Inflammatory Bowel Disease (IBD) refers to long-term inflammation of the digestive tract. The two major types are Ulcerative Colitis (UC) and Crohn’s Disease (CD). Both conditions cause abdominal pain, diarrhea, weight loss, and nutritional problems. IBD is chronic, with periods of flare-ups and remission. Early diagnosis and proper treatment help control inflammation and prevent complications.
1. Types of Inflammatory Bowel Disease
1. Ulcerative Colitis (UC)
- Affects only the colon (large intestine)
- Inflammation is continuous and limited to the mucosal layer
- Begins in the rectum and may extend upwards
2. Crohn’s Disease (CD)
- Can affect any part of the gastrointestinal tract
- Inflammation is patchy (“skip lesions”)
- Affects deeper layers of the intestinal wall
- May cause fistulas, strictures, and abscesses
2. Causes and Risk Factors
The exact cause of IBD is unknown, but several factors contribute to its development:
- Immune system overreaction
- Genetics and family history
- Environmental triggers (pollution, infections)
- Smoking (strongly linked to Crohn’s disease)
- Stress (worsens symptoms)
- Diet high in processed foods and low in fiber
3. Symptoms of IBD
Common Symptoms
- Chronic diarrhea
- Abdominal pain and cramps
- Rectal bleeding
- Urgency to pass stools
- Fatigue and weakness
- Loss of appetite
- Unexplained weight loss
Systemic Symptoms
- Joint pain
- Eye inflammation
- Skin rashes
- Liver disorders
4. Diagnosis of IBD
- Colonoscopy: Direct visualization and biopsy
- Blood tests: Anemia, inflammatory markers (ESR/CRP)
- Stool tests: Rule out infections, check fecal calprotectin
- CT or MRI scans: Detect complications like fistulas and strictures
- Endoscopy: Useful in upper GI involvement
5. Treatment of Inflammatory Bowel Disease
Treatment aims to reduce inflammation, manage symptoms, and maintain long-term remission.
1. Aminosalicylates (5-ASA)
Used especially in ulcerative colitis.
- Mesalamine
- Sulfasalazine
- Olsalazine
2. Corticosteroids
Used during acute flare-ups, not for long-term maintenance.
- Prednisolone
- Budesonide
3. Immunomodulators
- Azathioprine
- Mercaptopurine
- Methotrexate
4. Biologic Agents
Used in moderate to severe IBD or when other medications fail.
- Anti-TNF agents (Infliximab, Adalimumab)
- Anti-integrin agents
- Anti-IL agents
5. Antibiotics
- Metronidazole
- Ciprofloxacin
6. Symptomatic Treatment
- Antidiarrheals (with caution)
- Iron supplements for anemia
- Vitamin B12, folic acid supplementation
7. Surgical Treatment
Needed when complications occur or when medical therapy fails.
- Colectomy (for severe ulcerative colitis)
- Resection of diseased bowel (Crohn’s disease)
6. Complications of IBD
- Bleeding and anemia
- Perforation
- Fistulas and abscesses
- Strictures leading to obstruction
- Malnutrition
- Increased risk of colon cancer
7. Lifestyle and Dietary Management
- Eat low-fiber foods during flare-ups
- Avoid dairy if lactose intolerant
- Stay hydrated
- Limit spicy, fatty, or processed foods
- Quit smoking
- Reduce stress through yoga, meditation, or exercise
8. Role of the Pharmacist
- Ensure adherence to long-term medications
- Educate patients about biologic therapy
- Identify drug interactions and side effects
- Monitor for steroid-related complications
- Counsel on diet, nutrition, and stress management
- Encourage vaccination (e.g., influenza, pneumococcal)
Detailed Notes:
For PDF style full-color notes, open the complete study material below: