Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is the umbrella term for a group of long-term conditions in which the immune system causes ongoing inflammation of the digestive tract. The three main types are Crohn's disease, ulcerative colitis and microscopic colitis.

IBD usually follows a relapsing-remitting pattern: flares, when symptoms are active, followed by periods of remission, when symptoms settle.

Where each type affects the gut:

Crohn's Disease

Can affect any part of the gut, from mouth to anus, in patches. Most often the end of the small intestine.

Ulcerative Colitis

Affects only the large bowel (colon) and rectum, causing inflammation and ulcers in the lining.

Microscopic Colitis

A less widely known form where inflammation of the colon is only visible under a microscope.

Crohn's disease and ulcerative colitis are the two most common forms. In a small number of people the pattern doesn't fit neatly into either and is described as IBD-unclassified.

Symptoms vary by type and by which part of the gut is affected. Common ones include:

• Persistent diarrhoea, sometimes with blood or mucus
• Tummy (abdominal) pain and cramping
• Tiredness and fatigue
• Unintended weight loss and loss of appetite
• A frequent or urgent need to empty the bowel

The exact cause isn't fully understood, but IBD is thought to develop from a combination of factors:

Genetics & family history

IBD is more common if a close relative has it

The immune system

An over-active immune response in the gut

The gut microbiome

The community of bacteria living in the bowel

Diet & environment

Lifestyle and environmental factors may play a role

Your doctor may use several tests to diagnose IBD:

1

Blood tests to check for inflammation and anaemia

2

A stool test for faecal calprotectin, a marker of gut inflammation

3

Endoscopy (colonoscopy) to look at the bowel lining and take biopsies

4

Scans such as MRI or CT to assess the small bowel

Treatment has two goals: settling a flare, then maintaining remission. The right approach depends on the type, location and severity of the condition.

Anti-inflammatory medicines

To calm the gut lining, for example aminosalicylates such as mesalazine

Immune-modifying & biologic therapies

For moderate-to-severe disease, for example azathioprine, infliximab, adalimumab or vedolizumab

Short courses of steroids

To bring a flare under control, for example prednisolone or budesonide

Surgery

For some people when medicines aren't enough

Diet & wellbeing support

Support for nutrition and overall wellbeing alongside medical treatment