contributing to long-term remission of the disease. Additionally, treatment can help prevent complications that may arise from the disease.

Both medication and surgical methods can be employed in treatment.

In Medication Treatment:

  • Anti-inflammatory medications such as corticosteroids to reduce inflammation.
  • Immunosuppressive drugs like azathioprine and methotrexate to suppress the immune response.
  • Antibiotics may be used if an infection develops due to the disease.
  • Depending on the patient’s condition, the doctor may prescribe anti-diarrheal, pain relief medications, and vitamin supplements.

When significant weight loss occurs or nutritional intake severely declines in patients with inflammatory bowel disease, nutritional support may be initiated. Specialized nutritional methods, such as tube (enteral nutrition) or intravenous nutrition (parenteral nutrition), may be implemented to facilitate recovery and rest the intestine.

In the surgical treatment of ulcerative colitis and Crohn’s disease, the affected section of the intestine is removed, allowing the remaining intestine to function healthily. Surgical intervention may also be necessary for complications such as intestinal obstruction. However, surgery does not provide a definitive solution for these diseases. The operation is performed to improve the patient’s overall condition and prevent possible complications.

If you suspect you have inflammatory bowel disease, consult a qualified healthcare facility for necessary examinations. It is beneficial for individuals diagnosed with inflammatory bowel disease to consult a gastroenterologist to discuss the most effective treatment methods and obtain detailed information about the disease.

Wishing you healthy days.