IBD is a chronic condition, which means it cannot be cured, but it can be managed with treatment. It tends to have periods when it is active, known as a flare up, and when it is in remission, where there are no symptoms.
Medications and changes to your diet and lifestyle can help you lead a normal life and treatments for IBD are focused on managing your symptoms and taking measures to prevent them from flaring up – this is often referred to as maintenance treatment or therapy.
If medication, diet or lifestyle changes do not help, in some cases, surgery may be used to treat IBD.
Here we take a closer look at how to treat IBD.
How is IBD treated?
IBD treatment will depend on the severity of the symptoms you have. Some people only experience mild symptoms, and, if this is the case, a change in diet or lifestyle may be all that you need.
In more severe cases, IBD treatments may consist of dietary changes, medications or in very severe cases, surgery.
Medication for IBD
Medications that you may be prescribed include:
Aminosalicylates - also known as 5-ASAs, these are used to reduce inflammation in the gut. They are usually the first step in managing IBD symptoms during a flare up. This medication can also be used long-term to reduce the risk of future symptoms.
Corticosteroids - these are a more powerful anti-inflammatory medication and may be used if 5-ASAs have not helped. Corticosteroids and 5-ASAs may be prescribed together as a way to manage a flare up but are not normally used as a long-term treatment because side effects are more common if used for a long time.
Immunosuppressants – these include azathioprine, and will reduce activity in your immune system's activity. They may be used if other medications have not had an effect or as a maintenance method for reducing flare ups. They can take a while to have an effect and they make you more susceptible to infection, so it is important to speak to a doctor as soon as possible if you have any symptoms of an infection when taking these medicines.
Biologics – these are usually only used in severe cases when other IBD treatments haven’t worked. They are antibody-based treatments that are injected to target specific parts of the immune system.
These IBD treatments are the most common used for mild or moderate flare ups in Crohn’s disease or ulcerative colitis. When a severe episode of IBD occurs, stronger medication or specialist treatment in hospital may be needed.
Food and IBD
Certain foods may affect your symptoms, or you may find it difficult digesting certain food. It may help you to adjust your diet, but everyone is different, so you’ll need to work out what works for you. A food diary and your specialist team can help you do this.
As an example, some people find that spicy food, or dairy products trigger a flare up, or make their symptoms worse.
If your IBD is severe, or unmanageable, your specialist team may suggest surgery as the best treatment. This will be based on the impact of your symptoms on your general health, compared to the risks of surgery.
The surgical procedures for Crohn’s disease and ulcerative colitis will usually involve removing a small portion, or all, of the affected part of the intestines. There are different surgeries available, but the most common is a colectomy with ileostomy.
The colon is removed during the surgery, but the rectum is left. The end of the small intestine is then brought out through an opening in the abdomen wall (known as a stoma). An external bag is then fitted onto the opening to collect waste. This is often a temporary measure, but sometimes may be permanent.
What happens if IBD is left untreated?
If IBD is left untreated, it can lead to further complications and severe problems with the digestive system. Ignoring the problem can make it worse, so seeking treatment as soon as possible will allow you to manage the symptoms effectively.
Complications of Crohn’s disease can include:
- Intestinal stricture - scar tissue from Crohn's can cause parts of the bowel to become narrow and cause blockages.
- Fistulas - over time, ulcers may develop and these can develop into tracts, which are known as fistulas.
Complications of ulcerative colitis may include:
- Osteoporosis - while not a direct symptom of the condition, long term use of corticosteroids as treatment for ulcerative colitis can make you more at risk for osteoporosis.
Once you have an IBD treatment, ongoing care will usually be managed by a number of medical professionals, such as specialist nurses, a GP or specialist doctors such as gastroenterologist.
At Push Doctor, we can help you get the diagnosis you need. Speak to our doctors today and get a referral to a specialist for further investigation.
- NHS, Inflammatory Bowel Disease: Causes of IBD, 25/04/2017.
- NHS, Complications: Ulcerative colitis, 17/03/2016.
- NHS, Overview: Crohn's Disease, 04/04/2018.