Table of contents:
- Causes and Risk Factors for Inflammation of the Bowel
- Inflammatory Bowel Symptoms
- Inflammatory Bowel Diagnosis
- Inflammatory Bowel Treatment
- Inflammatory Bowel Complications
- Inflammatory Bowel Prevention
Inflammation of the intestines is a chronic inflammation of the digestive tract characterized by irritation to wounds. Inflammation of the intestines can cause symptoms such as persistent diarrhea, abdominal pain, bloody stools, weight loss, and fatigue
Inflammatory bowel disease (IBD) is divided into two, namely ulcerative colitis and Crohn's disease. Ulcerative colitis is chronic inflammation of the innermost lining of the large intestine or colon, while Crohn's disease is inflammation that can occur throughout the digestive system, from the mouth to the rectum.
Inflammation of the intestines can occur in anyone, but the most common age group affected by this disease is 20–30 years in Crohn's disease and 30–40 years in ulcerative colitis. Some data also show that intestinal inflammation often occurs at the age of 60–70 years, especially in ulcerative colitis.
Causes and Risk Factors for Inflammation of the Bowel
Until now, it is not known exactly what causes intestinal inflammation. However, the disease is thought to result from a combination of genetic susceptibility, environmental exposure, and immune system disorders.
The immune system ideally functions to fight bacterial or viral infections. However, in people with inflammatory bowel disease, the immune system responds inappropriately or abnormally, causing inflammation of the digestive tract.
In addition, a person is more at risk of developing colitis if they have the following factors:
- Under 35 years old
- Has a parent or sibling with a history of inflammatory bowel disease
- Has a smoking habit
- Living near an industrial area
- Often taking non-steroidal anti-inflammatory drugs (NSAIDs)
History of appendicectomy in children is also a risk factor for colitis. However, the benefits of this operation in conditions of acute appendicitis (appendicitis) certainly outweigh the possible risks in the future.
When viewed by gender, Crohn's disease is more common in women, while ulcerative colitis is more common in men.
Inflammatory Bowel Symptoms
Inflammatory bowel symptoms vary, from mild to severe, depending on the location and severity of inflammation in the digestive tract. These symptoms tend to recur. So, people with inflammatory bowel disease may experience periods without any symptoms at all.
The most common symptoms include:
- Stomach pain or cramping
- stomach bloating
- Persistent diarrhea
- Appetite decreases
- Losing weight
- bloody CHAPTER (hematochezia)
Bloody bowel movements due to intestinal inflammation can also cause anemia or lack of blood. This condition often causes complaints of fatigue and paleness in patients with intestinal inflammation.
Inflammation of the intestines can also cause complaints outside the digestive tract, such as arthritis, skin lesions or sores, eye inflammation, and urinary tract disorders.
When to see a doctor
Immediately check with a doctor if you experience symptoms of intestinal inflammation, or there is a change in bowel habits. Although generally not classified as a serious disease, but in some cases, intestinal inflammation can cause dangerous complications.
Inflammatory Bowel Diagnosis
Doctors can determine if a patient has colitis after asking about symptoms, performing a physical examination, and carrying out supporting examinations, which include:
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Stool examination
This examination is carried out to detect infection and the presence of blood in the stool that cannot be seen with the naked eye.
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Endoscopy
Endoscopy is performed to see the lining of the intestinal cavity by inserting a camera tube through the rectum or mouth. In colitis, endoscopy can see the extent of the disease.
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Blood test
This test aims to determine whether the patient has anemia, infection, or other conditions that may arise due to intestinal inflammation.
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Biopsi
A biopsy is done by taking a sample of tissue from the intestine, to be examined in the laboratory. This examination can determine the type of intestinal inflammation experienced by the patient.
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Scan test X-rays, abdominal ultrasound, CT scan, or MRI are done to see a complete picture of the intestines or digestive tract. This procedure can also be used to check for complications due to inflammatory bowel disease.
Inflammatory Bowel Treatment
Inflammatory bowel treatment aims to suppress the inflammatory process and relieve symptoms, which in turn will improve the patient's quality of life. There are a number of methods that can be done, namely:
Medications
For more serious conditions, doctors may prescribe certain medications. The type of drug prescribed will be adjusted to the location of the disease in the gastrointestinal tract, as well as the mild or severe disease.
The following are the stages of administering drugs that are commonly done by doctors:
1. Drug 5 – Aminosalicylates
Drugs 5–Aminosalicylates can be taken orally or inserted into the anus. This drug is commonly given to mild to moderate intestinal inflammation.
2. Corticosteroids
Corticosteroids aim to suppress the inflammatory process. This drug can be given to mild to severe intestinal inflammation.
3. Immunosuppressive drugs
This drug functions to inhibit the immune system from attacking the intestines and causing inflammation. Examples of this type of drug are azathioprine, 6-mercaptopurine, and ciclosporine.
4. Biological therapy
Biological therapy, also known as immunotherapy, is an inflammatory bowel therapy option that uses the body's immune system. There are two groups of therapy used to treat intestinal inflammation, namely:
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Tumor Necrosis Factor Antagonists
This drug targets tumor necrosis factor (TNF) immune cell activity to suppress inflammation. Examples of drugs in this class are infliximab, adalimumab, golimumab, and certolizumab pegol.
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Anti-integrin Monoclonal Antibody / Anti-adhesion Molecule
This drug targets the activity of integrin immune cells in suppressing the inflammatory process. This therapy is effective for initial therapy when new disease appears and for preventing recurrence. Several types of drugs in this class are natalizumab, vedolizumab and ustekinumab.
In addition to the main drugs above which play a role in suppressing the inflammatory process, there are several other drugs that can be given to relieve symptoms that arise due to inflammation in the intestines or gastrointestinal tract, such as:
- Antibiotics, such as ciprofloxacin or metronidazole, if infection occurs
- Antidiarrheals, such as loperamide
- pain relievers, such as ibuprofen or paracetamol, to treat abdominal pain
- Iron supplements, to treat chronic intestinal bleeding that can cause iron deficiency anemia
- Supplements of calcium and vitamin D, to avoid the risk of osteoporosis in people with Crohn's disease
Operating procedure
If lifestyle changes and medications can't solve the inflammation of the intestine, the doctor will recommend the patient undergo surgery. The method of surgery performed depends on the type of intestinal inflammation experienced, namely:
1. Surgery for ulcerative colitis
The operation that can be done for ulcerative colitis is to remove the entire colon and rectum (proctocolectomy) so that the remaining food from the small intestine is directly discharged into the anus. If the small intestine cannot be connected to the anus, the doctor will make a special opening in the abdomen (stoma) to remove stool.
2. Surgery for Crohn's disease
The main purpose of surgery is to remove the damaged part of the digestive tract, close the abnormal tract (fistula) if it forms, and remove pus.
Please note that surgery cannot cure Crohn's disease. In other words, surgery must still be followed by other treatments to reduce the risk of this disease relapse.
Inflammatory Bowel Complications
If not treated properly, colitis can lead to a number of dangerous complications. Complications that can arise include:
- Dehydration and malnutrition
- Inflammation of the skin, eyes, and joints when colitis recurs
- Intestinal obstruction
- Formation of an abnormal channel (fistula)
- Blood clots in the intestinal veins
- Toxic megacolon
- Colon cancer
Inflammatory Bowel Prevention
Inflammation of the intestines cannot be prevented, but there are several ways that can be done to relieve symptoms and prevent symptoms from recurring, namely:
1. Changing eating and drinking patterns
Patients with inflammatory bowel disease need to avoid foods that can exacerbate inflammation or irritation of the intestines. Usually, patients will be advised to limit their consumption of milk, alcohol, caffeine, and spicy foods because they can cause diarrhea.
In addition, patients are also advised to limit the consumption of fatty foods and drink more water. Symptoms of colitis will also improve if the sufferer eats smaller portions, with more frequent meals.
2. Quitting smoking habit
Smoking can exacerbate intestinal inflammation, especially in Crohn's disease.
3. Exercise regularly
Exercise regularly can help restore normal bowel function and also reduce stress.
4. Manage stress well
Although the relationship is still debated, many people with colitis have symptoms that recur when experiencing severe stress. Therefore, manage stress with relaxation or breathing exercises, either on a regular basis or at any time between busy schedules.
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