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Inflammatory Bowel Disease

Comprehensive care for digestive disorders by Dr. Akeel Alisa

Understanding Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) is a term used to describe two long-term conditions that cause chronic inflammation of the digestive tract:

  • Ulcerative Colitis (UC): Affects the lining of the large intestine (colon) and rectum.
  • Crohn’s Disease: Can affect any part of the digestive tract, from the mouth to the anus, and often involves deeper layers of the bowel wall.

Both conditions are lifelong and typically alternate between periods of remission (few or no symptoms) and flare-ups (active inflammation and distressing symptoms).

IBD is not the same as Irritable Bowel Syndrome (IBS). While IBS is a functional condition, IBD is an inflammatory disease that can cause long-term damage to the gut if not managed properly.

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Symptoms of IBD

IBD symptoms vary depending on the severity and location of inflammation, but common signs include:

Common Causes of Constipation:

  • Persistent diarrhoea (often with blood or mucus)
  • Abdominal pain and cramping
  • Urgency to open the bowels
  • Fatigue and low energy
  • Unexplained weight loss
  • Loss of appetite
  • Fever during flare-ups
  • Anaemia (due to blood loss or poor absorption)

Some patients also experience symptoms outside the gut, such as joint pain, skin rashes, mouth ulcers, or eye inflammation.

Causes and Risk Factors

The exact cause of IBD remains unclear, but factors thought to contribute include:

  • Immune system dysfunction: The body mistakenly attacks healthy gut tissue.
  • Genetics: Family history increases risk.
  • Gut microbiome imbalance: Abnormal gut bacteria may play a role.
  • Environmental factors: Diet, smoking, infections, and stress may trigger flare-ups.

When to See a Specialist

You should consult a gastroenterologist if you experience:

  • Persistent diarrhoea lasting more than a few weeks
  • Rectal bleeding or blood in the stool
  • Severe or recurring abdominal pain
  • Unexplained weight loss and fatigue
  • A family history of Crohn’s disease or ulcerative colitis

Early diagnosis is vital, as untreated IBD can lead to long-term complications.

Diagnosis

A gastroenterologist may recommend a combination of tests to diagnose IBD and distinguish between Crohn’s disease and ulcerative colitis:

  • Blood tests: To detect anaemia and inflammation markers.
  • Stool tests: To rule out infection and check for inflammation (faecal calprotectin).
  • Colonoscopy: A camera test to view the bowel lining, take biopsies, and confirm inflammation.
  • MRI or CT scans: To assess the extent of disease, especially in Crohn’s disease.
  • Capsule endoscopy: Sometimes used to examine the small intestine.

Treatment Options

While there is no cure for IBD, treatments aim to control inflammation, manage symptoms, and prevent complications. Options include:

1. Medications

  • Aminosalicylates (5-ASAs): Reduce inflammation in ulcerative colitis.
  • Corticosteroids: Used short-term to control flare-ups.
  • Immunomodulators: Help regulate the immune system.
  • Biologic therapies: Target specific parts of the immune response and are highly effective in moderate-to-severe disease.

2. Dietary and Lifestyle Support

  • Tailored nutritional advice to prevent deficiencies.
  • Avoiding foods that trigger flare-ups.
  • Stress management, exercise, and sleep optimisation.

3. Surgery

In some cases, surgery may be required to remove damaged sections of bowel, treat strictures, or manage complications. Surgery can be curative in ulcerative colitis (removal of the colon) but not in Crohn’s disease, where inflammation may recur in other areas.

Complications of Untreated IBD

If not managed properly, IBD can lead to:

  • Severe anaemia and malnutrition
  • Strictures (narrowing of the bowel)
  • Fistulas and abscesses (in Crohn’s disease)
  • Toxic megacolon (a rare but life-threatening complication)
  • Increased risk of bowel cancer over time

Why See a Gastroenterologist?

IBD is complex and requires expert, ongoing management. A gastroenterologist can:

  • Provide an accurate diagnosis and rule out other causes of symptoms.
  • Create a personalised treatment plan tailored to your type and severity of disease.
  • Monitor your condition closely to prevent flare-ups and complications.
  • Offer access to advanced therapies and clinical trials.

Living with IBD

Although IBD is a lifelong condition, many patients lead full and active lives with the right treatment and support. Regular monitoring, lifestyle adjustments, and access to modern therapies mean flare-ups can be controlled and long-term complications minimised.

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What Patients Say About Dr Alisa

Read testimonials from patients who have experienced Dr Alisa's expert care.

My consultation with Dr Akeel Alisa was highly satisfactory and he was very thorough. The Gastroscopy procedure was performed satisfactorily with no pain or discomfort at all. I am very pleased with treatment received so far.

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I was fully vaccinated investigated by Dr Akeel Alisa and I was reassured. My endoscopy and colonoscopy were straight forward and painless. I am very happy with the care I received.

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Dr Akeel Alisa and Nursing team at Cromwell Hospital Endoscopy team offered me great care and all was perfect. Well pleased.

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