If your cramps are painful and you’re losing weight, you may have IBD

KARACHI: Inflammatory Bowel Disease (IBD) is a young person’s disease, which usually attacks students or people who are either starting a family or building a career, said Dr Hasnain Shah, a consultant gastroenterologist at the Aga Khan University Hospital (AKUH).

A number of consultant gastroenterologists from the AKUH discussed ways to manage this disorder at the Digestive Day that was held at the hospital on Wednesday.

People who suffer from bloody diarrhoea and weight loss may have IBD, which typically starts with a cramp in the abdomen. It is accompanied by diarrhoea, often tainted with mucus or blood, said Shah, who added that in some cases, the situation becomes so bad that a person may require hospitalisation.

These symptoms can flare up and recede without warning. However, infections and dysentery may also be responsible for such signs, Shah added.

Sometimes a sigmoidoscopy, a colonoscopy or a biopsy can also determine the reason behind such symptoms, said Dr Rustam Khan, who added that these exams typically reveal a characteristic pattern. Blood and stool tests can also help rule out infections that mimic IBD, he said.

“What triggers IBD is unknown,” said Dr Khalid Mumtaz. “Some experts believe that a defective immune system may cause antibodies to injure the colon while others speculate that an unidentified microorganism may be responsible instead,” added Mumtaz, who was of the belief that IBD is caused by several factors, including genetics.

There are a number of medical treatments that can help reduce the inflammation, said Dr Shahab Abid. Anti-inflammatory drugs, such as aminosalicylates, are the first in the line of treatment for patients suffering from mild to moderate cases of IBD. Corticosteroids are extremely effective for the treatment of severe cases, but come with adverse side effects if used for a long time. Meanwhile, new drugs such as Infliximab can control IBD when other medicines stop working, Abid added.

IBD is a combination of two disorders - Crohn’s disease and ulcerative colitis - that result in a recurrent inflammation in the intestines.

Although the two diseases share many characteristics, they differ in terms of the outcome.

Crohn’s disease causes ulcers or open wounds in the small and large intestines whereas ulcerative colitis usually develops in the large intestine, mostly towards the rectal area, explained Dr Saeed Hamid, also a consultant gastroenterologist at the AKUH.

“In ulcerative colitis, the lining of the intestine is affected, while several layers of the intestinal wall swell up in the Crohn’s disease, making the latter the more severe of the two disorders,” he added.

Crohn’s disease can be diagnosed using special x-rays, said Khan. However, it cannot be treated through surgery, said Dr M Salih, who added that the procedure can only be used to treat acute cases of ulcerative colitis.

If cases of ulcerative colitis are left undiagnosed for as long as eight to 10 years, they can develop into colon cancer, especially if a patient has a family history of cancer, said Salih, who was of the view that people should get regular checkups of the colon even if they are not troubled by any of the likely symptoms.

Published in The Express Tribune, July 30^th, 2010.