Don’t Ignore Persistent Digestive Problems

Symptoms such as diarrhea, abdominal pain, and cramps may be caused by a number of conditions. They can be due to a viral infection, or to a foodborne illness. Lactose intolerance, celiac disease, irritable bowel syndrome, or food allergies or sensitivities often produce these symptoms. But they also may result from inflammatory bowel disease, a medical condition that can have serious consequences.

Inflammatory bowel disease (IBD) is a general term that encompasses ulcerative colitis (UC) and Crohn’s disease (CD), as well as several other, less common gastrointestinal diseases.

“IBD is an interruptive illness that is lifelong,” explains Ellen Scherl, MD, the Jill Roberts professor of inflammatory bowel disease at Weill Cornell Medicine. “IBD patients sometimes achieve remission (absence of symptoms), but many patients experience recurrences of symptoms, which are called ‘flares.’ Our goal is to help people with IBD achieve remission and to control symptoms during flares.”

If you have a form of IBD, an accurate diagnosis is essential so you can get the treatment needed to effectively manage the condition.

Some Symptoms Are Similar

UC is superficial inflammation of the colon (large intestine). UC can start in the rectum and goes contiguously up the colon. Common symptoms are persistent diarrhea, abdominal pain, and cramping.

“To be diagnosed with UC, a person must have blood in the stool or rectal bleeding,” explains Dr. Scherl. “However, this doesn’t mean that all bloody diarrhea is caused by UC.”

CD can affect the gastrointestinal (GI) tract anywhere from the mouth to the anus. The inflammation of CD goes into deeper layers than UC, and CD can be present in multiple segments of the GI tract. Symptoms may include diarrhea, abdominal pain, nausea, weight loss, mouth sores, fever, blood in the stool, and rectal bleeding.

Effects of Crohn’s Disease

According to Dr. Scherl, CD can have three distinct effects: inflammatory, stricturing, and fistulizing.

Inflammation occurs because the body mistakenly mounts a defense against its own tissues—the key feature of an autoimmune disorder.

A fistula starts as an ulcer that extends through the intestinal wall and forms a tunnel to another section of the intestine, to another organ such as the bladder or vagina, or to the skin’s surface.

Stricturing is narrowing of the intestinal tract that can cause a blockage in the bowel.

CD may also cause kidney stones, joint pain, and skin lesions. And the inflammation can cause reduced absorption of nutrients, which may result in malnutrition.

Testing and Treatment

A person suffering from a GI condition must get a correct diagnosis in order to be treated successfully. Diagnosis can be challenging, since many conditions produce similar symptoms.

For example, UC and CD need to be treated with anti-inflammatories and medication that suppresses the immune response, but irritable bowel syndrome, which commonly causes diarrhea and/or constipation and abdominal pain, is not inflammatory or autoimmune in nature and must be treated differently.

Diagnostic tests may include blood tests, stool studies, endoscopy (examination of the esophagus, stomach, and first section of the small intestine), colonoscopy (examination of the colon, or large intestine), magnetic resonance imaging, or computed tomography.

IBD that is undiagnosed and/or untreated can result in serious complications, such as dysplasia (the formation of abnormal cells that may become cancerous) or a bowel blockage that may require surgery.

Ease Symptoms with Lifestyle

Research has shown that high stress levels can make IBD symptoms worse, so stress management is often recommended for people with IBD; meditation, breathing exercises, and physical activity may help.

And diet often is important for people with IBD. In general, foods that contain insoluble fiber, caffeine, alcohol, and greasy or fried foods often make symptoms worse. However, some foods trigger flares for some people but not others. A registered dietitian can help you create an eating plan that eliminates trigger foods while providing adequate nutrition.

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