It's time to talk about your bowels.
Sure, nobody likes to talk about what happens behind a closed bathroom door — or any problems they have after. But your bowels can signal serious health issues that you may otherwise write off as something with less significance.
Take something as common as rectal bleeding. It could be from a hemorrhoid or anal fissure. Or it could be a sign of something more serious like inflammatory bowel disease. Or even colon cancer.
That’s a broad range of health issues from a single bowel symptom. If it’s a one-time occurrence, you might be able to move on. Symptoms that present over weeks, months or longer, however, should raise a red flag that you might have a severe bowel issue like inflammatory bowel disease.
What is inflammatory bowel disease?
Inflammatory bowel disease, or IBD, is a broad term used to describe a variety of diseases that share a common trait: chronic inflammation of the gastrointestinal tract. There are two main types of IBD:
- Ulcerative colitis – In ulcerative colitis, chronic inflammation is limited to the large intestine and extends continuously upward from the anus a variable distance. This disease is characterized by redness and ulcers along the lining of the colon and rectum.
- Crohn’s disease – Crohn’s disease can occur anywhere along the digestive tract, from your mouth to your anus. It most commonly occurs in the last part of the small intestine and the colon, where there’s a mix of healthy and inflamed spots.
You can also have an inflammatory bowel disease that doesn’t quite fit either of those two conditions. No matter where the IBD diagnosis falls on the spectrum, symptoms can overlap. The main symptoms of inflammatory bowel disease include rectal bleeding, diarrhea, abdominal pain, anemia and unexplained weight loss — which can also occur in other bowel conditions.
What’s the difference between IBD and IBS?
One of the bowel conditions that has similar symptoms to IBD is IBS, or irritable bowel syndrome. Despite the overlapping symptoms and similar names and initials, they are two very different conditions. And you can actually have both of them at the same time.
The difference lies in the underlying cause: inflammation. IBD is a chronic inflammatory disorder, the diagnosis of which is confirmed with testing. Chronic bowel inflammation involves injury to the bowel. Over time, such damage to the large bowel can lead to colorectal cancer.
IBS, on the other hand, is a disorder with irritation rather than inflammation. It includes things like bowel spasms and sensitivity, which don’t damage the bowel.
Irritable bowel syndrome is far more common. It’s estimated to affect up to 15 percent of Americans — more than 10 times the amount of people living with inflammatory bowel disease. In some cases, you may need to see a gastroenterologist and undergo testing, like a colonoscopy, to distinguish IBS from IBD — and get the appropriate treatment.
How do you treat IBD?
Living with IBD isn’t easy. Symptoms can be severe and debilitating. Even when the symptoms have gone away, the inflammation may still be there, causing damage and putting your health at risk.
That’s why gastroenterologists like those in The Iowa Clinic’s Inflammatory Bowel Disease Center aim to not only improve symptoms, but to improve inflammation. Being free of symptoms can make you feel good. But reducing inflammation — or getting rid of it entirely — helps keep those symptoms away for good and prevents complications down the line.
There’s been a paradigm shift in IBD treatment in the past 15 years, according to The Iowa Clinic’s IBD experts. Once a diagnosis is made, the disease is objectively monitored and tightly controlled, similar to the way blood sugars are closely watched with diabetes. While everybody’s treatment plan is different, it primarily comes down to medication and diet.
IBD Medications
Your treatment may include anti-inflammatory drugs, immunosuppressants, antibiotics or a combination of the three. Since inflammatory bowel disease is an autoimmune disorder, medications that suppress the immune system may be necessary.
You share in the decision-making with your GI doctor to figure out the best medication regimen for you and your lifestyle. Together, you fine-tune the treatment plan to resolve your unique symptoms and triggers.
An IBD Diet
“Eat a healthy diet” is not new advice or even nutrition guidance specific to inflammatory bowel disease. But the effects of chronic inflammation in your digestive tract can leave you deficient in essential nutrients, low in iron and struggling to maintain your weight. So eating a well-balanced diet with an emphasis on fruits and vegetables is important.
You need to make sure that you’re getting enough protein, calories and nutrients. You can have low levels of vitamin B12, vitamin D or other nutrients. So you need to know which ones you’re lacking so you can adjust your diet accordingly. Even if you eat a well-balanced diet, you may still need to fortify it with the appropriate vitamins and supplements for your deficiencies.
Where do I go if I have bowel problems?
With inflammatory bowel disease on the rise across the world, it’s important to open up and discuss your bowel issues with your primary care provider. They can help you rule out the multitude of other conditions that may appear to be IBD.
If your provider suspects inflammatory bowel disease — or other serious bowel problems — they’ll refer you to a gastroenterologist for further testing. With modern diagnostic tools and treatment approaches, there are more arrows in the quiver to address your symptoms, treat your bowel inflammation and improve your quality of life.