How to Recognize the Symptoms of Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) is a general term used to identify chronic inflammation of all or part of the digestive tract.^[1] Inflammatory Bowel Disease primarily refers to Crohn’s Disease and ulcerative colitis. The condition is characterized by symptoms including severe abdominal pain. Inflammatory Bowel Disease is debilitating for many people and can also be life-threatening if not properly treated.^[2] Because IBD is so serious, it’s important to recognize the symptoms of the disease and see your doctor to confirm a diagnosis. She can then develop a treatment plan to help you manage the disease.

EditSteps

EditIdentifying the Symptoms of IBD

1. Be aware of your risk for IBD. The exact cause of IBD isn’t known, but doctors know that certain factors may aggravate but not cause the disease. Being aware of your risk for this disease can help you recognize it and get a diagnosis and treatment in a timely manner.^[3]
   
   • Most people are diagnosed with IBD before the age of 30, but others may not develop the disease until they are in their 50s or 60s.^[4]
   • Caucasians, especially Ashkenazi Jews, are at the highest risk of IBD, but it can occur in any race.^[5]
   • If a close relative, such as a parent or sibling, has IBD you are at higher risk for developing the disease.^[6]
   • Cigarette smoking significantly increases your risk of developing Crohn’s Disease.^[7]
   • Using certain nonsteroidal anti-inflammatory medications (NSAIDS), such as ibuprofen, naproxen sodium, and diclofenac sodium, can increase your risk of developing IBD or worsen the disease if you already have it.^[8]
   • Environmental factors, such as living in an urban area or northern climates and eating a diet high in fat and refined foods, may increase your risk of developing IBD.^[9]
2. Recognize symptoms of Crohn’s Disease. Although Crohn’s Disease and ulcerative colitis may have similar symptoms, they still differ slightly. Recognizing the symptoms of Crohn’s Disease can help you get a diagnosis from your doctor and take steps to manage the disease in your everyday life. Not all patients have severe symptoms, so it is important to be aware of the various ways that Crohn's disease can present.
   
   • You may experience persistent diarrhea, cramping, abdominal pain, fever, and occasional blood in your stool.^[10]
   • Loss of appetite and weight loss may also occur with Crohn’s Disease. It can also affect your joints, eyes, skin, and liver.^[11]
   • The most common complication of Crohn’s Disease is intestinal blockage as a result of swelling and scar tissue. Symptoms of blockage, such as cramping pain, vomiting, and bloating, may be present. You may also develop fistulas as a result of sores or ulcers in the intestinal tract.^[12]
   • People with Crohn’s Disease are at a higher risk of colon cancer and need to be screened more often than the general population.^[13]
3. Recognize symptoms of ulcerative colitis. Although ulcerative colitis may have similar symptoms to Crohn’s Disease, it is nevertheless slightly different. Recognizing the symptoms of ulcerative colitis can help you get a diagnosis from your doctor and take steps to manage the disease in your everyday life.
   
   • Typical symptoms of ulcerative colitis are frequent bloody stools, cramping abdominal pain, and severe urgency to have a bowel movement or diarrhea.^[14]
   • Loss of appetite and weight loss are common symptoms of ulcerative colitis. You may also experience fatigue and abdominal bloating.^[15]
   • Most people with ulcerative colitis will have mild symptoms, though others can have severe cramping, fever, bloody diarrhea, and vomiting.^[16]
   • Severe bleeding can lead to anemia in ulcerative colitis patients. They may also have skin lesions, join pain, liver disorders, and eye inflammation.^[17]
   • People with ulcerative colitis are at a higher risk of colon cancer and, like people with Crohn's disease, need to be screened regularly.^[18]
4. Observe your bodily functions closely. It’s important to pay attention to your body and bodily functions for any symptoms of IBD. These signs, such as diarrhea or fever, can indicate the disease, especially if they don’t go away.
   
   • Watch your bowel movements for frequent diarrhea or the need to quickly evacuate your bowels.^[19]
   • Check the toilet tissue or toilet bowl for signs of blood before you flush.
   • Watch your underwear or towels for signs of rectal bleeding or bowel leakage.
   • Many people with IBD have a persistent low-grade fever and may also experience night sweats.^[20]
   • Some women may experience a loss of their normal menstrual cycle.^[21]
5. Evaluate your appetite and weight. Consider if you have experienced a recent, prolonged loss of appetite or unintended weight loss, especially in conjunction with other symptoms of IBD. These may be clear signs that you’re suffering from IBD and should see a doctor.^[22]
   
   • The loss of appetite may be a result of abdominal pain and cramping and inflammation. This can lead to unintended weight loss.^[23]
6. Pay attention to aches and pains. Inflammatory Bowel Disease can present itself with severe or chronic pain in the abdomen and may even cause joint pain. If you have prolonged stomachaches or pain in the joints that is not related to other conditions or physical activity, you may have this symptom as a result of IBD.
   
   • You may have general abdominal pain or cramping with IBD.^[24]
   • There may also be abdominal bloating accompanied by pain or cramping.^[25]
   • Aches and pains from IBD may present themselves in other parts of your body as well. Watch for pain in your joints or eye inflammation.^[26]
7. Examine your skin. Examine your skin to notice changes in your overall complexion or skin texture, such as red bumps, ulcers, or rashes. These could indicate IBD, especially if experienced in conjunction with other symptoms.
   
   • Some skin lesions can turn into fistulas, which are infected tunnels that develop in the skin.^[27]

EditGetting Medical Diagnosis and Treatment

1. See your doctor. If you discover any of the signs or symptoms of IBD and/or are at risk for the disease, see your doctor as soon as possible. Early diagnosis is important to help treat and manage the disease.
   
   • Your doctor may diagnose IBD only after she rules out other possible causes for your symptoms.^[28]
   • Your doctor may use a variety of tests to help diagnose IBD.^[29]
2. Get tests and a diagnosis. If your doctor suspects that you have IBD, she may order tests after conducting your physical exam and ruling out other causes. These tests are the only way to confirm a diagnosis of IBD.
   
   • Your doctor may order a blood test to check for anemia, which is a common side effect of IBD. The blood tests may also determine if you have any signs of infection, bacteria, or viruses in your system.^[30]
   • Your doctor may order a stool sample called a fecal occult blood test that checks for hidden blood in your stool.^[31]
   • Your doctor may order an endoscopic procedure, such as a colonoscopy or upper endoscopy, to examine your intestines. In these procedures, a small camera is inserted into some portion of your gastrointestinal tract. If the doctor sees areas that are inflamed or abnormal, she will take biopsies. These are especially important in making the diagnosis.^[32]
   • Your doctor may also order an imaging procedure, such as an X-ray, CT scan, or and MRI. These will help your doctor examine the tissues of your gastrointestinal tract and see if there are any complications of IBD, such as a perforated colon.^[33]
3. Get treatment for IBD. If your doctor confirms a diagnosis of IBD with tests, she will prescribe a course of treatment based the severity of the disease. There are many different treatment and management options for IBD.
   
   • Treatment for IBD revolves around reducing the inflammation that triggers the symptoms of the disease. There is no cure for IBD.^[34]
   • Treatment for IBD generally involves drug therapy or surgery; most people with Crohn’s Disease will have to have some surgery during their lifetime.^[35]
   • Your doctor may prescribe anti-inflammatory drugs such as aminosalicylates or corticosteroids, to help relieve IBD short term. These drugs can cause side effects such as night sweats, insomnia, hyperactivity, and development of excessive facial hair.^[36]
   • Some doctors may prescribe immunosuppressants such as cyclosporine, infliximab, or methotrexate.^[37]
   • Your doctor may also prescribe an antibiotic such as ciprofloxacin to help control or prevent infection.^[38]
4. Get surgery for IBD. In cases where medication and lifestyle changes don’t help IBD, your doctor may elect to do surgery to help manage the disease. Surgery is a last resort treatment and can have some unpleasant side effects that are not particularly long lasting.^[39]
   
   • Surgery for both ulcerative colitis and Crohn’s disease involves removing parts of the gastrointestinal tract.^[40]
   • You may have to wear a colostomy bag to collect bowel movements following surgery. It may be a difficult adjustment to living with a colostomy bag, but you can still lead a full and active life.^[41]
   • Almost one half of people suffering from Crohn’s will require surgery, but it will not cure the disease.^[42]A total colostomy can cure the GI aspects of ulcerative colitis, though it will not cure the systemic symptoms of the disease (uveitis, arthritis, etc.)

EditTrying Natural Treatments

1. Change your eating and nutritional habits. There is some evidence that changing your diet and taking nutritional supplements can help manage the symptoms of IBD. Your doctor may suggest changing your eating and nutritional habits along with other medical therapies.^[43]
   
   • Your doctor may suggest a feeding tube or nutrient injections to help your bowel rest and reduce inflammation.^[44]
   • Your doctor may also suggest a low-residue diet of foods that will not cause a blockage in your bowel.^[45] Low-residue foods, which are low in fiber include yogurt, creamy soups, refined white breads and pastas, and crackers. You’ll want to avoid raw fruits and vegetables, nuts, and whole grain products.^[46]
   • Your doctor may also suggest taking iron, calcium, Vitamin D, and Vitamin B-12 supplements to help replace nutrients lost as a result of the symptoms of IBD.^[47]
   • Eating small meals that are low in fat and not high in fiber may help with the symptoms of IBD.^[48]
   • Drinking plenty of liquids can help alleviate the symptoms of IBD. Water is the most optimal choice to help keep you hydrated.^[49]
2. Consider trying alternative therapies. While most haven't shown much benefit, they have had positive results for some. Talk with a doctor before trying any herbal or alternative therapies.
   
   • Recent studies have shown that alternative therapies such as consuming more soluble fiber or probiotics, drinking peppermint oil teas, or trying hypnotherapy and cognitive behavioral therapy are effective at helping some patients minimize the symptoms of IBD.^[50]
3. Alter your lifestyle habits. Making changes to your lifestyle habits can help manage your IBD. From quitting smoking to avoiding stress, these changes may help alleviate your symptoms.^[51]
   
   • Smoking may make Crohn’s Disease worse, and those who smoke are more likely to have relapses and need repeat surgeries.^[52]
   • Reducing stress may also help alleviate the symptoms of IBD. You can reduce stress through regular relaxation and breathing exercises or meditation.^[53]
   • Regular and even gentle exercise will not only help reduce stress, but may also help normalize bowel function. Speak to your doctor about the best type of exercise to manage your IBD.^[54]

EditUnderstanding IBD

1. Learn about IBD. Since IBD is an umbrella term for Crohn’s Disease and ulcerative colitis, it’s important to know the difference between these similar diseases. This may help you more effectively recognize any symptoms of the disease and get timely treatment.^[55]
   
   • Crohn’s Disease is a chronic inflammation of the gastrointestinal tract. In contrast to ulcerative colitis, Crohn’s Disease mostly affects the end of the small bowel, or ileum, and the beginning of the colon, though it may appear anywhere along the gastrointestinal tract, from the mouth to the anus.^[56]
   • Ulcerative colitis and Crohn's are both abnormal immune responses, but each of them affects a different site. Ulcerative colitis causes chronic inflammation in the colon and the development of open sores or ulcers in the colon.^[57] While Crohn’s Disease can affect any part of the gastrointestinal tract, ulcerative colitis only affects the colon.^[58]
2. Join a support group or see a therapist. IBD can be an extremely devastating disease for you and your loved ones. Joining a support group of IBD patients or speaking to other doctors or a therapist can help you understand and manage the disease.^[59]
   
   • The Crohn’s and Colitis Foundation of America offers many tools on its website, including stories of others afflicted with IBD. You can also find a support group using their site at http://www.ccfa.org.

EditTips

• Your prognosis may vary depending on which type of Inflammatory Bowel Disease you have, just as symptoms may vary from person to person. Despite the frustration and pain that comes with these conditions, many people with Inflammatory Bowel Diseases lead healthy, active lives with professional management of their condition and its related symptoms.

EditWarnings

• Do not attempt to treat Inflammatory Bowel Disease without the help of a health specialist. It is important to follow the guidance of a health professional familiar with gastrointestinal ailments and the related treatments for your condition or symptoms.

EditSources and Citations

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