Update | June 8, 2022 Author : Joana Torres Inflammatory bowel disease is characterized by a chronic and recurrent inflammation of the digestive tract . It is a progressive disease , which can worsen over time and cause other complications – like anemia, osteoporosis, arthritis, eye inflammation, among others - if it is not properly diagnosed and treated. It affects more than 5 million people worldwide and about 25 thousand people in Portugal. The cause of the bowel inflammatory disease is unknown. It is thought that in genetically predisposed people there is an exaggerated reaction of the immune system to the intestinal flora (the bacteria that inhabit our intestines), which triggers a chronic inflammation that leads to symptoms . Symptoms of inflammatory bowel disease Symptoms of inflammatory bowel disease vary, depending on the severity of the inflammation and where it occurs. They can vary from mild to severe; Periods of active disease followed by periods of remission are likely to occur. Signs and symptoms that are common in inflammatory bowel disease include: Diarrhea; Fatigue; Abdominal pain and cramps; Blood in stools; Reduced appetite; Involuntary weight loss; Fistulas and/or abscesses in the anus (in Crohn disease); Extraintestinal symptoms such as joint pain, oral thrush, anemia, among others, may also occur. When and how is the diagnosis of inflammatory bowel disease made? Inflammatory bowel disease is most often diagnosed during adolescence or in young adults , although it can also be diagnosed during childhood or later in life. After inflammatory bowel disease appears for the first time, periods of active disease tend to alternate with periods of remission of symptoms. The diagnosis of inflammatory bowel disease is made based on: Clinical history; Physical exam of the patient; Additional medical tests deemed necessary. Among the additional tests , it may be advisable, for example, to perform: Blood tests, which may suggest inflammation; Stool analysis, which can reveal inflammation in the intestine - fecal calprotectin ; Ileocolonoscopy, to view the interior of the colon, check the extent and severity of the disease, detect possible complications, and obtain tissue samples to confirm the diagnosis. Computed tomography, magnetic resonance and capsule videoenteroscopy may be indicated, depending on the specifics of the case. Inflammatory bowel disease: ulcerative colitis and Crohn disease Types of inflammatory bowel disease include ulcerative colitis and Crohn disease. Ulcerative colitis It is an inflammation of the innermost layer of the colon and rectum wall, thus of the terminal region of the digestive tract . It affects only the innermost layer of the wall (mucosa), with a diffuse and continuous inflammation, of varying severity. The severity varies from a mild process to the presence of ulcerations, which is related to the severity of the symptoms. Read about the causes, symptoms and treatment of ulcerative colitis . Crohn disease Crohn disease is a chronic inflammation that can reach any region of the digestive tract , from the mouth to the anus, most often located in the last segment of the small intestine (ileon) and in the large intestine. Inflammation can extend to all layers of the digestive wall, with the formation of ulcers, and sometimes with complications such as strictures, fistulas and/or abscesses. Typically, Crohn disease is not continuous, that is, inflamed areas can be interspersed with healthy areas. Read about the causes, symptoms and treatment of Crohn's disease . Treatment of inflammatory bowel disease The goal of treating inflammatory bowel disease is to reduce the inflammation that triggers its signs and symptoms. In the best cases, this can lead to not only symptom relief, but also long-term remission and reduced risk of complications. Treatment of inflammatory bowel disease usually involves drug therapy and / or surgery. Drug therapy Depending on the cases, medicines used are: Anti-inflammatory drugs that act in the intestine (aminosalicylates); Corticoids; Antibiotics; Immunosuppressive drugs, for example azathioprine, methotrexate; Biological. Surgery It is reserved for forms of disease that do not respond to drug therapy, namely steroids, immunosuppressants and biologicals and for patients who develop complications – stenosis and/or fistulas. More about the gastroenterology team from Hospital da Luz network. If you have symptoms suggestive of inflammatory bowel disease : Talk to your doctor Schedule a gastrenterology appointment Call LUZ 24 - 217 104 424 (call to the national landline), which will perform the triage and refer you for a gastrenterology consultation at the appropriate time. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
