Inflammatory Bowel Disease is a group of inflammatory colon and small intestine diseases. Ulcerative colitis and Crohn’s Disease are the two main components of the IBD. Ulcerative colitis is the disorder of the colon (large intestine). Crohn’s Disease can affect any part of the digestive system from mouth to anus.

Symptoms associated with IBD are abdominal pain, cramps, swelling, bloody diarrhea, weight loss and extreme tiredness. IBD is treated with aminosalicylates, immunosuppressants, biologics, antibiotics. About 60% of Crohn’s Disease is treated with surgical interventions.

Irritable bowel syndrome affects the large intestine. Causative factors underlying IBS are bacterial and viral infections resulting in diarrhea, muscle contractions in the intestine, changes of microflora in the gut. Symptoms associated with IBS are abdominal pain, diarrhea, changes in bowel movements, constipation.

Food, stress, hormones are the causative triggers of IBS symptoms. IBS is diagnosed by colonoscopy, upper endoscopy, stool tests, blood tests, and tests for lactose intolerance. IBS treatment is managed by lifestyle changes and medication.

Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine. Crohn's disease and ulcerative colitis are the principal types of inflammatory bowel disease.[3] Crohn's disease affects the small intestine and large intestine, as well as the mouth, esophagus, stomach and the anus, whereas ulcerative colitis primarily affects the colon and the rectum.

IBD also occurs in dogs and is thought to arise from a combination of host genetics, intestinal microenvironment, environmental components and the immune system. There is an ongoing discussion however the term chronic enteropathy might be a better term to use than Inflammatory bowel disease in dogs because it differs from IBD in humans in how the dogs respond to treatment. For example, many dogs respond to only dietary changes compared to humans with IBD who often need immunosuppressive treatment. Some dogs may also need immunosuppressant or antibiotic treatment when dietary changes are not enough. After having excluded other diseases that can lead to vomiting, diarrhea and abdominal pain in dogs, intestinal biopsies are often performed to investigate what kind of inflammation that is occurring (lymfoplasmacytic, eosinophilic or granulomatous). In dogs, low levels of cobalamin in the blood have shown to be a risk factor for negative outcome.

In spite of Crohn's and UC being very different diseases, both may present with any of the following symptoms: abdominal pain, diarrhea, rectal bleeding, severe internal cramps/muscle spasms in the region of the pelvis and weight loss. Anemia is the most prevalent extraintestinal complication of inflammatory bowel disease. Associated complaints or diseases include arthritis, pyoderma gangrenosum, primary sclerosing cholangitis, and non-thyroidal illness syndrome (NTIS).Associations with deep vein thrombosis (DVT) and bronchiolitis obliterans organizing pneumonia (BOOP) have also been reported. Diagnosis is generally by assessment of inflammatory markers in stool followed by colonoscopy with biopsy of pathological lesions.

IBD is a complex disease which arises as a result of the interaction of environmental and genetic factors leading to immunological responses and inflammation in the intestine.

Diet

Dietary patterns are associated with a risk for ulcerative colitis. In particular, subjects who were in the highest tertile of the healthy dietary pattern had a 79% lower risk of ulcerative colitis.

Gluten sensitivity is common in IBD and associated with having flareups. Gluten sensitivity was reported in 23.6 and 27.3% of Crohn's disease and ulcerative colitis patients, respectively.

A diet high in protein, particularly animal protein, may be associated with increased risk of inflammatory bowel disease and relapses.

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Jessica Watson
Managing editor
Clinical Gastroenterology Journal