Chronic inflammatory bowel disease (IBD) refers to forms of disease with inflammatory changes in the intestinal mucosa. The background to this is a strong immune reaction that is directed at bacterial or other structures.
This results in diarrhea, which can sometimes be bloody, and abdominal pain.
In Germany, around 360,000 people are affected by IBD. The annual incidence rate is around 10 per 100,000 inhabitants, which means that around 7,600 to 8,400 people are newly diagnosed with IBD every year.
Crohn's disease and ulcerative colitis are among the most common types of IBD. Both develop in people who have a certain susceptibility to them according to their genome. The triggers are therefore genetic factors. However, the detailed correlations of the development are not yet fully understood.
External influences such as
- psychosocial aspects and
- dietary and immunological factors
are so multifactorial that this interplay remains partially unclear.
Comparison of ulcerative colitis and Crohn's disease © bilderzwerg / Fotolia
Diarrhea can of course also be triggered by other diseases. However, if it lasts longer than six weeks, it is rarely caused by agastrointestinal infection(gastroenteritis) alone. Then
- CED,
- a malfunction of the digestive glands (e.g. pancreas) or
- a malfunction of the digestive enzymes in the intestinal mucosa
is a probable cause.
Common symptoms of chronic inflammatory bowel disease are severe diarrhea with cramping, severe abdominal pain. Also
can occur at the same time. Different factors play a role in each patient. The symptoms are therefore also different. The inflammation in the intestine continues to affect the whole body and can manifest itself in diseases of the
manifest themselves.
A disease has a particularly sensitive effect when the intestinal function is no longer complete. This means that the intestine can no longer absorb and process food sufficiently.
In this case there is
- weight loss,
- malnutrition and
- deficiencies.
IBD can also lead to such malnutrition if larger sections of the small intestine are affected. This can be the case with Crohn's disease.
If a very high protein loss is no longer compensated for by appropriate food intake, life-threatening conditions can occur.
Comprehensive specialist diagnostics are of great importance in order to reliably diagnose chronic inflammatory bowel disease. The doctor records the individual's medical history and includes all factors that could be a trigger. This so-called anamnesis includes information on
- any existing stress,
- the diet,
- other personal illnesses and
- possible illnesses in the family.
Imaging procedures are used for diagnosis. An ultrasound examination and a colonoscopy with tissue sample (biopsy) provide important information. This can be carried out under light anesthesia. Virtual procedures without an endoscope are also possible.
Carrying out a colonoscopy © bilderzwerg / Fotolia
Blood counts and stool samples are other important methods for diagnosing IBD. If the blood values are elevated, the laboratory findings indicate an inflammatory process in the body or bowel:
- Increased leukocyte count (white blood cells),
- increased C-reactive protein,
- increased erythrocyte sedimentation rate.
An acute bacterial infection is first looked for in the stool sample . Other markers for a chronic inflammatory bowel disease are
- elevated calprotectin, a protein of the immune system cells, and
- elevated lactoferrin levels.
Lactoferrin is also a protein and indicates an ongoing defense reaction of the immune system.
IBD has similar symptoms to non-inflammatory bowel diseases (e.g. irritable bowel syndrome). An examination of the inflammatory markers in the blood and stool is therefore an important diagnostic criterion.
IBD can be treated with medication that interferes with the body's immune response. The classic medication here is cortisone.
However, cortisone is not given over a long period of time so that the side effects do not accumulate (get out of hand) over time. Other so-called immunomodulatory drugs can be used here.
In some cases, the surgical removal of
- sections of the small intestine,
- parts of the large intestine or
- the entire large intestine
is a helpful therapeutic measure for Crohn's disease or ulcerative colitis, for example.