12 myths about IBD

IBD is a disease that affects the gastrointestinal system. Symptoms often include abdominal cramps, bloating, constipation, and diarrhea.

Symptoms can fluctuate and can last for days, weeks, or months at a time. In 2015, an estimate 3 million people in the United States had IBD.

Globally, the disease has affected approximately 6.8 million people in 2017.

The most common forms of IBD are Crohn’s disease and ulcerative colitis. Both involve chronic inflammation of the digestive tract.

Despite the relatively high prevalence of IBD, a lot of misinformation and misunderstanding surrounds it.

Here, we fight fiction with facts. To aid us in our quest, we enlisted the help of Dr. Abhik Bhattacharya, Assistant Professor of Medicine in the Division of Gastroenterology at Icahn School of Medicine in Mount Sinai, NY.

IBD and Irritable Bowel Syndrome (IBS) both affect the digestive system and have similar acronyms. Perhaps this explains some of the confusion. However, the two conditions are not the same.

Dr Bhattacharya explained to Medical News Today that IBS “is a disorder of the interaction between the gut and the brain, resulting in diarrhea, constipation or both, as well as bloating and pain. [It] can be made worse or precipitated by stress and anxiety.

Conversely, he continued, IBD “is a disease of a deregulated immune system, in which the immune system begins to attack your own gastrointestinal system, causing damage.”

“The disease can lead to stress, aggravate anxiety, depression and loss of sleep due to the devastating consequences it can have on a person’s daily functioning,” he said. “Symptoms can include bleeding in the stool, diarrhea, severe abdominal pain, involuntary weight loss, fevers, chills, rectal pain, fatigue, etc.

IBD is caused by the immune system, so stress is not the direct cause. However, as Dr Bhattacharya explained, it “can make life very stressful”.

Stress can trigger IBD flares and exacerbate symptoms in some people, which might help explain the confusion. However, stress does cause IBD.

Some small, decades-old studies have looked at the links between personality traits and IBD. However, when MNT asked Dr Bhattacharya if there were any links between a person’s character and IBD, he said succinctly: “We don’t know of any.

Crohn’s disease and ulcerative colitis are the most common forms of IBD. However, these are separate conditions, and people cannot have both.

“You can have Crohn’s disease or ulcerative colitis,” Dr. Bhattacharya said. “However, in a very small subset of patients, it is difficult to determine whether they have Crohn’s disease or ulcerative colitis. The disease, however, manifests itself over the course of a patient’s life.

Fortunately, this is wrong. “There are many extremely effective treatments for IBD. Depending on what you have and the severity of the disease, we have a plethora of medical treatment options, ”explained Dr. Bhattacharya. He then described some of the interventions available:

“These include, but are not limited to, biologics, such as Remicade [infliximab], Humira [adalimumab], Cimzia [certolizumab pegol], Simponi [golimumab], Entyvio [vedolizumab], and Stelara [ustekinumab], or small molecules like Zeposia [ozanimod] and Xeljanz [tofacitinib]. They are powerful immunosuppressive drugs, and we are constantly developing new drugs through clinical trials. “

“No, not everyone needs surgery,” said Dr Bhattacharya MNT. He explained that in the past, the majority of people with IBD would have had surgery.

However, “with the advent of highly effective and safe immunosuppressive drugs,” surgery rates have declined dramatically over the past 20 years.

According to Crohn’s & Colitis UK, around 15% of people with ulcerative colitis will need surgery 10 years after diagnosis. However, in agreement with Dr Bhattacharya, the organization notes that the improvement in available treatments means that this percentage is decreasing.

“The goal of treatment,” said Dr. Bhattacharya, “is to prevent surgery due to complications from bowel damage.” He advocates early treatment with strong drugs soon after diagnosis. This, he explained, prevents damage, thus eliminating the need for surgery.

This is not true. “Most IBD medications are very safe during pregnancy,” said Dr Bhattacharya.

He explained that the goal is to keep people with IBD in remission during pregnancy “because the worst thing that can happen to both the baby and the mother is for the disease to be active.”

“We have assembled and continue to collect a large amount of data regarding drug safety during pregnancy. “

– Dr Bhattacharya

There is, however, one important exception: methotrexate. Dr Bhattacharya told us that methotrexate “is stopped even when women with IBD are planning to become pregnant.”

After the IBD medications work and the symptoms go away, it may be tempting to stop taking the medication. However, this is not what doctors recommend. Dr Bhattacharya said MNT:

“Right now, we don’t have a good way to stop medication for IBD patients in remission. […] We do not recommend stopping the drugs.

He explained that stopping treatment can have serious consequences. For example, symptoms may come back and if the person starts the same treatments again, they may not work.

“While we have options when it comes to treatment,” he said, “those options aren’t limitless and we don’t want to run through the drugs. There is good data to support that when […] a set of medications for IBD [fails], your response to another type may be less likely.

As Dr Bhattacharya said MNT, a ‘gluten-free diet works for [people with] celiac disease and non-celiac gluten sensitivity ”, but this will not benefit people with IBD.

Although, as the name suggests, IBD significantly affects the gut, the disease can have ramifications in many other parts of the body as well.

“Besides the gastrointestinal system, which includes the mouth to the anus, IBD can have extra-intestinal manifestations like affecting the skin, eyes and joints, to name a few,” said Dr Bhattacharya.

According to a review extra-intestinal manifestations of IBD, they “can involve almost any organ system […] and can pose a significant challenge to physicians caring for patients with IBD.

For example, IBD can affect the musculoskeletal system, as well as the eyes, kidneys, and lungs. It can also damage the hepatopancreatobiliary system, which includes the pancreas, liver, gallbladder, and bile ducts.

Currently, there is no cure for IBD. However, as Dr Bhattacharya said, “It is a work in progress. “

Researchers are working tirelessly to better understand the disease so that they can design better treatments and, perhaps one day, a cure.

This, fortunately, is a myth. “They absolutely can,” confirmed Dr Bhattacharya. “With proper medical management and, sometimes, surgery, IBD patients can lead completely normal lives. “

“We have lawyers, doctors, athletes, actors, comedians, rock stars and presidents – Eisenhower and John F. Kennedy – who have [or had] IBD and has lived more than a functional life.

After earning a bachelor’s degree in neuroscience from the University of Manchester in the UK, Tim completely changed course to work in sales, marketing and analytics. Realizing that his heart really is in science and writing, he changed course once again and joined the team at Medical News Today as a news editor. Now News Editor, Tim leads a team of leading writers and editors who report on the latest medical research in peer-reviewed journals; he also writes a few articles himself. When he has the chance, he enjoys listening to the heaviest metal, watching the birds in his garden, thinking about dinosaurs and wrestling with his children.

You can follow Tim on Twitter.

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