10 Things to Know about Inflammatory Bowel Disease

iStock_000015424718XSmallInflammatory Bowel Disease (IBD) is a chronic condition that can be painful and inconvenient. We talked to UAB Professor Peter J. Mannon, MD, MPH, an expert in IBD, to learn more about its causes, types, treatments, and expertise at UAB.

1. IBD is fairly common.
Inflammatory Bowel Disease (IBD) is fairly common, says Peter Joseph Mannon, MD, MPH affecting more than one million people in North America alone. Most patients are diagnosed within their teens and 20s according to Mannon.

2. IBD and IBS are not the same thing.
IBD mainly includes Crohn’s disease and ulcerative colitis, which are inflammatory conditions, meaning the immune system is hyperactive and patients generally require immunosuppressive drugs, which dampen the immune response. IBS (Irritable Bowel Syndrome) is a non-inflammatory condition that can be managed by lifestyle changes, as well as medication. Some of the symptoms however can overlap both conditions, such as abdominal pain and changes in bowel habits.

3. Know the symptoms.
Many of the symptoms for Crohn’s and ulcerative colitis are similar including an increase in stool frequency and urgency, abdominal pain, bloating after meals, as well as having very loose stool or diarrhea. With Crohn’s disease, sometimes the inflammation can extend beyond the bowel and affect other organs.

4. The majority of IBD cases are Crohn’s and ulcerative colitis.
Crohn’s disease can affect the small intestine, the colon, or both. In less frequent circumstances, it can even affect the stomach, the esophagus, mouth, and skin. However, ulcerative colitis is limited to the colon. Another difference is that ulcerative colitis inflammation is limited to just the inside lining of the colon, whereas Crohn’s disease affects the full thickness of the bowel wall.

5. IBD is not restricted to Crohn’s and ulcerative colitis.
We recognize other sorts of autoimmune conditions such as autoimmune enteritis that can affect the small intestine and the colon, and there is an increasing recognition of another inflammation of the esophagus called eosinophilic esophagitis,” he says. Crohn’s and ulcerative colitis do make up 90 percent of Inflammatory Bowel Disease cases.

6. IBD is genetically linked.
There is a genetic predisposition to IBD. “We do know that there is a genetic predisposition to IBD,” says Mannon. However, these genes do not predict it 100 percent of the time. “In fact, more people who are healthy have these same exact gene defects,” he says. “While we do know there is a genetic component and there are certainly some families where there is a big concentration of the disease, it is recognized that environmental factors are also at play, and research is being done to understand what those are.”

7. IBD can affect moms-to-be.
“The bulk of IBD patients get their disease during their peak reproductive years so we always discuss family planning with them,” Mannon says. “Our goal is to make sure that the IBD is well controlled before people become actively engaged in their family planning and we support them through the pregnancy.” The biggest risk for pregnancy is having active disease that is not well controlled before getting pregnant, because this can predict poor pregnancy outcomes, including low birth weight, miscarriages, or early deliveries. “What we know is that many of the drugs that we use to treat inflammatory bowel disease can be used in a monitored manner around the time of and during pregnancy,” said Mannon.

8. Enlist the support of a team.
Through the UAB IBD Center, patients have access to their gastroenterologist, IBD surgeons, OB/GYNs with high-risk obstetrics experience, and more. “We also have Dermatology, Ophthalmology, Rheumatology, and Nutrition Services at UAB,” Dr. Mannon says. “All of these specialties can address both the complications of the IBD and sometimes the complications caused by the medications that people are on.”

9. Patients should make this lifestyle change.
“People always ask if there is anything they can do about their lifestyle to improve inflammatory bowel disease,” Mannon says. “Truth be told, study after study, there is not one factor about diet or lifestyle in general except for tobacco use. This repeatedly has been shown to make Crohn’s disease much worse in terms of the need for surgery and the poor response to drugs.”

10. UAB is changing how we treat IBD.
“I think people want to come here because it is a center of expertise not only for the administration of drugs but also for the management and monitoring.” Mannon and the UAB team see patients in the Digestive Health Center, conveniently located on the first floor of the Kirklin Clinic. “We have the blood drawing area right there, we have a pharmacy in the building, and we have Radiology in the same building. The gastroenterologists and IBD surgeons even have clinic hours together in the same area. It makes things very convenient,” said Mannon.


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