Inflammatory bowel diseases occur when digestive organs, especially the intestine, are exposed to inflammation for a long time. These diseases progress with occasional exacerbation and remission. With appropriate treatment, it is possible to stop the progression of the disease and prevent the development of complications related to the disease.
What is an inflammatory bowel disease?
Definition of inflammatory bowel disease; It is used for diseases caused by chronic inflammation in the digestive system, especially in the intestines. The two most common types of inflammatory bowel diseases are ulcerative colitis and Crohn’s disease.
Ulcerative colitis; It is a disorder that mainly affects the large intestine and rectum. In ulcerative colitis, the superficial layer lining the large intestine is affected and ulcer formation is observed on the intestinal surface.
Crohn’s disease; Although it can affect any part of the digestive system, it most frequently causes small intestine involvement. While only the surface layer of the intestine is affected in ulcerative colitis, deeper tissues may be affected in Crohn’s disease.
Symptoms of inflammatory bowel diseases vary according to the area affected by the disease and the degree of inflammation. Some patients show milder symptoms, some patients may have severe symptoms. Inflammatory bowel diseases; It may progress with exacerbation of symptoms and remission periods in which symptoms are relieved. Common symptoms in ulcerative colitis and Crohn’s disease:
- Abdominal pain
- Blood in feces
- Abdominal cramps
- Loss of appetite
- Fatigue, weakness
- Involuntary weight loss
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People who show one or more of the symptoms of inflammatory bowel diseases and who have recently noticed a change in bowel movements; It will be beneficial to apply to a doctor and have the necessary tests done. Since inflammatory bowel diseases can cause very serious health problems, diagnosis and treatment should not be missed.
What are the complications of inflammatory bowel diseases?
Inflammatory bowel diseases can cause some unwanted effects in the body. Complications that can be common in both ulcerative colitis and Crohn’s disease:
- Colon cancer: Patients who have a large part of their large intestine affected by ulcerative colitis or Crohn’s disease have an increased risk of developing colon cancer. Patients diagnosed with inflammatory bowel cancer are screened for colon cancer 8-10 years after diagnosis.
- Scanning start time patient; It may vary depending on the characteristics such as age, additional diseases, family history. Therefore, diagnosed patients should discuss with their doctor about when to begin colon cancer screening.
- Skin, eye and joint inflammations: During the exacerbation periods of inflammatory bowel diseases, diseases such as arthritis (joint inflammation), skin lesions, uveitis can be seen.
- Medication side effects: Some drugs used in the treatment of inflammatory bowel diseases may have a small risk of cancer development.
- Corticosteroids used in treatment; It can lead to conditions such as osteoporosis, high blood pressure.
- Primary Sclerosing Cholangitis: This condition, in which the bile ducts in the liver become inflamed and narrow, may lead to deterioration in liver functions. People with primary sclerosing cholangitis are more likely to have inflammatory bowel disease.
- Clot: Inflammatory bowel diseases increase the risk of blood clots in the veins.
Undesirable conditions that may occur due to Crohn’s disease:
- Intestinal obstruction: Crohn’s disease can affect all layers of the intestinal wall. The intestinal wall in the affected part thickens and contracts, preventing the progress of digestive materials into the intestine.
- Malnutrition: Crohn’s disease; He may have difficulty eating because of diarrhea, abdominal pain and cramps. In addition, problems may occur in nutrient absorption in the intestine. These situations cause the patient not to get the foods needed by the body. Anemia may develop due to vitamin B12 and iron deficiency in patients with Crohn’s disease.
- Fistula formation: Fistula means the formation of an abnormal connection between two different body parts. In Crohn’s disease, the intestinal wall may become completely inflamed and progress to other organ walls and form a fistula. The most common fistula formation is seen in the anal (perianal) region. The fistula may become an infected abscess.
- Anal fissure: In Crohn’s patients, a small tear may occur on the skin surface surrounding the anus. This condition is called anal fissure formation.
Complications seen in ulcerative colitis:
- Toxic megacolon: In ulcerative colitis patients, the large intestine may swell and expand suddenly, causing a picture called toxic megacolon.
- Perforation in the intestine: Perforation may occur spontaneously as well as toxic megacolon may cause intestinal perforation.
- Excessive fluid loss: Excessive fluid loss from the body due to diarrhea can lead to dehydration.
What causes inflammatory bowel diseases?
The issue that inflammation is caused by intestinal diseases has not been adequately clarified yet. Experts; He thinks that many factors such as nutrition, genetics, stress and environmental factors can be effective in the development of the disease.
The immune system also plays a role in the development of inflammatory bowel diseases. Normally the immune system; It recognizes and destroys microorganisms such as harmful bacteria, viruses, parasites that enter the digestive system as in the whole body. During this process, inflammation occurs in the intestine through the immune system to fight infection. When the infection is eliminated, the inflammation resolves and the intestine returns to its former state. This is the infection process in healthy people. In inflammatory bowel disease, inflammation occurs in the intestine even though there is no infection. The immune system attacks healthy gut cells, the body’s own cells, and causes organ damage.
Conditions that pose a risk for inflammatory bowel diseases:
- Age: Patients diagnosed are usually less than 30 years old. However, in some people, the disease may not occur until the age of 50.
- Family history: The disease is more common in people with first-degree relatives such as parents, siblings and children with inflammatory bowel disease.
- Smoking: Smoking is the most important controllable risk factor in the development of Crohn’s disease.
- Non Steroidal Antiinflammatory Drugs: NSAIDs containing active ingredients such as ibuprofen, naproxen sodium, diclofenac sodium pose a risk for both the development of the disease and the progression of the existing disease.
How is the diagnosis and treatment of inflammatory bowel diseases?
In the diagnosis, a comprehensive investigation is carried out by taking into account other conditions that may cause symptoms and signs. Blood tests and stool tests are applied to evaluate possible diseases. Methods such as endoscopy and colonoscopy are used to evaluate the effects of ulcerative colitis or Crohn’s disease on the digestive organs. In patients with conditions such as intestinal perforation (perforation) where endoscopic methods cannot be applied; Imaging methods such as X, ray, CT, and MR can be used.
The main purpose in the treatment of inflammatory bowel diseases; It is the reduction of inflammation that causes discomfort. Reducing inflammation; It provides both symptom and symptom relief and long-term remission of the disease. In addition to these, the complications that may occur due to the disease can be prevented thanks to the treatment.
Both drug therapy and surgical methods can be used in the treatment.
In drug therapy;
- Anti-inflammatory drugs such as corticosteroids to reduce inflammation
- Nitotriopine, methotrexate-like drugs to suppress the immune response
- Antibiotics can be used if the infection has developed due to the disease.
Depending on the patient’s condition, the doctor; He / she may prescribe anti-diarrhea, pain medication and vitamin supplements.
When excessive weight loss is observed in patients with inflammatory bowel disease or when the patient’s diet is seriously impaired, nutritional support may be initiated for the patient. Special nutrition methods that provide nutrition through tube (enteral nutrition) or vascular access (parenteral nutrition) can be applied to the patient. In this way, both the recovery of the patient and the rest of the bowel are provided.
In the surgical treatment of ulcerative colitis and Crohn’s disease, it is aimed to remove the affected intestine and to restore the remaining intestine to a healthy function. Treatment of complications such as intestinal obstruction due to the disease may also require surgical intervention. However, surgery does not provide a definitive solution for these diseases. Surgery is performed to improve the general condition of the patient and to prevent possible complications.
If you are suspected of having an inflammatory bowel disease, you should apply to a well-equipped health center and have the necessary checks. It will be useful for people diagnosed with inflammatory bowel disease to consult a gastroenterologist to discuss the most effective treatment methods and to have detailed information about the disease.
We wish you healthy days.
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