IS IBD A RARE DISEASE?

Canada (particularly Alberta) has one of the highest rates of IBD in the world. It affects almost 30,000 Albertans with over 1,500 new cases occurring annually. It is estimated that about 1 in 150 people in Alberta have IBD.

WHAT IS THE DIFFERENCE BETWEEN IBD AND IRRITABLE BOWEL SYNDROME (IBS)? COULD MY SYMPTOMS BE IBS?

IBS stands for Irritable Bowel Syndrome. This is a different condition from IBD, although some of the symptoms are similar. Like IBD,

Both IBD and IBS can have symptoms of abdominal pain, diarrhea and change in bowel habit.

  • IBS is a condition in which patients have bowel symptoms without having ulceration or inflammation of their bowel. IBS can cause abdominal pain, bloating and bouts of diarrhea or constipation. However, it does not cause the type of inflammation typical of Crohn’s or UC, and there is no blood loss with IBS.
  • IBS is much more common than IBD
  • Approximately 10-15% of the population suffer from IBS
    • Patients with IBS do not have "alarm symptoms" (blood in stools, weight loss, nocturnal bowel movements (getting up in the middle of the night to defecate), nutritional deficiencies)
    • Patients with IBS have normal tests including blood tests, x-rays or endoscopy
  • IBD is a chronic illness in which inflammation of the intestine is detected on blood work and endoscopy (or radiology tests)
    • Some patients with IBD may continue to have symptoms that persist even when there is no longer any visible ulcers or inflammation of their bowels – these patients may have co-existing IBS

However, some people with Crohn’s may develop IBS-like symptoms. They may, for example, get diarrhea even when their IBD is inactive. IBS is more common in people with IBD than in the general population.

A key difference is that IBD patients do not have lesions, ulcerations, or bleeding in the intestine that are visible during colonoscopy.

HOW DO I KNOW IF I HAVE IBD INSTEAD OF AN INFECTION OF THE BOWELS?

There are many causes of diarrhea and bloody diarrhea. Infection of the bowel can cause similar symptoms to IBD but generally are shorter in duration. In order to rule out infection, you may be required to provide stool samples to the lab to test for infection.

The suspicion of IBD is higher in patients with a family history of IBD, a presence of other symptoms such as anemia, nutritional deficiencies (e.g., vitamin B12, iron) and/or significant weight loss.

Patients with IBD may also get bowel infections. It is important to distinguish IBD from infection because the treatments are different.

WHY ARE PATIENTS WITH CROHN'S DISEASE SOMETIMES TOLD THEY HAVE "COLITIS"?

"Colitis" is a non-specific term describing inflammation of the colon; "ulcerative colitis" is a specific diagnosis. Patients with Crohn's disease involving only the colon can be described as having "Crohn's colitis".

CAN CROHN’S LEAD TO CANCER?

You may have a slightly increased risk of bowel cancer if you have had CD affecting all or most of the colon for more than 8 to 10 years. Bowel cancer risk is increased further if you have primary sclerosing cholangitis, which also increases the risk of developing cancer in the liver. For more details, see Bowel Cancer and IBD.

IF I SMOKE, WILL I GET IBD?

Active and ex-smokers are at increased risk of acquiring Crohn's Disease. Active smokers are less likely to develop ulcerative colitis than people who have never smoked. Quitting smoking can improve the course of CD and help make medications more effective for the treatment of CD.

IF I HAVE HAD STOMACH FLU (GASTROENTERITIS), WILL I GET IBD?

There have been a few studies that have made the observation of an increased risk of developing IBD after an episode of gastroenteritis especially during the first year following the episode.

IF I GET MY CHILD VACCINATED, WILL HE OR SHE GET IBD?

The current studies do not suggest an association of immunizations with the onset or aggravation of IBD.

DOES ACCUTANE CAUSE IBD?

The association is controversial - although some studies suggest an association, other studies do not.

IF I HAVE IBD, SHOULD I AVOID ACCUTANE TREATMENT FOR MY ACNE?

If you have IBD or a family history of IBD, you need to discuss this with your gastroenterologist. Although there may be an association, the risk is still considered very low. You will have to weigh the potential risks and benefits.

IF I TAKE NSAID (NON-STEROIDAL ANTI-INFLAMMATORY) MEDICATIONS, WILL I GET IBD?

Conclusions from current studies are inconsistent. NSAIDs can also cause ulcerations in the small and large bowel which can "mimic" IBD making it more difficult to make a diagnosis.

Most clinicians probably believe there is an association between NSAIDs and the onset or aggravation of IBD and would suggest avoiding these types of medications if there are alternatives. However, if you are on NSAIDs for a good reason (eg. debilitating arthritis), then the benefit may outweigh the risk.

WHAT IS A NSAID?

This class of medication is often used to treat pain, fever and inflammation. It is commonly used for headaches and arthritis. These medications may be obtained over-the-counter or prescribed. Examples include: ibuprofen (Advil®, Motrin®), naproxen (Aleve®), diclofenac (Arthrotec®), indomethacin (Indocid®), ketorolac (Toradol®), etc.

IF I TAKE ORAL CONTRACEPTIVES, WILL I GET IBD?

Association is again somewhat controversial and even if association exists, the absolute risk is very low. Most clinicians would likely favour continued use of oral contraceptives for most patients.

WHAT ARE PERIANAL FISTULAS AND PERIANAL FISSURES?

Perianal fissures are tears of the skin of the anal canal. They can present with razor-sharp pain on passage of stool and bleeding. Perianal fistulas are abnormal connections (tract) between the bowel and skin around the anus. Symptoms include feeling discharge/drainage from around the skin around the anus. Sometimes the tract can become blocked and lead to formation of an abscess which presents as a painful swelling of this area

 

WHAT IS TOXIC MEGACOLON?

toxic megacolon is when your large intestine (colon) becomes so distended that it is at risk of bursting. It presents as a very distended abdomen with abdominal pain, slowing of bowels, not passing stool (constipation) or gas, fever, chills, and fast heart rate. This requires emergent medical care and surgery. 

Video: Frequently Asked Questions


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