Inflammatory bowel disease, usually shortened to IBD, was once thought to be rare in India. That is changing fast, and specialists across urban India are now seeing it regularly, often in young, working-age adults. IBD is a long-term condition that causes inflammation in the digestive tract, and while it cannot yet be cured, it can be controlled very effectively. Understanding the disease is the first step to living well with it.
What Is IBD?
IBD is an umbrella term for conditions in which the body’s own immune system mistakenly attacks the lining of the digestive tract, causing ongoing inflammation. This is different from the much more common irritable bowel syndrome, which does not cause this kind of inflammation or damage. The two main forms of IBD are Crohn’s disease and ulcerative colitis, and although they share many features, they differ in important ways.
Crohn’s Disease Versus Ulcerative Colitis
Knowing the difference helps make sense of the symptoms and treatment. Ulcerative colitis affects only the large intestine and rectum, and the inflammation is continuous along the inner lining. Crohn’s disease, by contrast, can affect any part of the digestive tract from mouth to anus, often in patches, and the inflammation can go deeper into the bowel wall. This is why Crohn’s disease can sometimes cause complications such as narrowing or abnormal connections between loops of bowel.
Symptoms to Be Aware Of
IBD symptoms tend to come and go, with flare-ups followed by quieter periods. Common features include:
- Persistent or recurring diarrhoea, sometimes with blood or mucus
- Crampy abdominal pain
- Urgency to pass stool or a feeling of incomplete emptying
- Unintended weight loss and tiredness
- Reduced appetite and, in some cases, low-grade fever
- Symptoms outside the gut, such as joint pains or mouth ulcers
How IBD Is Diagnosed
Because the symptoms overlap with many other conditions, a careful diagnosis is essential. This usually involves blood and stool tests, followed by a colonoscopy, which allows the specialist to see the inflammation directly and take small tissue samples for examination. Imaging scans may be used, particularly in Crohn’s disease, to assess parts of the small bowel that the camera cannot reach. An accurate diagnosis guides the right treatment and helps predict how the disease may behave.
Managing IBD: A Step-by-Step Approach
Treatment is tailored to the severity and type of disease and usually follows a stepwise plan. Milder disease may be controlled with anti-inflammatory medicines, while more active disease may need medicines that calm the immune system, including modern biologic therapies that target inflammation precisely. The goal is to bring flare-ups under control, keep the disease quiet for as long as possible, and allow the bowel lining to heal. Good nutrition and regular monitoring are an important part of long-term care.
When Surgery Is Needed
Many people with IBD never need an operation, but surgery has an important role in certain situations. In ulcerative colitis, removing the affected large intestine can be curative for the bowel disease in severe cases that do not respond to medicines. In Crohn’s disease, surgery is used to deal with complications such as narrowing, blockage or abscesses, while preserving as much healthy bowel as possible. Having a specialist who can manage IBD both medically and surgically ensures that the right treatment is chosen at the right time.
Living with IBD or unexplained gut symptoms?
Dr. Gautham Krishnamurthy manages inflammatory bowel disease both medically and surgically at P&G Hospital, Chennai, offering coordinated, long-term care. For appointments, contact reception.