Inflammatory bowel disease and irritable bowel syndrome

A profile of two bowel-related medical conditions

Feces aren’t something everyone is readily willing to talk about. But everybody poops – varying in frequency, degree, and form.

Chronic bowel diseases and disorders are a reality for a large number of Canadians. In fact, Canada has one of the highest rates of inflammatory bowel disease in the world. Conditions involving symptoms such as diarrhea and bloody stools are often followed by stigma. Therefore, it’s important to give these diseases the exposure and awareness they deserve.

Inflammatory bowel disease
Inflammatory bowel disease (IBD) is characterized by chronic inflammation in the digestive tract. Diseases falling under this spectrum include Crohn’s disease and colitis, which impede the body’s ability to “digest food, absorb nutrients, and eliminate waste in a healthy manner.” Symptoms include fatigue, abdominal pain, gas, diarrhea, bloody and frequent stools, nausea, and vomiting. People will have either Crohn’s or colitis, not both, and people living with IBD can also have irritable bowel syndrome (IBS).

The main form of colitis is ulcerative colitis, which affects the colon and rectum, and causes long-term ulcers in the digestive tract. Indeterminate colitis is a term used when it is “unclear whether inflammation is due to colitis or Crohn’s.”

Crohn’s disease is characterized by inflammation anywhere in the gastrointestinal tract. People living with Crohn’s disease often find that they have to avoid certain foods, particularly during flare-ups. These can include milk, popcorn, spicy or greasy foods, and gluten. Women living with Crohn’s also experience a higher risk of oral contraceptive failure.

According to the Canadian Digestive Health Foundation, sick leave and absenteeism related to IBD costs the Canadian economy $104.2 million per year.

Diagnosis for IBD can be done through endoscopic and imaging procedures, as well as blood tests.

There is no cure for Crohn’s disease, but ulcerative colitis can be alleviated with a surgical removal of the colon. Both can be managed through medication such as steroids.

Genetics and environmental factors are believed to play large roles in the development of IBD. Inflammatory bowel disease is prevalent in urban areas, moderate climates, and developed countries. Food additives in processed foods have recently been linked to IBD, according to research recently published in Nature by an immunologist at Georgia State University. One in 150 Canadians suffers from Crohn’s and colitis, and since 1995, the prevalence of Crohn’s has nearly doubled in children. Young immigrants to Canada are also at a higher risk of developing IBD.

Risk factors associated with IBD include a heightened risk of colorectal cancer. The longer a person has Crohn’s or colitis, and, therefore, the older they become, the higher the chance of colorectal cancer. According to Crohn’s and Colitis Canada, someone living with Crohn’s or colitis for 30 years has a 30 per cent chance of developing colorectal cancer.

Since the symptoms of colorectal cancer, such as bloody stools, resemble the everyday experiences of people living with IBD, regular screening is imperative for early detection. It is recommended that people who have had IBD for more than 10 years undergo a colonoscopy once or twice a year.

Irritable bowel syndrome
Irritable bowel syndrome is a chronic gastrointestinal disorder that affects the colon. Symptoms include abdominal pain, bloating, mucus in the stool, constipation, and diarrhea. People suffering from IBS will typically experience either constipation or diarrhea, or alternate between the two.

According to the Mayo Clinic’s website, IBS can flare up during stress and menstrual periods, and by eating foods such as: spicy foods, carbonated drinks, fats, beans, and alcohol. Obesity also increases the severity of IBS symptoms.

After the common cold, IBS is the highest reason for absences at school or work, according to
Diagnosis of IBS is achieved by examining the symptoms. If the patient experiences two of the following characteristics, the chances of IBS are likely: “the pain or discomfort is relieved by defecation; the pain or discomfort is associated with an increase or decrease in stool frequency; and/or the pain or discomfort is associated with the stools becoming harder or softer in consistency.” Other diseases must be ruled out as well, which is done through blood and stool tests, X-rays, and endoscopic procedures.

Irritable bowel syndrome can be treated by removing certain foods from the diet such as gluten and those high in gas; and with antidiarrheal medication, fibre supplements, antibiotics, and probiotics.

Canada has one of the highest rates of IBS in the world, with five million Canadians affected, and Maritime provinces with the highest prevalence. Irritable bowel syndrome affects women twice as much as men.

Raising awareness of diseases and disorders like irritable bowel syndrome and inflammatory bowel disease helps bring visibility to, in some cases, debilitating lifelong conditions that are not always outwardly noticeable.