Inflammatory Bowel Disease Treatment in Delhi, India

Inflammatory bowel disease (IBD) is typically a group of colon and small intestine inflammatory conditions. The main forms of IBD are Crohn's disease and ulcerative colitis (UC). The main difference between Crohn's disease and UC is the location and nature of the inflammatory changes. Crohn's can affect any part of the gastrointestinal tract, from mouth to anus (skip lesions), although a majority of the cases start in the terminal ileum.

Inflammatory Bowel Disease (IBD) encompasses several chronic inflammatory conditions affecting the gastrointestinal tract. The types of IBD are:

• Crohn's disease: This type of IBD can affect any part of the GI tract, from the mouth to the anus. However, it most commonly affects the small intestine and the beginning of the large intestine (colon). The inflammation in Crohn's disease can be patchy, meaning there may be areas of healthy tissue between areas of inflamed tissue.
• Ulcerative colitis: This type of IBD only affects the colon's inner lining (large intestine) and rectum. The inflammation in ulcerative colitis is continuous, affecting the entire colon or rectum.
• Microscopic colitis: This type of IBD causes inflammation in the colon's inner lining that can only be seen with a microscope. Microscopic colitis is more common in women than in men.

The exact cause of inflammatory bowel disease (IBD) remains unknown. While diet and stress were once thought to be potential causes, doctors now understand that these factors may aggravate IBD but are not the root cause.

One possible cause of IBD is a malfunction in the immune system. When the immune system tries to fight off an invading virus or bacterium, an abnormal immune response can cause it to attack the cells in the digestive tract.

Several gene mutations have been linked to IBD. Heredity also appears to play a role, as IBD is more common in individuals with family members who have the disease. However, it's important to note that most people with IBD do not have a family history of the condition.

Signs and symptoms of Inflammatory Bowel Disease (IBD) can vary depending on the type of IBD and the severity of the condition. Common signs and symptoms may include:

• Abdominal pain and cramping: Persistent or recurring abdominal pain, often in the lower abdomen, is a common symptom of IBD.
• Diarrhoea: Chronic or recurrent diarrhoea, sometimes accompanied by blood or mucus, is a hallmark symptom of IBD.
• Rectal bleeding: Blood in the stool may occur, ranging from mild spotting to more significant bleeding.
• Weight loss: Unintentional weight loss can occur due to decreased appetite, nutrient malabsorption, and inflammation.
• Fatigue: Persistent fatigue or weakness may be experienced, often due to the chronic inflammation and malabsorption associated with IBD.
• Fever: Low-grade fever may be present during flare-ups of inflammation in the gastrointestinal tract.
• Reduced appetite: Loss of appetite or early satiety (feeling full quickly) may occur, particularly during active disease periods.
• Anaemia: Iron deficiency anaemia can develop due to chronic blood loss from inflamed intestinal tissue.
• Joint pain: Some individuals with IBD may experience joint pain, swelling, or inflammation, particularly in large joints such as knees and ankles.
• Skin problems: Skin problems, such as erythema nodosum (painful red nodules under the skin) or pyoderma gangrenosum (painful ulcers), can occur in some individuals with IBD.

Diagnosing Inflammatory Bowel Disease (IBD) typically involves a combination of medical history evaluation, physical examination, and diagnostic tests. Here's an overview of the diagnostic process for IBD:

• Medical history evaluation: Your inflammatory bowel disease specialist will inquire about your symptoms, including their duration, severity, and any factors that worsen or alleviate them. They will also ask about your medical history, including any previous gastrointestinal conditions or surgeries.
• Physical examination: Your inflammatory bowel disease specialist will conduct a physical examination, focusing on your abdomen, to assess for tenderness, swelling, or signs of inflammation.
• Laboratory tests: Blood tests may be ordered to check for signs of inflammation, anaemia (low red blood cell count), and nutritional deficiencies. Stool tests may also be performed to check for signs of infection, blood, or inflammation in the gastrointestinal tract.
• Endoscopic procedures: Endoscopy involves using a thin, flexible tube with a camera (endoscope) to visualise the inside of the digestive tract. Common endoscopic procedures used in diagnosing IBD include:
• Colonoscopy: This procedure allows visualisation of the entire colon and the terminal ileum (the end of the small intestine).
• Flexible sigmoidoscopy: Similar to colonoscopy, but focuses on the lower part of the colon (sigmoid colon).
• Upper endoscopy (Esophagogastroduodenoscopy, or EGD): This procedure examines the oesophagus, stomach, and the beginning of the small intestine (duodenum).
• Biopsy: During endoscopic procedures, tissue samples (biopsies) may be taken from the intestinal lining for microscopic examination. Biopsies can help confirm the presence of inflammation and differentiate between Crohn's disease and ulcerative colitis.
• Imaging tests: Imaging studies, such as X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), or ultrasound, may assess the extent and severity of inflammation in the gastrointestinal tract and detect complications such as strictures or fistulas.

Here's an overview of the common treatment approaches for IBD:

Medications 

• Anti-inflammatory Drugs: Aminosalicylates (such as mesalamine) help reduce inflammation in the intestinal lining and are often used to treat mild to moderate cases of IBD, particularly ulcerative colitis.
• Corticosteroids: These drugs (such as prednisone) are used to reduce inflammation and control symptoms during flare-ups of IBD. However, they are generally not recommended for long-term use due to potential side effects.
• Immunomodulators: Drugs like azathioprine, 6-mercaptopurine, and methotrexate work by suppressing the immune system to reduce inflammation and remission in IBD.
• Biologic Therapies: Biologic drugs, such as anti-TNF agents (infliximab, adalimumab), vedolizumab, ustekinumab, and others, target specific molecules involved in the inflammatory process and are used to treat moderate to severe cases of IBD that are not adequately controlled with other medications.

Nutritional Therapy 

In certain cases, nutritional therapy may be recommended to manage symptoms and promote healing of the intestinal lining. This may involve specialised liquid formulas, dietary modifications, or, in severe cases, total parenteral nutrition (TPN).

Lifestyle Modifications 

• Dietary changes: Some individuals with IBD find relief from symptoms by avoiding certain trigger foods, such as spicy foods, dairy, or high-fibre foods. Working with a dietitian can help identify dietary triggers and develop a personalised nutrition plan.
• Stress management: Stress can exacerbate symptoms of IBD. Stress-reduction techniques such as mindfulness, meditation, yoga, or counselling may help manage stress and improve overall well-being.

Surgery

Surgery may be necessary for complications of IBD, such as strictures, fistulas, bowel obstructions, or severe disease refractory to medical treatment. Surgical options may include bowel resection, strictureplasty, or the creation of an ostomy (ileostomy or colostomy) to divert stool.

Max Hospitals is a premier destination for individuals seeking Inflammatory Bowel Disease (IBD) treatment, offering unparalleled care and solutions. Here's why Max Hospitals is the preferred choice for IBD:

World-Class Medical Expertise

At the heart of Max Hospitals is a team of highly skilled specialists and medical professionals with extensive experience in treating IBD. With a track record of successful treatments, they bring immense knowledge, expertise, and dedication to ensure every patient receives optimal care.

Comprehensive Patient Care 

Dealing with IBD is not only a medical journey but also an emotional one. Recognizing this, Max Hospitals provides comprehensive support. From initial consultations and wellness programs focused on IBD management to ongoing assistance post-treatment, patients and their families are embraced by a compassionate and understanding team.

Reputation and Trust

With a longstanding legacy in healthcare, Max Hospitals is synonymous with successful IBD treatments in Delhi and beyond. Our consistent outcomes and patient-centric approach have earned the trust of individuals seeking relief from IBD symptoms and referring physicians.

Accessibility

Strategically situated, Max Hospitals ensures that high-quality IBD care is easily accessible. With branches in key cities across India, we have extended a beacon of hope for numerous individuals grappling with the challenges of IBD.

Choosing Max Hospitals for IBD means embarking on a journey of healing supported by expertise, advanced technology, and genuine care.

Why do people get Inflammatory Bowel Disease? 

Inflammatory Bowel Disease (IBD) is believed to result from a combination of genetic, environmental, and immune system factors. While the exact cause is unknown, it is thought that genetics, environmental triggers, and an abnormal immune response to gut bacteria may play a role in the development of IBD.

How common are Crohn's disease and ulcerative colitis? 

Crohn's disease and ulcerative colitis, the two main forms of Inflammatory Bowel Disease (IBD), are relatively rare but have been increasing in incidence worldwide. In the United States, it's estimated that around 1.6 million people have IBD, with Crohn's disease affecting approximately 700,000 individuals and ulcerative colitis affecting around 900,000 individuals.

What's the difference between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS)? 

Inflammatory Bowel Disease (IBD) refers to chronic inflammation of the digestive tract and includes conditions like Crohn's disease and ulcerative colitis, which involve inflammation and damage to the digestive tract. Irritable Bowel Syndrome (IBS), on the other hand, is a functional disorder characterised by abdominal pain, bloating, and changes in bowel habits without evidence of inflammation or damage to the digestive tract.

Can children have IBD? 

Yes, children can develop Inflammatory Bowel Disease (IBD), although it is less common in paediatric populations compared to adults. Both Crohn's disease and ulcerative colitis can occur in children, and the symptoms and treatment approach may differ from those in adults.

Is Inflammatory Bowel Disease inherited? 

While genetics can predispose individuals to develop Inflammatory Bowel Disease (IBD), it is not solely inherited. A family history of IBD does increase the risk of developing the condition. Still, environmental factors and abnormalities in the immune system also play significant roles in the development of IBD.

Is IBD an autoimmune disease? 

Yes, Inflammatory Bowel Disease (IBD) is considered an autoimmune disease. It occurs when the body's immune system mistakenly attacks its digestive tract, leading to chronic inflammation and damage to the gastrointestinal tract.

Does IBD increase the risk of colon cancer? 

Yes, individuals with long-standing and poorly controlled Inflammatory Bowel Disease (IBD), particularly those with ulcerative colitis, have an increased risk of developing colon cancer. Regular monitoring and screening are essential to detect precancerous changes or early-stage cancer in individuals with IBD.

What foods trigger IBD?

The specific foods that trigger symptoms in individuals with Inflammatory Bowel Disease (IBD) can vary widely from person to person. Common triggers include high-fibre foods, dairy products, spicy foods, fatty foods, caffeine, alcohol, and artificial sweeteners. It's essential for individuals with IBD to identify their triggers through a process of trial and error and to work with a healthcare provider or dietitian to develop a personalised diet plan.

 Is IBD life-threatening? 

Inflammatory Bowel Disease (IBD) itself is not typically considered life-threatening. Still, complications associated with the condition, such as severe inflammation, intestinal blockages, malnutrition, and an increased risk of colon cancer, can pose serious health risks. With proper management and treatment, most individuals with IBD can lead productive lives, but close monitoring and adherence to treatment plans are essential to minimise complications.

What are surgical treatments for Crohn's disease? 

Surgical treatment for Crohn's disease may be necessary in cases of complications such as bowel obstructions, fistulas, or abscesses that do not respond to medical therapy. Surgical options include resection of the affected bowel segment, strictureplasty to widen narrowed sections of the intestine or surgery to drain abscesses or repair fistulas. However, surgery does not cure Crohn's disease and may be followed by a recurrence of symptoms in the remaining intestine.

What are surgical treatments for ulcerative colitis? 

Surgical treatment for ulcerative colitis may involve the removal of the entire colon and rectum (proctocolectomy) with the creation of an ileal pouch-anal anastomosis (IPAA or "J-pouch") to preserve continence. Alternatively, some individuals may undergo a total proctocolectomy with permanent ileostomy. Surgery is usually reserved for cases of severe or medically refractory ulcerative colitis, and the choice of procedure depends on factors such as disease severity, patient preference, and surgical risk.

What types of alternative treatments are helpful for IBD? 

Some individuals with Inflammatory Bowel Disease (IBD) may find relief from symptoms through complementary and alternative treatments such as acupuncture, probiotics, herbal supplements, dietary modifications, stress reduction techniques, and mind-body therapies like yoga or meditation. While these approaches may offer symptom relief for some individuals, it's essential to consult a healthcare provider before starting any alternative treatments to ensure they are safe and appropriate.

How long will IBD last?

Inflammatory Bowel Disease (IBD) is a chronic condition characterised by periods of active disease (flare-ups) alternating with periods of remission. The duration and severity of flare-ups vary widely among individuals, and some may experience long-term remission with proper treatment. However, IBD is typically a lifelong condition that requires ongoing management and monitoring to control symptoms and minimise complications.

Reviewed By Dr Naresh Aggarwal Associate Director - Gastroenterology Gastroenterology, Hepatology & Endoscopy on 21 Aug 2024.