How to Deal with Inflammatory Bowel Disease (IBD)?

Medically reviewed by July 08, 2024| Written by

How to Deal with Inflammatory Bowel Disease (IBD)?

Inflammatory bowel disease (IBD) is an autoimmune disease that needs medical treatment. People diagnosed with IBD must learn to manage the condition with the help of their doctors and a qualified dietitian.  

The first question most people ask when they hear about inflammatory bowel syndrome (IBD) is, don't you mean irritable bowel syndrome (IBS)?

The confusion is common because most people are more familiar with the acronym "IBS". However, the two are not the same.IBS is a syndrome, while IBD is a disease.  

Asyndrome is a set of symptoms or conditions that occurs together and may be a sign of a certain disease or a risk of developing the disease. Meanwhile, a disease is a medical condition with a known cause and associated with specific signs and symptoms.

IBD involves mainly two conditions: ulcerative colitis and Crohn's disease. In both these diseases, the immune system malfunctions, resulting in chronic inflammation of the digestive tract lining, which can damage it.

In ulcerative colitis, the inflammation and ulcers (sores) appear along the large intestine and rectum lining. In Crohn's disease, the inflammation commonly appears in the small intestine and the beginning of the large intestine, but it can also affect the entire digestive tract. 

IBD is characterized by periods of relapse and remission, with many of the IBD medications aimed at prolonging remission and preventing relapse. 

People often wonder whether IBD is caused by the food they eat. We will answer this question in the process of learning more about this serious disease that can even be life-threatening for some people. 

What are IBD symptoms?

IBD can be a fairly mild condition for some people and more severe for others. IBD symptoms can come and go with relative symptom-free periods for patients. 

IBD symptoms include:

  • Stomach pain and cramping
  • Diarrhea, sometimes with blood
  • Urgency to have a bowel movement
  • Inability to contain fecal matter
  • Vomiting
  • Blood in stools
  • Rectal bleeding
  • Unintended weight loss
  • Loss of appetite
  • Fatigue

If the symptoms are ignored and the inflammation is not treated, IBD can cause serious damage to the intestines. The damage includes abscesses, narrowing in the bowel (strictures), and breaks in the bowel, causing its contents to leak into other organs like the bladder or the vagina. 

In some people, the inflammation can cause issues in other areas of the body, such as the eyes, mouth, liver, kidneys, skin, joints, spine, and blood circulation. Therisk of colon cancer increases the longer the inflammation from IBD continues.

Not a symptom, but certainly a serious side effect of IBD is the mental health toll it takes. It’s because living with an autoimmune disease is taxing. Considering the pain, discomfort, and fatigue caused by the disease and the constant fear of flare-ups, it's understandable that a person with IBD could suffer fromanxiety and depression

What is the Most Common Age to Get IBD?

A person can be diagnosed with IBD at any age. Most cases of ulcerative colitis are diagnosed when people are in their20s and 30s and others are diagnosed after 50. Crohn's disease is mostly diagnosed earlier, in a person's teens and early 20s.

Around 16% of IBD cases are diagnosed after the age of 65 years, with 4% diagnosed before the age of 5.  

What is the Cause of IBD Disease? 

The gastrointestinal system (GI) is extremely complex and doctors still don't fully understand it. That’s why the exact cause of IBD is still not known. 

The following three factors seem involved, but exactly how is unknown: 

1. Immune System Response

In people with IBD, the gut microbiome, which consists of trillions of microbes, such as bacteria, viruses, and fungi gets disrupted. Researchers have observed complex chemical and molecular reactions during IBD flare-ups. These interactions alter the composition of the gut microbiome composition and trigger immune responses.

 The immune system responds by releasing antibodies to fight off this perceived threat.Research shows the innate immune system induces inflammatory responses, but the adaptive immune system creates a chronic inflammatory response in IBD patients. Both systems work together to protect the body against intruders, with the innate system providing an initial defense and the adaptive system offering targeted and lasting protection.

2. Genetics 

Scientists have identified several genes that may be involved in IBD and have concluded that a family history of IBD is the main risk factor for IBD. A Swedish study found that first-degree relatives of patients with Crohn’s Disease havean eight-fold higher risk of developing IBD. 

3. Environmental Triggers

Environmental factors like smoking, stress, and medications including aspirin, ibuprofen, or antibiotics may trigger IBD in people who are already genetically predisposed to the disease. Infections can also irritate GI tract into developing IBD. It’s because the immune system often keeps responding even after the episode has cleared up, setting the stage for IBD.

Note: It is essential to understand that IBD is not caused by diet but certain foods put youat a higher risk of developing IBD. For instance, some research suggests that people whose diets contain large amounts of processed foods, red meat, saturated and animal fats may havean increased risk of developing IBD.

Can IBD be cured? 

There is no cure for IBD. It is a serious autoimmune disease that doesn't respond satisfactorily to home remedies, lifestyle adaptions, or diet changes. 

IBD is challenging to live with and must be managed. A crucial part of managing IBD is medication to reduce inflammation and alleviate the various other symptoms of IBD. After all, it’s the inflammation that is at the root of all the symptoms and complications associated with the disease. 

Taking medication can't be avoided – most people are on one or more medications from the time they are diagnosed. These include drugs to suppress the immune system attack on the GI, anti-inflammatory drugs, pain medication, antibiotics, and steroids.  

Surgery is also employed to manage IBM because medications don't always work. When the damage to the intestine is severe, surgeons may have to remove part of it. The aim is to leave enough so the body can still absorb nutrients, but in severe cases that is not always possible.

Lifestyle changes are also employed to manage the disease, but there's a limit to what lifestyle changes can do for a person with IBD. Healthy lifestyle habits can't cure or reverse IBD, but can help alleviate the intensity of symptoms like abdominal pain.

The one lifestyle habit consistently highlighted as detrimental for anyone with IBD is smoking. This habit seems to aggravate IBD symptoms and patients are advised not to smoke.

Research has looked into what causes flare-ups, but so far, no definite triggers have been identified. Patients are advised to: 

  • Keep a food and symptom diary to identify foods that cause a flare-up.
  • Avoid foods that cause gas or irritate the intestines, such as greasy and highly processed foods.
  • Stay physically active and drink enough water.
  • Avoid caffeine, carbonated, and alcoholic drinks.
  • Find ways to handle stress.
  • Get enough sleep.
  • Find assistance for mental health. 
  • Follow a nutritious diet as suggested by a qualified dietitian.
  • Take recommended vitamins or supplements.

What to Eat for IBD? 

The Crohn’s & Colitis Foundation has a list ofspecialized IBD diets but states that none of these have been proven to prevent or control IBD. The exception isenteral nutrition, which is not a diet but a nutrient-rich formula.

The fact of the matter is that people experience the disease differently. Foods that trigger a reaction for you may not be a trigger for someone else. That is why it’s important to keep a food log to track your diet and symptoms. 

A Mediterranean-style diet is currently the only one recommended by the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD), according to the Crohn's & Colitis Foundation. 

The Mediterranean diet includes fruits, vegetables, whole grains, fish, legumes, nuts, and olive oil. The diet includes a limited amount of red meat and moderate amounts of poultry, eggs, cheese, and yogurt. The diet is rich in fiber and plant-based foods, including herbs and spices. 

A recent study of patients with Crohn's disease and ulcerative colitis who followed the Mediterranean diet for six monthsreported reduced malnutrition, improved disease symptoms, lowered inflammation, and improved quality of life.

Check out ourMediterranean meal plan for dietitian-backed advice regarding how much and when to eat for proper care of IBD.

Should I Increase My Fiber Intake to Heal IBD? 

Scientists have not yet found a substance that can heal IBD. But the disease is taking such a heavy toll on IBD patients' quality of life that research is continuing unabated. 

The role of fiber in IBD is also being explored. While healthy people must follow a diet high in fiber for optimal health, people living with IBD can often not handle fiber. Their colons tend to be damaged by inflammation, which causes a narrowing of the bowels so undigested matter from fruits, vegetables, and whole grains cannot move through and become stuck, causing severe symptoms.

For these people, a low-residue (low fiber) diet may be more appropriate. 

On the other hand, if a person with IBD can tolerate fruits and vegetables, it's recommended to include them in an IBD diet as they counteract inflammatory conditions. 

One study found thatlong-term intake of dietary fiber, particularly from fruit, is associated with a lower risk of Crohn’s Disease but not Ulcerative colitis. 

What Foods to Avoid in IBD?

There is not enough evidence about what causes flare-ups, but the IOIBD has released the followingguidelines

For Ulcerative Colitis:

  • Reduce red meat intake.
  • Reduce intake of palm oil, coconut oil, and dairy fats.
  • Increase intake of omega-3 fatty acids. The source should be actual marine fish, not supplements.

For Crohn's Disease:

  • Increase the amount of fruits and vegetables. (However, in case of the narrowing of the bowel due to inflammation, these soluble fibers should be avoided or limited.
  • Reduce intake of saturated fats.

For Both Conditions:

  • Reduce the intake of emulsifiers and thickeners found in processed foods. Emulsifiers such as soy lecithin are used to help mix water and oil. Several gums are used as thickeners, such as guar gum and xanthan gum. Look out for thickeners in salad dressings, baked goods, gluten-free foods, and vegan ice creams.
  • Avoid trans-fats. Many processed foods contain trans-fats.
  • Limit intake of maltodextrin and artificial sweeteners and foods containing them.
  • Avoid unpasteurized dairy products.

There are no specific recommendations regarding wheat, gluten, complex carbohydrates, refined sugars, fructose, or pasteurized dairy products. But if you have IBD, it would be wise to keep track of your diet and avoid food items that trigger a flare-up. 

Research is continuing and people with IBD can participate inclinical trials to help accelerate understanding of the disease and possibly benefit from new trial medications.

FAQs

Is IBD life-threatening?

IBD is a serious condition that cannot be left untreated. With appropriate treatment, people with IBD can live relatively normal lives. However, if left untreated, the disease can become life-threatening, with severe complications, including: 

  • Severe inflammation and damage to the intestine
  • Malnutrition due to poor absorption of nutrients
  • Severe flare-ups that require hospitalization
  • Increased risk of colon cancer

What is the Recovery Time for IBD?

You cannot recover from IBD. So far, scientists have not discovered the cause of or a cure for IBD. However, it is common for people to experience remission of IBD, which can last for months or even years. Medications can help to prolong remission or avert flare-ups.  

Can you Live with Untreated IBD?

You can live with untreated IBD, but your life would probably be intolerable. IBD causes severe abdominal discomfort, and the inflammation is very painful. Medication is needed to control the inflammation. 

In addition, damage to the intestines due to inflammation will make it difficult to absorb nutrition from the food you eat so you'll likely suffer from malnutrition, which weakens the immune system, putting you at risk for poor health in general.

Also, keep in mind that people with IBD have an increased risk for colorectal cancer. Long-standing uncontrolled inflammation of the colon increases this risk.