Inflammatory bowel disease (IBD), or IBD for short.
This is not a single disease, but a general term for a group of diseases. It mainly includes Crohn’s disease and ulcerative colitis.
1, IBD is not caused by “what you eat” or “what you do”.
2. IBD is not contagious.
3, IBD is not a rare disease, there are about 1.4 million patients in the United States, at least 140,000 of them are teenagers under 18 years old.
4, IBD is a chronic disease, which means a long-term treatment process. But this does not mean that your life will be a mess, you can still live long and enjoy a good life.
5, although IBD is a chronic disease, but does not mean that every day onset.
6. IBD “comes and goes without a trace”. IBD can be very serious when it starts, but when it doesn’t, there are no symptoms, and you may even forget that you are a patient with IBD.
7. Most people with IBD are “healthy” more often than they are “sick”.
8. although IBD will be with you for the rest of your life, it does not mean that it will “rule” your life.
9. People with IBD can do what they want to do, go to school, work, get married, have children, travel – do whatever you want to do, just like normal people.
10. IBD develops mainly because the body’s resistance factor treats its own intestine as the “enemy” leading to repeated damage to the intestinal mucosa, so immunosuppression is the main treatment modality.
11. Crohn’s disease can occur in any part of the GI tract, and if lesions are found in the large intestine, the doctor will advise the patient to have a full GI tract examination if possible, especially small bowel microscopy and capsule endoscopy to see if similar lesions are occurring in other areas.
12. ulcerative colitis occurs mainly in the proximal rectum and anus, where fewer oral drugs reach the lesion, so enema therapy delivers drugs directly to the lesion with better results
13. The gastrointestinal tract is like the walls of a house, with stucco and brick layers. Ulcerative colitis is mainly an inflammation and ulceration of the stucco layer of the intestinal wall, so patients are prone to bloody stools and mucus. Crohn’s disease lesions of the stucco layer of the intestinal wall are not heavy, so bleeding is not heavy, because the entire intestinal wall and brick layer are involved, easily causing narrowing of the intestinal wall, abdominal pain, abdominal distension.
14, Crohn’s disease ulcers are more difficult to distinguish from intestinal tuberculosis, lymphoma and leukoaraiosis, sometimes requiring experimental treatment to determine, and it is difficult to have an easy way to confirm the diagnosis of these diseases.
15, IBD can present with extra-intestinal manifestations that can be helpful in diagnosis: arthritis, oral ulcers, ocular symptoms, skin manifestations, etc. Fever secondary to infection, which requires differentiation between tuberculosis or lymphoma
16. IBD can occur at any age, mostly in young people aged 15 to 35 years, with a similar prevalence in men and women
17. Crohn’s disease and ulcerative colitis are both chronic diseases that require long-term treatment plans. There are a range of different medications to treat IBD. Remember, it is a treatment, not a cure, and these medications will not cure the disease, but will keep it below a certain level. In this state, you will not feel any symptoms. This state is called remission, and it can last for at least several months or even years
18. There are two key goals in treating IBD: to control acute attacks and relieve symptoms as soon as possible; to maintain the disease in a state of remission as long as possible; when the disease has another acute attack and symptoms worsen, it is known as a relapse. Both Crohn’s disease and ulcerative colitis present with alternating periods of acute exacerbation and remission
19. Each patient’s symptoms are different, so their treatment is “individualized”. The treatment plan depends on the extent of intestinal involvement. Specific drugs reach specific areas to work, which is why doctors choose these drugs. The previous examination gives the doctor a clear indication of the location and extent of the lesion, so that specific drugs can be chosen to treat it more effectively and in a more targeted manner. Of course it may take some time to select the right medication or combination of medications for you. As your symptoms begin to improve, your doctor may also adjust the dose or medication as appropriate.
20. The common drugs used to treat IBD are divided into four main categories, some used to relieve acute attacks and some used for maintenance. (1) Aminosalicylates: These are the most common drugs used to treat IBD and belong to the aspirin class. They are used in patients with mild to moderate Crohn’s disease or ulcerative colitis. This class of drugs includes mesalazine, balsalazide, olsalazine, and salazosulfapyridine. (2) Glucocorticoids: They work quickly, so they are often used to control flare-ups of the disease. In addition to rapidly controlling inflammation, they also rapidly suppress the body’s immune response. Prednisone and methylprednisolone are commonly used drugs. (3) Immunomodulators: These drugs include 6-MP (6-mercaptopurine), azathioprine, and methotrexate. These drugs regulate the body’s immune system and can be used as long-term maintenance medications. (4) Infliximab: for patients with moderately to severely active IBD who are not sensitive to conventional drugs. This drug has a rapid onset of action, is effective in promoting mucosal healing and reducing postoperative recurrence, can reduce to discontinue steroid hormones, and is also a maintenance drug in remission, effectively reducing the rate of surgery and hospitalization, but is more costly.
21. It is often annoying to take medications regularly every day, and, all medications have side effects, some of which are even worse than the disease itself. Examples include headaches, nausea, hormone-induced “full moon face” that affects beauty, emotional instability, fatigue, and skin rashes. However, these side effects will disappear when the drug is stopped. Doctors will also explain these side effects and how to deal with them. But the most important thing is to take the medication as prescribed by your doctor. Take the medication even when you feel “well”.
Surgery often does not cure the disease, but in cases of significant bleeding, perforation, obstruction, or a large ulcer confined to a segment of the intestine, the lesion can be surgically removed and the two healthy segments of the intestine can be joined and sutured together. Some patients may require several surgeries to remove the diseased segment of intestine
23. No food can cause Crohn’s disease or ulcerative colitis. However, when you have one of these diseases, you need to pay more attention to your daily diet than before. Especially during an attack, some changes to your diet can help you relieve symptoms and replace lost nutrients.
24. IBD is a chronic disease that requires long-term treatment, so patients need to protect their hospitalization and examination records and organize them well for the doctor’s reference at follow-up appointments. Also maintain good communication with the visiting physician.
25, Patients with abdominal pain can reduce abdominal pain as well as some other symptoms with a low-fiber, low residue or liquid diet. High-fiber foods usually include fresh fruits, vegetables, grain seeds, nuts, and the husks of grains, animal Achilles tendons that contain a lot of connective tissue, and old muscles, etc. These types of foods can cause more food residues to be excreted into the intestines to form stools. This type of food rich in dietary fiber should be used sparingly. The food selected should be soft, less residue, easy to chew and swallow, such as meat should be selected from the tender lean parts, vegetables selected from the tender leaves, flowers and fruits, melons should be peeled, fruits with juice. Low-fiber, low residue diet food residue intake is reduced to a minimum.
26, nutrition is particularly important for patients with inflammatory bowel disease. Patients with inflammatory bowel disease, especially those with Crohn’s, are prone to malnutrition. The reasons for this are mainly as follows: firstly, the patient’s appetite decreases; secondly, the chronic disease state increases the demand for calories, especially when inflammatory bowel disease breaks out; finally, the digestion and absorption of proteins, fats, carbohydrates, water, vitamins and minerals decreases in patients with inflammatory bowel disease (especially Crohn’s disease), so that most of the nutrients in food are not taken in by the body. On the other hand, a good nutritional status facilitates the body’s self-recovery. Therefore, any malnutrition needs to be corrected. Restoring and maintaining a good nutritional status is an important aspect of the treatment of inflammatory bowel disease
27. The possibility of drinking milk varies from person to person. Some people are intolerant to lactose (a sugar contained in milk). This is due to a lack of lactase, a digestive enzyme, in the epithelium of the small intestine. Lactose intolerance can lead to symptoms such as intestinal cramps, abdominal pain, bloating, diarrhea, and increased gas. Because the symptoms of lactose intolerance are so similar to those of inflammatory bowel disease, it can be difficult to distinguish between the two. If diarrhea and bloating occur after drinking milk indicating possible lactose intolerance, then milk intake should be restricted.
28. Some drugs for inflammatory bowel disease, especially 5-aminosalicylates, will interfere with the absorption of folic acid (a vitamin). Folic acid, which has an important role in the fight against cancer and in reducing fetal malformations, must be supplemented for patients using such drugs.
29. Regarding vitamin supplementation: vitamin B12 is absorbed in the distal ileum. Therefore, patients with ileitis (Crohn’s disease can invade the ileum) do not get enough vitamin B12 from food and thus need additional vitamin B12 injections. if you are a low-fiber eater, then you need additional vitamin C supplementation (fruits are usually rich in vitamin C). If you are a patient with chronic inflammatory bowel disease, then a regular multivitamin supplement is necessary. In addition, if you suffer from malnutrition or have had intestinal surgery, you will need to supplement with additional vitamins, especially vitamin D. Vitamin D supplementation is usually around 800 U/day, especially in areas with low sunlight. Calcium supplementation also needs to be boosted, with calcium citrate being appropriate for the elderly and for patients taking acid-producing medications. Patients on steroid hormones and those with Crohn’s disease are prone to osteoporosis; therefore, monitoring of bone density is necessary for these populations.
30. Most patients with inflammatory bowel disease do not require mineral supplementation. However, for patients with extensive involvement of the small intestine or patients with important bowel segments surgically removed, supplementation with calcium, phosphorus, and magnesium is necessary. In addition, iron therapy helps to correct iron deficiency anemia. However, oral iron can darken the stool and sometimes cause false positives for fecal occult blood
31. Although Crohn’s disease is a serious chronic disease, it is not fatal. Living with it is indeed challenging: you have to take medications and sometimes be hospitalized, but you need to remember that most people with Crohn’s disease can still have a colorful life. It is also important to remember that maintenance medication in remission can significantly reduce the recurrence of Crohn’s disease and that most patients are asymptomatic in remission.