What Is Inflammatory Bowel Disease?
Inflammatory bowel diseases (IBD) are a group of inflammatory conditions. The immune system normally protects the body from infection. In people with IBD, the immune system launches an attack that inflames the digestive tract.
The most common inflammatory bowel diseases are:
- Crohn’s disease. This type of IBD inflames the lining and the deeper layers of your digestive tract.
- Ulcerative colitis. This type of IBD involves ulcers (sores) and inflammation on the inner lining of your large intestine (colon) and rectum.
IBD affects approximately three million adults in the United States or 1.3 percent of US adults.* You can develop IBD at any age, but IBD is most often diagnosed between ages 15 and 35 or ages 55 and 70.
Inflammatory Bowel Disease Symptoms
Symptoms of IBD may be different for different people. Possible symptoms can include:
- blood in stools,
- abdominal pain,
- weight loss,
- joint pain, or
- painful mouth ulcers.
People with IBD may experience flares or episodes of active symptoms and remission or periods of time without symptoms. Healing inflammation in your intestine will reduce the frequency of IBD flares and prevent complications.
What Does Inflammatory Bowel Disease Feel Like?
With IBD, you may feel any of the following:
- Persistent diarrhea or constipation
- Rectal bleeding
- Abdominal pain or cramping
- Loss of appetite or weight loss
If you have severe abdominal pain that does not go away, be sure to contact your doctor, urgent care, or go to the emergency room.
The cause of IBD is unknown. Risk factors for developing the disease may include the following:
- Genetic risk
- Environmental factors
- Changes in intestinal bacteria
Complications From IBD
You can develop some complications (additional symptoms or conditions) from IBD. These could include any of these conditions or symptoms:
Inflammation of your skin, eyes, and joints. Sometimes disorders like arthritis, skin lesions, and uveitis (eye inflammation) can happen when you experience an IBD flareup.
Colon cancer. When ulcerative colitis or Crohn's disease affects most of your colon, it can increase your risk of colon cancer. Learn more about cancer screenings for colon cancer.
Medication side effects. Some medications used for IBD treatment can increase your risk of infection. Some medications can cause skin changes or a small increased risk for developing certain cancers. Your doctor will work closely with you to monitor any side effects from medications if they prescribe any.
Blood clots. Active IBD raises the risk of blood clots in your veins and arteries. Treating your IBD and controlling the inflammation can lower this risk.
Primary sclerosing cholangitis. In this condition, inflammation causes scarring in the bile ducts, which eventually makes them narrow. It can gradually cause liver damage.
Find more specific complications in the information about ulcerative colitis and Crohn’s disease.
Treatment for Inflammatory Bowel Disease
There is no cure for IBD, but several treatments are available that can heal your intestinal inflammation and control disease symptoms. IBD treatment usually involves medication, diet/lifestyle changes, or surgery.
Anti-inflammatory drugs: Your doctor may prescribe specific anti-inflammatory drugs to reduce the inflammation in your digestive tract.
Immune system suppressors: These drugs work to suppress the immune response that is causing the inflammation in your body tissues and organs.
Biologics: Biologics are medications that work to neutralize proteins in the body that are causing inflammation.
Antibiotics: Your doctor may prescribe antibiotics when you might have an infection in addition to the inflammation in your digestive tract.
Other medications and supplements: In addition to controlling inflammation, some medications may help relieve your symptoms. Your doctor will let you know if you should consider taking any of the following:
- Anti-diarrhea medications
- Pain relievers
- Vitamins and supplements
Be sure to check with your doctor before taking any over the counter products and supplements.
If medication, diet, and lifestyle changes don't relieve your IBD symptoms, or if there have been complications from the chronic inflammation, your doctor may recommend surgery. If you develop precancerous or cancerous changes in your colon, you may need surgery.
During surgery, your surgeon removes a damaged portion of your digestive tract. Then they reconnect the healthy sections. Your surgeon may also close fistulas and drain abscesses if those have developed from the condition.
Certain foods can make your inflammatory bowel disease worse. Planning a diet that fits your condition can help reduce flares from IBD. These types of food are standard recommendations for a nutritious diet:
- Fruits and veggies
- Lean proteins
- Calcium-rich foods
Foods to avoid could include these:
- Processed foods, for example foods containing titanium dioxide or sulfites
- Emulsifiers and thickeners
- Foods containing maltodextrin and artificial sweeteners
- Unpasteurized dairy products
- Trans fats
You could also keep a diary of the particular foods or combinations of foods that seem to trigger your flare-ups so that you can avoid them.
Fiber is something you want to manage carefully. High-fiber fruits and vegetables can increase symptoms during a flare. If you have stricturing Crohn’s disease (narrowing in the bowel), be careful with high fiber foods. When your IBD is doing well or in remission, we encourage you to eat high-fiber fruits and vegetables.
When to See a Doctor for IBD
You should see a doctor if you have signs or symptoms of inflammatory bowel disease. Uncontrolled IBD can damage your bowel and can cause other complications.
Who Treats Inflammatory Bowel Disease?
Gastroenterologists are the specialists who treat IBD. Gastroenterologists specialize in diseases and conditions of the digestive tract. These include your stomach, esophagus, small intestine, colon, rectum, pancreas, gallbladder, bile ducts, and liver.
Gastroenterologists Near You
Inflammatory Bowel Disease Vs. IBS
IBD and IBS can have similar symptoms, however IBD is a group of conditions that cause inflammation in your digestive tract.
IBS creates symptoms when the contents of your large intestine move too quickly or too slowly. Pain receptors in the intestine are very sensitive. Testing usually won’t show any physical reasons for your symptoms.
The symptoms that are similar between IBD and IBS include:
- diarrhea or constipation,
- belly pain, and
- passing stool more often or feeling like you need to go right away.
With IBD, symptoms get worse over time. You may get:
- bloody or black stools,
- weight loss or loss of appetite,
- inflamed skin or joints, and/or
- inflamed eyes.
Pain in IBD Vs. IBS
Both IBS and IBD can cause abdominal pain.
What to Expect When You See a Gastroenterologist
When you see a gastroenterologist, they will start the appointment by reviewing your medical history. If your medical history is already entered into your electronic medical records, this will help the process. Is also helps your specialist if you know your family history—whether your parents or other relatives had similar conditions.
Your specialist will examine you to check for inflammation and other signs that maybe point to a cause of your symptoms. Be prepared to change into a medical gown for this exam. They might also have you take some tests or have certain procedures.
Tests & Procedures
Tests and procedures can include lab tests, endoscopic procedures, and imaging procedures.
Lab tests: These could include blood tests, where your doctor checks for anemia (a condition where you don't have enough blood cells to carry oxygen to your body), inflammation, and vitamin deficiencies. Stool tests can check for inflammation in the digestive system or infections from viruses or bacteria.
Endoscopies: In endoscopic procedures, your doctor will use an endoscope, or a flexible tube with a camera) to look at your colon and rectum. They can also take small biopsies, or samples, to test.
Imaging Scans: Your doctor may order images of your abdomen to check for inflammation or other complications. A radiologist may use a CT scan, X-ray, or MRI.
*Dahlhamer JM, Zammitti EP, Ward BW, Wheaton AG, Croft JB. Prevalence of inflammatory bowel disease among adults aged ≥18 years — United States, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(42):1166–1169. https://www.cdc.gov/mmwr/volumes/65/wr/mm6542a3.htm.