Inflammatory bowel diseases occur as a result of prolonged inflammation of the digestive system, primarily the intestines. These diseases progress through intermittent flare-ups, exacerbations, and remissions (the cessation of symptoms). With appropriate treatment, it is possible to halt the progression of the disease and prevent some of the associated side effects and complications.

What is Inflammatory Bowel Disease?

Inflammatory bowel disease (IBD) is a term used to describe diseases resulting from chronic inflammation of the digestive system, particularly the intestines. The most common types of IBD  are ulcerative colitis  and  Crohn's  disease.

Ulcerative colitis is a disease that primarily affects the large intestine and rectum. Ulcerative colitis is a condition caused by inflammation of the lining of the large intestine. Approximately 95% of disease symptoms involve the rectum, the final section of the large intestine. Ulcerative colitis generally progresses (spreads) from the anus upward through the large intestine.

Crohn's disease  can affect any part of the digestive system, but it typically affects the small intestine. While ulcerative colitis affects only the surface of the intestine, Crohn's disease also affects deeper tissues.

The symptoms of inflammatory bowel disease vary depending on the affected area, region, and the degree of inflammation. Some patients experience milder symptoms, while others experience more severe symptoms. Inflammatory bowel diseases typically progress through periods of flare-ups, exacerbations, and remissions, followed by periods of symptom relief. Common symptoms of ulcerative colitis and Crohn's disease include:

• Diarrhea
• Stomach ache
• Blood in the stool (feces)
• Abdominal cramps
• Decreased appetite
• Fatigue, weakness
• Unintentional weight loss

symptoms can be listed.

Individuals who exhibit one or more of the symptoms of inflammatory bowel disease listed above or who have recently noticed a change in their bowel movements should consult a doctor immediately and undergo the necessary tests and examinations. Because inflammatory bowel diseases can cause serious health problems, they require careful attention to diagnosis and treatment.

What are the Complications of Inflammatory Bowel Diseases?

Inflammatory bowel diseases can cause some unwanted side effects in the body. Common complications (problems) experienced in ulcerative colitis and Crohn's disease include:

Colon cancer

Patients with ulcerative colitis or Crohn's disease affecting a large portion of the colon are at increased risk of developing colon cancer. Patients diagnosed with inflammatory bowel disease undergo screening tests 8-10 years after diagnosis due to the increased risk of developing colon cancer. The timing of screening tests varies depending on the patient's age, comorbidities, medical history, and family history. Therefore, patients diagnosed with the disease should consult their doctor to determine when to begin colon cancer screening.

Skin, eye and joint inflammations: During periods when the symptoms of inflammatory bowel diseases become severe, conditions such as arthritis (joint inflammation), skin lesions and uveitis are encountered.

Medication side effects:  Some medications used to treat inflammatory bowel diseases can, in rare cases, pose a risk factor for the development of cancer cells. Corticosteroids used in treatment can also cause conditions such as osteoporosis and high blood pressure.

Primary Sclerosing Cholangitis

When the bile ducts within the liver become inflamed and narrowed, liver function may deteriorate. Patients diagnosed with primary sclerosing cholangitis are at increased risk of developing inflammatory bowel disease.

Unwanted Conditions That May Occur Due to Crohn's Disease

Intestinal obstruction: Crohn's disease is a disorder that affects all layers of the intestinal wall. The intestinal wall in the affected layer thickens and narrows, preventing digestive substances from passing through the intestine.

Malnutrition: Crohn's disease patients experience difficulty eating due to diarrhea, abdominal pain, and cramping. This also leads to problems with nutrient absorption in the intestines. These problems can lead to nutritional deficiencies, leading to nutritional deficiencies. Crohn's disease patients often experience anemia due to vitamin B12 and iron deficiencies.

Fistula formation:  A fistula is caused by an unnatural connection between internal organs or between internal organs and the body surface. In Crohn's disease, the intestinal wall can become completely inflamed, extending to other organ walls and forming a fistula. Fistula formation is most commonly observed in the anal (perianal) region. The fistula becomes infected and becomes an abscess.

Anal fissure:  In patients with Crohn's disease, an anal fissure is a small tear in the skin surrounding the anus.

Complications Seen in Ulcerative Colitis

Toxic megacolon: It is an uncommon but seriously life-threatening disease in which all or part of the large intestine swells suddenly and gangrene develops with tissue loss due to lack of blood flow (toxic megacolon).

Perforation in the intestine:  While intestinal perforation may be caused by toxic megacolon, perforation may also occur spontaneously.

Excessive fluid loss: Excessive fluid loss from the body due to diarrhea can cause dehydration.

What Causes Inflammatory Bowel Diseases?

There's no definitive information about the cause of inflammatory bowel diseases. Based on research, experts predict that many factors, including nutrition, genetics, stress, and environmental factors, may contribute to the development of the disease.

The state of the immune system also plays a role in the development of inflammatory bowel disease. Normally, the immune system recognizes and destroys harmful microorganisms such as bacteria, viruses, and parasites that enter the digestive system, as it does throughout the body. During this time, inflammation occurs in the intestines, mediated by the immune system, to combat the infection. Once the infection is gone, the inflammation resolves, and the intestines return to their normal state and function. This is the same process as the infection in healthy individuals. In inflammatory bowel disease, inflammation occurs in the intestines despite the absence of an infection. The immune system attacks healthy intestinal cells, the body's own cells, causing organ damage.

Conditions That Pose Risk for Inflammatory Bowel Diseases

Age:  Patients diagnosed with the disease are usually younger than 30 years old. However, in some people, the disease may not be detected until their 50s.

Family history:  The disease is more common in people whose first-degree relatives, such as parents, siblings, or children, have inflammatory bowel disease due to genetic transmission.

Smoking:  Smoking is the most important controllable risk factor for the development of Crohn's disease.

Non-Steroidal Anti-Inflammatory Drugs: NSAID group drugs containing active ingredients such as ibuprofen, naproxen sodium, diclofenac sodium pose a risk factor for disease development and progression of the existing disease.

How are Inflammatory Bowel Diseases Diagnosed and Treated?

A comprehensive investigation is conducted to assess the diagnosis, taking into account other disease findings that may be causing the symptoms and signs. Blood tests and stool tests are performed to evaluate potential diseases identified through the investigation. Endoscopy and colonoscopy are used to interpret the effects of ulcerative colitis or Crohn's disease on the digestive organs. In cases where endoscopic procedures are not feasible, imaging procedures such as X-ray, CT, and MRI may be used in patients with conditions such as intestinal perforation.

The primary goal of treating inflammatory bowel diseases is to reduce the inflammation that causes the condition. Reducing inflammation can alleviate signs and symptoms and lead to long-term remission (a period free of disease activity). Treatment can also help prevent complications from the disease.

Both Medication and Surgery Can Be Used in Disease Treatment

In drug therapy;

• • Anti-inflammatory drugs such as corticosteroids to reduce inflammation
• Drugs such as azothriopine and methotrexate to suppress the immune system
• If an infection has occurred due to the disease, antibiotics prescribed by the doctor may be used.
• Depending on the patient's disease status, the doctor may prescribe antidiarrheal, painkiller and vitamin supplements.

When patients with this condition experience excessive weight loss or a disruption in their diet, a specialist may consider initiating nutritional support. Specialized nutritional techniques are implemented, which provide nutritional supplements through a tube (enteral nutrition) or intravenous (parenteral nutrition). These procedures help both the patient recover and the intestines recover by resting them.

Surgical treatment for ulcerative colitis and Crohn's disease aims to remove the damaged section of intestine and restore the remaining intestine to healthy function. Surgery may also be necessary to treat complications that arise from the disease, such as intestinal obstruction. However, surgery is not always a definitive solution for these conditions. Surgery is performed to improve the patient's overall condition and prevent potential complications.

If you suspect you have inflammatory bowel disease, you should visit a well-equipped healthcare center and undergo the necessary checkups. At Private Ankara Magnet Hospital, we conduct the necessary examinations and tests under the guidance of our specialist physicians. It would be more beneficial for those diagnosed with inflammatory bowel disease to consult a gastroenterologist at Private Ankara Magnet Hospital to receive detailed information about the disease and the most effective treatment methods.