Inflammatory bowel disease (IBD) are chronic inflammatory disorders of unknown cause which involves the gastrointestinal tract. Inflammatory bowel disease mainly occurs in age groups of 15 years to 30 years and between the age group of 60 to 80 years.
Types of Inflammatory Bowel Disease:
- Ulcerative colitis.
- Crohn’s disease.
Ulcerative colitis involves the only colon, while Crohn’s disease involves any part of the gastrointestinal tract from mouth to anus.
Factors which favors the development of Inflammatory Bowel Disease:
- It is associated with SLE and autoimmune thyroiditis.
- Ulcerative colitis is more common in both non-smokers and ex-smokers.
- Crohn’s disease is most common in smokers.
- Inflammatory bowel disease is associated with low-residue and high refined sugar diet.
In Inflammatory Bowel Disease (both Ulcerative colitis and Crohn’s disease), the wall of the intestine is infiltrated with both acute and chronic inflammatory cells.
In ulcerative colitis inflammation (swelling) involves the rectum which is called proctitis, the inflammation (swelling) may spread proximally to involve the sigmoid colon, the condition is known as proctosigmoiditis and in very few cases inflammation (swelling) occurs in the whole colon which is then known as pancolitis.
Symptoms of ulcerative colitis:
- Bloody diarrhea is the main symptom, the first attack of ulcerative colitis is very severe and then there are relapse and remission occurs in the course of the disease.
- Relapses are aggravated by many factors like the use of painkillers, antimicrobials or antibiotics, abdominal infections like gastroenteritis, emotional stress, etc.
- Other symptoms depend upon the site involved and the severity of the disease. like if the rectum is involved (proctitis) there is bleeding from the rectum and discharge of mucus, this condition is often presented with a continuous or recurrent feeling to pass the stool (tenesmus) also. Some patients pass stool containing fluid which is of small volume.,while some patients suffered from constipation and pass stools which looks like pellets.
- In proctosigmoiditis presentation is different in this there is bloody diarrhea with the presence of mucus. Mostly the patients are well, but in some patients, there are symptoms of fever, weakness, and discomfort in the abdomen.
- If there is severe colitis, there is a loss of appetite, feeling of “not feeling well”, loss of weight, pain in the abdomen and as the severity increases fever and increased pulse rate are the main symptoms.
The most commonly involved site is the terminal ileum and right side of the colon, sometimes only colon or only terminal ileum is involved, the lesions are also found in ileum and jejunum. The wall of the involves the site of the intestine becomes thickened.
Symptoms of Crohn’s disease:
- Diarrhea, weight loss, pain in the abdomen are the major symptoms.
- If Crohn’s disease involves Ileum, it shows symptoms of abdominal pain, because of subacute intestinal obstruction, pain is often associated with watery diarrhea without blood and mucus.
- Loss of weight occurs because pain is increased after eating and the patient tries to avoid taking food, to avoid pain. Some other factors like deficiency of fat, vitamins or protein and also malabsorption leads to loss of weight.
- Symptoms in Crohn’s colitis are almost the same as ulcerative colitis.
- Lesions are not found in the rectum and the presence of perianal disease favors Crohn’s disease.
Complications of Inflammatory bowel disease (ulcerative colitis and Crohn’s disease):
- Fistulae and perianal disease.
- Perforation of the small intestine or big intestine.
- Life-threatening inflammation of the large intestine (colon).
- Conjunctivitis, iritis, episcleritis, mouth ulcers, liver abscess or portal pyemia, fatty liver, joint pain of large joints, are the complications of Inflammatory bowel disease that occur during the active phase of inflammatory bowel disease (IBD).
Food to avoid in Inflammatory bowel disease (Crohn’s disease and Ulcerative colitis):
- Spicy foods, caffeine, alcohol, red meat.
- Foods which contain lactose, wheat, refined sugar (sucrose).
- Soft drinks, soda.
- Lactose a sugar which is found in milk, cream, soft cheese.
- Sugar-free gums, candy, ice-creams as they contain sorbitol and mannitol.
- High-fat foods, trans fats, milk, and fresh cheese.
- Whole grains and nuts.
- Raw green vegetables.
- Fruits containing skin and seeds.
- Broccoli and cauliflower, corn.
- Processed foods and ready meals, fatty fried foods, cream sauce.
- High fiber foods must be avoided in Inflammatory Bowel Disease especially those which are rich in insoluble fiber, for example, wheat bran, brown rice, carrots, and potatoes, fruits with edible seeds.
Food to be taken in Inflammatory bowel disease (Crohn’s disease and Ulcerative colitis):
- Cooked and peeled vegetables.
- Unsaturated fats or omega 3 fatty acids rich oil and food to be taken in Inflammatory Bowel Disease, which are found in olive oil, peanut butter.
- Ground flax seeds, hemp seeds, chia seed.
- Fermented veggies like sauerkraut.
- Poached and peeled fruits.
- Low fiber fruits like banana, peach, watermelon, etc.
- Oats, garlic, onion, legumes, asparagus.
- Raw honey, fermented cabbage, microalgae,grain-free tempeh
- Vegetables and fruit juices are good in Inflammatory Bowel Disease as they have less insoluble fibers.
- Lean meat, fish oil.
- Grilled fish in vegetable oil.
- Soy, tofu, and eggs they are a good source of lean protein.
- Yogurt (lactose-free),miso,kefir,kimchi,aged cheese,
- Canned fruit.
- White bread and rice (not brown), waffles and rice snacks, pasta, etc.
- Sigmoidoscopy with biopsies.
- Barium studies.
- Full blood count to access hemoglobin level and secondary infections, it also reflects the cause of anemia which may be due to bleeding, or malabsorption of iron, vitamin B12 or folic acid.
- CRP helps in monitoring the activity of Crohn’s disease.