By Christine Bowen / Special to The Herald
Many people confuse the acronyms IBS and IBD. IBS stands for Irritable Bowel Syndrome and IBD stands for Inflammatory Bowel Disease. These two conditions can overlap in some of the symptoms they create, but IBD can be life-threatening.
Both IBS and IBD can interfere with quality of life, but the symptoms and lab tests for Inflammatory Bowel Disease can help to distinguish it from IBS. IBS is defined by a collection of symptoms, and IBD is a condition that results from the immune system attacking a harmless virus, bacteria or food in the gut, causing inflammation that leads to bowel injury. IBD can be painful and can be very severe, sometimes requiring hospitalization during a flare. Early diagnosis and management of IBD can help to reduce future complications of this condition.
The main two types of IBD are Crohn’s disease and Ulcerative Colitis. Crohn’s can affect any part of the digestive tract (mouth to anus) and causes inflammation and ulcers in the digestive tract. Ulcerative Colitis affects the large intestine (colon to anus). Other less common types of IBD are microscopic colitis, collagenous colitis and even a type of inflammation that is associated with diverticulitis called SCAD (Segmental Colitis Associated with Diverticulitis). Sometimes IBD can cause symptoms outside of the digestive tract like arthritis or inflammation of the eyes. When this happens, the conditions are called “extraintestinal manifestations.”
Symptoms of IBD
• Blood in your bowel movements.
• Abdominal pain and/or cramping.
• Loose bowel movements.
• Weight loss.
• Nutrient malabsorption.
• Fever and chills.
• Fatigue.
Tests can distinguish IBD from other conditions that may look an awful lot like IBD (diverticulitis, hemorrhoids, IBS, gut infections, autoimmune diseases, celiac disease and bowel cancer). Often, we are the most likely to share our digestive symptoms with our primary care providers and they may or may not send us to a digestive specialist like a gastroenterologist. It is important that we have certain tests done to get a diagnosis as quickly as possible.
Blood tests: Complete blood count, comprehensive metabolic panel, iron panel, ferritin, vitamin b-12 and folate, inflammatory markers (hs-CRP and ESR), autoimmune markers (ANA with reflex, ANCA, ASCA, a celiac panel (I like a more full panel with 5 markers instead of 1-2).
Stool tests: Calprotectin, Lactoferrin and stool tests to rule out infections.
Colonoscopy/endoscopy: Can be used to screen for and diagnose IBD
MRI or CT scan of our abdomen (area between our lower rib cage and our pelvis): Dilated bowel loops and other signs of inflammation can be seen. CT is especially useful in ruling out diverticulitis or internal bleeding.
Other: Abdominal x-ray, abdominal ultrasound, endoscopy, capsule endoscopy MR enterography
IBD causes
Often it is more than one of these risk factors that will ultimately cause IBD.
Family history: One in four people with IBD have a family history of it.
Race and ethnicity: IBD is more common in white people. It’s also more common in Jewish people, especially Ashkenazi Jews.
High stress: Stress can suppress our immune system function and can alter our microbiome.
Poor diet: Diets that are high in processed foods and sugar can predispose people to develop IBD.
Toxic exposure: Chemicals, mold, asbestos, etc…can harm the immune and nervous systems.
Infections: Vviruses, bacteria, parasites and more can create injury to the intestines.
Depleted microbiome: Antibiotics, poor diet, infections and more can cause the healthy gut bugs to fall out of balance. If we lose these health-promoting bugs, our gut can be more vulnerable to IBD.
IBD management
Conventional: IBD is typically managed with steroids, immune modifying drugs, biologic drugs and anti-inflammatory drugs. Some gastroenterology centers have nutrition specialists in their group, but these are few and far between. The most collaborative care team I know of is the one at Seattle Children’s Hospital Gastroenterology Department.
Holistic: We may not be able to control our genes or our race but we can absolutely help to change or improve other things that influence health in our bodies and guts.
Nutrition: Changing your diet to increase the amount of fresh, organic and nutritious food in it can really help your gut health. Simply, by not eating fast food, processed food, and sugar, you can start to calm inflammation. Taking this approach one step further, dietary plans such as The Specific Carbohydrate Diet (SCD) or the Autoimmune Protocol (AIP) can further help to rebalance the microbiome and promote gut healing (best done with the support of a provider).
Lifestyle
Stress reduction: Stress reduction can improve so many aspects of our lives. Simple strategies like saying “no” to things that you don’t want to do, or taking a minute to reflect on what you are grateful for can be great places to start. A counselor can help you organize your thoughts and get tools for managing stress levels, too.
Therapeutic Movement: Studies show that increased daily exercise can improve IBD outcomes.
Get support: Living with IBD can be very difficult and is often painful and isolating. Make sure you are surrounding yourself with people (friends, family, counselors, other healthcare providers) who are there for you through thick and thin and are supporting your progress instead of sabotaging your progress.
Herbs and nutrients: There is no “one size fits all” supplement approach for IBD. Working with a holistic doctor such as an ND who specializes in IBD (like me!) can help you find out which combination of probiotics, anti-inflammatory herbs and gut healing treatments are right for you.
Takeaway
if IBD is caught early and managed well — in whichever ways are right for each person — then it can be a condition that significantly improves and minimally interferes with people’s lives. But if not well-managed, IBD can be a life-threatening condition.
If you suspect you have IBD or do have a diagnosis of IBD, please make sure you are advocating for yourself and your optimal well being in all of your health care visits and continue to pursue healing treatments beyond what is offered. Your health is worth it!
Dr. Christine Bowen of Everett is a licensed naturopathic doctor, keynote speaker and has been published in the Townsend Letter. In practice since 2005, Bowen specializes in holistic approaches for digestive health and autoimmunity. Go to www.bothellnaturalhealth.com for more information. Connect with her via Facebook drchristinebowen or Instagram @drchristinebowen.
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