Inflammatory Bowel Disease (IBD)

IBD symptoms

Patients with IBD can experience a wide spectrum of symptoms, ranging from mild to severe. Additionally, individuals with Crohn’s disease and ulcerative colitis often exhibit many overlapping symptoms. Most commonly, IBD warning signs include:

• Diarrhea
• Abdominal pain
• Fatigue
• Weight loss
• Blood in the stools

Because IBD can affect different parts of the digestive tract, an accurate diagnosis is the first step leading to a more effective treatment plan.

Risk factors and causes

IBD occurs when the body’s immune system overreacts to a perceived threat in the intestines and causes chronic inflammation. However, we can’t pinpoint why a specific individual’s immune system responds in this way. As a result, the exact cause of IBD is unknown. Research suggests IBD may be caused by a combination of factors, including your genetics and gut microbiome, among others.

IBD and women’s health

Most people with IBD are diagnosed before the age of 35. Since women make up half of all cases, our specialists take care to address how IBD impacts different aspects of a woman’s health at various stages of her life and of her disease. Our IBD experts strive to educate our female patients about how their condition can affect:

• Contraceptive method choice
• Fertility
• Cervical health
• Pregnancy and delivery
• Bone health

We provide strategies on how to manage the disease during the pregnancy and postpartum period and how to avoid negative pregnancy outcomes and medication side effects. Our gastroenterology team works closely with our high-risk obstetricians and the patient’s primary obstetricians to ensure the best pregnancy outcomes. We also work closely with our women’s health center and division of endocrinology to assess and treat our patients for osteoporosis and osteopenia. (Bone loss may occur because of the disease or the medications used to control the disease).

Diagnosing IBD

Crohn’s disease and ulcerative colitis require different treatments, which is why an accurate diagnosis is important. Our gastroenterologists may use a variety of diagnostic tools to evaluate your condition. IBD tests may include:

• A physical exam

• Labwork, including blood tests and stool tests

• Upper GI endoscopy (to examine the esophagus, stomach, and upper GI tract)

• Colonoscopy (to examine the anus, rectum, colon, and end of the small intestine)

• Upper GI series, or barium swallow, which use x-rays to show outlines of the different parts of the bowel

• CT scans and MRI enterography

• Wireless video capsule

• Bedside intestinal ultrasound

Treating IBD

The goal of IBD treatment is remission, which occurs when the disease is effectively managed and considered inactive. Many people with IBD go through cycles of remission and “flare ups,” or sudden onsets of inflammation and symptoms. Fortunately, there are many treatment options that can help to reduce inflammation, ease symptoms, and lower your risk of additional health complications. Treatment typically involves IBD medications, which increase the likelihood of long-term remission.

IBD Medications

For patients with Crohn’s disease or ulcerative colitis, treatment may include one or more of the following medications:

• Oral anti-inflammatory medications, such as mesalamine, which are often used to treat mild to moderate ulcerative colitis
• Immunomodulators, which reduce inflammation by slowing down your immune system
• Biologics, delivered at an infusion center or via home-injections
• Targeted synthetic small molecules, a type of oral immune system suppressor used to treat moderate to severe ulcerative colitis
• Antibiotics, which may be used in addition to other medications to treat infections and complications in patients with IBD

We understand these medications can be a struggle to attain. With the help of our centralized MedStar Specialty Pharmacy experts, we are able to attain the right medication for you when you need it. When coupled with quality care coordination, these options can help patients with IBD successfully treat symptoms, avoid complications of their disease, and potentially reverse the damage caused by inflammation.

Surgery

For patients who have tried medication and lifestyle changes without symptom relief, your provider may help you weigh the pros and cons of surgery. IBD surgery may involve removing parts of small intestines, colon, or the rectum in order to improve your quality of life. These surgeries are often performed using minimally invasive and robotic-assisted techniques to decrease complication risk and speed up your recovery. Your provider will work together with you to individualize your care, decrease the need for ostomy (“bag”) formation, and minimize the amount of intestines removed.  For patients who are candidates for surgery, our gastroenterologists work closely with our colorectal surgeons for treatment.

Preventing IBD complications

In addition to caring for your disease, our goal is to prevent complications to your overall health from the disease and the medications you are using. We ensure you get appropriate vaccinations and screening for different conditions. Patients with ulcerative colitis and Crohn’s disease have an increased risk for developing colon cancer and others, which is why routine colonoscopies and other cancer screenings are especially important for this population. If you have IBD, talk to your doctor about when to begin colon cancer screening and other strategies for lowering your cancer risk.

Research and clinical trials

Clinical trials are designed to improve our understanding of IBD prevention, diagnosis, and treatment. Interested in participating in a clinical trial for ulcerative colitis or Crohn’s disease? Call 202-295-0570 to schedule a visit to discuss whether you qualify for one of our IBD clinical trials.