AdventHealth House Calls: Inflammatory bowel disease (IBD)

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Dr. Uday Navaneethan, the Director of IBD Center at AdventHealth Center for Interventional Endoscopy, joined Good Day Orlando on Monday morning at 8 a.m. He answered your questions on inflammatory bowel disease (IBD) below.

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Q: How would I know if I have inflammatory bowel disease?

A: You may have symptoms of blood in the stools, persistent diarrhea, weight loss, mucus in the stool. If you have any of these symptoms, you need to have it checked out with an IBD specialist/ gastroenterologist. 


Q: Is there a difference between IBS and IBD?

A: Yes, IBS is a condition in which the intestines are not inflamed, but have symptoms of diarrhea. With IBD, there is inflammation seen in the intestines and the intestines are swollen and inflamed. The treatment approaches are completely different. 


Q: Is IBD curable or once you have it, you’re stuck with it forever?

A: There is no cure for IBD, however with the current treatment options you have, you can have a normal quality of life. 


Q: What meds do you take if you have inflammatory bowel disease?

A: The medications depend on what symptoms you have. If you have mid disease, you can be treated with oral medications such as mesalamines. If the symptoms are severe, you need medications called biologics, which are injectable medications given any where from once every 2 weeks to once every 2 months to control your symptoms. 


Q: Can you get IBD at any age?

A: YES, It can happen at any age as early as 2 years of age to as late as the 80s. 


Q: Is inflammatory bowel disease genetic? 

A: Yes, there is a genetic reason to it and there are as many as 162 genes which have been implicated in the disease. It can run in families because of this genetic reason. As many as 5-20% of patients have a family member with IBD


Q: Are there certain things I can do to avoid getting inflammatory bowel disease?

A: We do not have good studies to show this; however there is rising incidence of IBD in the western world with westernized diet and the countries in Asia and Africa are also seeing an increase because of Westernized diet. So, may be use of processed foods and GMO foods may play a role; although we do not know this for sure. 


Q: What types of people most commonly get inflammatory bowel disease?

A: It can happen in family members who have IBD. Also, if you have an autoimmune predisposition such as thyroid problems, you may be at increased risk. 


Q: Can IBD lead to more severe health issues? Cancers, disease, etc?

A: Yes, IBD if untreated can increase the risk of colon cancer and surgeries in your abdomen (which may require a permanent bag).


Q: Are there certain dietary changes I can make to help my IBD?

A: Once you have IBD, you should limit fiber in your diet. Low fiber diet helps with your symptoms. Avoiding raw salads and nuts and limiting red meat may help


Q: My mother has Chrohns. Should I worry about me getting that or IBD?

A: You are at increased risk; however there is no guarentee that you will develop IBD. 5-20% of patients with IBD have a family member with IBD


Q: Why do people get IBD?

A: It is a combination of genetic and environmental factors which play a role in a person developing IBD. 


Q: What treatments do you recommend? Hoping for something simple 

A: Oral medications such as mesalamines are the simplest option to start followed by Entocort. If you do not respond to any of these medications, you can use biologics-medications injected IV or under the skin once every 2 weeks to 2 months.


Q: What side effects from the medicines should I watch for?

A: The medications used have a variety of side effects-your doctor will do periodic labs such as blood couints, liver tests, tests for TB and Hep B. Your doctor can guide you on this.


Q: Would exercise help inflammatory bowel disease?

A: We do not have much data on this; however it may help in improving your disease.


Q: Is surgery ever needed for IBD? 

A: Yes, 50% of patients will require at least one surgery in their life time..However, with close follow-up with an IBD specialist, you can decrease this risk.


Q: My doctor started me on an immunosuppressant. What does this mean about my ability to fight infection?

A: You are at slightly higher risk of infection, you should make sure that you get flu vaccine and pneumovax to decrease this risk. 


Q: Does IBD affect pregnancy at all?

A: Yes, it can affect pregnancy including pre-term birth, still birth and small for gestational age kids. You should make sure that  the disease is in remission before you become pregnant


Q: I have IBD. How often should I get a colonoscopy? 

A: Once every 1-2 years.


Q: What environmental factors play a role in developing IBD?

A: Diet is a big factor; Westernized diet plays a role; Smoking worsens the risk of Crohns disease, which is a type of IBD. 


Q: With IBD, will I have to take medicine the rest of my life? 

A: The answer depends..there is a small percentage of people (<5%) who can be off meds. However, the remainder of patients need them for life.


Q: Are there some medicines that can get me out of a flare quickly? 

A: Yes, medicines such as steroids along with biologics can get you off the flare quickly.


Q: What types of alternative treatment are helpful for IBD?

A: We do not have much evidence; acupuncture has been tried with some help. 


Q: Does stress play a role in the disease? 

A: Stress plays a role in worsening the severity of disease; it does not cause disease by itself.


Q: Are there different types of IBD? 

A: Crohns AND ulcerative colitis are the 2 types. Both have similar sxs and the treatment options overlap.


Q: What causes Crohn’s disease and ulcerative colitis?

A: A combination of genetic and environmental factors play a role, as many as 162 genes have been implicated. Diet along with smokimng also worsens. Using antibiotics early in life can also increase the risk.