Health Care

Understanding Inflammatory Bowel Disease

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Inflammatory bowel disease, or IBD, affects about 1.6 million Americans who are usually diagnosed before the age of 35. This painful (and potentially life-threatening) chronic condition is a blanket term that’s used to describe two specific conditions: Crohn’s disease and ulcerative colitis. Both have similar symptoms and the treatment options overlap.

To learn more about IBD, we spoke with AdventHealth Medical Group board-certified gastroenterologist Kalyani Meduri, MD .

Symptoms of IBD, Prevention and Who’s at Risk

If you have symptoms of bloody stools, persistent diarrhea, weight loss or mucus in the stool, it’s important to have it checked out with a gastroenterologist, such as Dr. Meduri.

“Anyone with a family history of IBD is at a greater-than-average risk, and a combination of genetic and environmental factors play a role,” explains Dr. Meduri. As many as five to 20% of patients have a family member with IBD.

Smoking also worsens the condition and increases the risk of Crohn’s disease, which is a type of IBD. Using antibiotics early in life can also increase the risk. Additionally, if you have an autoimmune predisposition such as thyroid problems, you may be at increased risk.

Treatment for Crohn’s Disease and Ulcerative Colitis

IBD is a chronic condition and there’s no cure, but with proper treatment, the right precautions and lifestyle changes, you could potentially live free from symptoms. Dr. Meduri explains, “There’s no cure for IBD, but with the right treatment, patients can have a normal quality of life.”

Medications That Help

The medications depend on what symptoms you have. If you have mild symptoms, you can be treated with oral medications but if the symptoms are severe, you may need medications called biologics, which are injectable medications given anywhere from once every two weeks to once every two months to control symptoms.

Oral medications such as mesalamine are the simplest option to start, followed by Entocort, a prescription corticosteroid medicine. If you don’t respond to any of these medications, you could use biologics. These medications have a variety of side effects and your doctor will do periodic labs such as blood counts, liver tests, tests for TB and Hep B.

Medicines such as steroids, along with biologics, can reduce the time of symptom flare-ups. Less than 5% of people can eventually live off medication, but the remainder of patients need them for life.

Additionally, some patients have tried acupuncture and found some success in reducing symptoms.

Other Considerations and Precautions

Dr. Meduri says to keep these other points in mind:

  • Limit fiber: Once you’ve been diagnosed with IBD, you should limit fiber in your diet (a low fiber diet will help with your symptoms and avoiding raw salads and nuts and limiting red meat may also help)
  • Get your flu shot: If you're on an immunosuppressant, you're at a slightly higher risk of infection and you should make sure that you get a flu vaccine and take Pneumovax® to decrease this risk
  • Talk with your OB/GYN about pregnancy: IBD can affect pregnancy, including pre-term birth, stillbirth, and small-for-gestational-age babies (make sure the disease is in remission before you become pregnant)
  • Surgery considerations: 50% of patients will require at least one surgery in their lifetime, but with a follow-up with an IBD specialist, you can decrease this risk
  • Know your colon cancer risk: If untreated, IBD can increase the risk of colon cancer and surgeries in your abdomen, which may require a permanent colostomy bag
  • Get your colonoscopies: Patients who have had symptoms of IBD for eight years or longer should get a colonoscopy every one or two years.”

Getting the IBD Care You Need

If you’re concerned about your symptoms or received an IBD diagnosis, we’re here to support you. To learn more or to request an appointment, contact Robin, our Bariatric and Digestive Health Nurse Navigator, at 352-521-1170 or click here.

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