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Got a Gut Feeling?

CNE Talks (Your) Health

Maybe indulging in a plate of pasta covered in your favorite creamy sauce sends you to the bathroom for several hours of diarrhea; or the pain in your abdomen after you sink your teeth into a juicy steak is so unbearable you avoid it.

These are the kind of gut feelings you definitely cannot ignore. You may have what's called inflammatory bowel disease (IBD) and need a doctor's help.

IBD, which includes ulcerative colitis and Crohn's disease, is characterized by chronic inflammation of part or all of the gastrointestinal tract. Symptoms, which can vary in severity and may go away until triggered again, can include:

  • Abdominal pain
  • Diarrhea
  • Rectal bleeding
  • Urgency and/or frequency of bowel movements
  • Fever
  • Weight loss

If any of these symptoms sound familiar, it's time to see a specialist who will order an endoscopy. In this test, a small scope with a camera on the end of it is inserted into the rectum to examine the bowel. The appearance, pattern of inflammation and biopsy results help the doctor determine if you have Crohn's disease or ulcerative colitis.

"Two to 20 cases of IBD are diagnosed per 100,000 persons each year, a number that appears to be rising," says Melissa Murphy, MD, a colorectal surgeon with Affinity Physicians at Kent Hospital, who adds that, "It is unclear whether more cases of IBD are occurring or whether more patients are being accurately diagnosed."

IBD has a genetic link, with up to 20% of patients having a first-degree relative who also has IBD. The disease is more common in whites and those of Jewish descent, compared with African Americans and Hispanics. And, while men and women have similar symptoms, Dr. Murphy says anatomic differences result in different fistula formations in women with Crohn's. Women also have a slightly higher incidence of Crohn's disease, with men slightly more likely to have ulcerative colitis.

Crohn's versus colitis

What's the difference between the two diseases? Dr. Murphy explains that it's a matter of where the IBD is present in a person's gastrointestinal tract and how deep the inflammation goes.

Crohn's disease can affect the entire tract from the mouth to the anus and the inflammation involves all layers of the bowel wall, which can lead to strictures (a narrowing of the intestine), perforations, and fistulae (abnormal connection in the intestine).

Ulcerative colitis is limited to the large intestine (colon and rectum) and only the first two layers.

The ultimate risk of both diseases is developing colorectal cancer.

Remedies for tummy troubles

Treatment for either form of IBD depends on the severity of the disease.

"Medications are designed to suppress the immune system's abnormal inflammatory response, and can include short-term treatment for 'flares' and maintenance therapy for disease control," Dr. Murphy says.

Medication – which she adds should be prescribed under the careful supervision of a gastroenterologist with experience managing IBD because they can have significant side effects – include:

  • Steroids
  • Aminosalicylates
  • Antibiotics
  • Immunomodulators
  • Biologic therapies such as infliximab and adalimumub

Surgery can also be necessary in some cases, Dr. Murphy says. For some patients with ulcerative colitis, surgery can remove the diseased colon and reconstruct an internal pouch from the small intestine. Crohn's patients may require operations for stricturing disease, perforation, and/or fistulae. The most common surgical intervention in Crohn's disease is the removal of the diseased or strictured section of the intestine.

Grateful gut

There are ways you can keep your intestinal tract healthy and happy – mainly by the things you eat and the things you avoid.

"Diets high in red meat and saturated fats have been linked to an increased risk of colorectal cancer, while high fiber diets have been shown to have a protective effect against colorectal cancer," Dr. Murphy says. "In addition, high-fiber diets can have favorable effects by decreasing constipation, diverticulosis, and hemorrhoidal disease."

The role of probiotics and prebiotics is not completely clear, but she notes that early studies indicate there may be a protective benefit against colorectal cancer.

In addition to your diet, you can also introduce lifestyle changes to help your gastrointestinal system. These include:

  • Exercise more – Dr. Murphy notes that higher levels of physical activity have been reported to reduce risk of colorectal cancer by up to 40%
  • Kick the habits - smoking and higher alcohol intake has been connected with increased colorectal cancer risk

"Maintaining a healthy weight, exercising regularly, eating a diet high in fiber, and limiting your alcohol intake can help keep you and your colon healthy," Dr. Murphy concludes.

To contact a physician, call our physician refferral line at 401-737-9950.

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