Inflammatory bowel diseases: causes, prevention and diet

Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that involve chronic inflammation of the digestive tract. Types of IBD include:

ulcerative colitis

This condition is characterized by inflammation and sores (ulcers) along the surface lining of the large intestine (colon) and rectum.

Crohn’s disease

This type of IBD is characterized by inflammation of the lining of the digestive tract, which can often affect the deeper layers of the digestive tract.

Ulcerative colitis and Crohn’s disease are both characterized by diarrhea, rectal bleeding, abdominal pain, fatigue and weight loss.

IBD can be debilitating and sometimes lead to life-threatening complications.

Symptoms of Inflammatory Bowel Disease

Symptoms of inflammatory bowel disease vary depending on the severity of the inflammation and where it occurs. Symptoms can range from mild to severe. You are likely to experience periods of active disease followed by periods of remission. Common signs and symptoms of Crohn’s disease and ulcerative colitis include:

– Diarrhea
– Fatigue
– Abdominal pain and cramps
– Presence of blood in the stool
– Decreased appetite
– Unintentional weight loss

When to consult a doctor

See your doctor if you notice a persistent change in your bowel habits or if you have any of the signs and symptoms of inflammatory bowel disease. Although inflammatory bowel disease is usually not fatal, it is a serious condition that in some cases can lead to life-threatening complications.

Causes of Inflammatory Bowel Disease

The exact cause of inflammatory bowel disease remains unknown. Previously, diet and stress were suspected, but doctors now know that these factors can make IBD worse but not the cause. One of the possible causes is a malfunction of the immune system. When your immune system tries to fight off an invading virus or bacteria, an abnormal immune response causes the immune system to also attack cells in the digestive tract. Heredity also appears to play a role as IBD is more common in people who have family members with the disease. However, most people with IBD do not have this family history.

Risk factors


Most people who develop IBD are diagnosed before age 30. But some people don’t develop the disease until their 50s or 60s.

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Family history

You are at higher risk if you have a close relative, such as a parent, sibling, or child, with the disease.


Smoking is the most important controllable risk factor for developing Crohn’s disease. Smoking can help prevent ulcerative colitis. However, its negative effects on general health outweigh its benefits, and quitting smoking can improve the overall health of your digestive tract, as well as provide you with many other health benefits.

Nonsteroidal anti-inflammatory drugs

These include ibuprofen, naproxen sodium (Aleve), diclofenac sodium and others. These drugs can increase the risk of developing IBD or make the disease worse in people with IBD.


Ulcerative colitis and Crohn’s disease have some complications in common and others that are specific to each condition. The complications that are found in both conditions can be the following:

colon cancer

Having ulcerative colitis or Crohn’s disease that affects most of the colon can increase the risk of colon cancer. Cancer screening usually begins about eight to ten years after diagnosis. Ask your doctor when and how often you should have this test.

Inflammation of the skin, eyes and joints

Certain disorders, including arthritis, skin lesions, and eye inflammation (uveitis), can occur during IBD flare-ups.

Blood clots

IBD increases the risk of blood clots forming in veins and arteries.

Complications of Crohn’s disease can include:

An intestinal obstruction

Crohn’s disease affects the entire thickness of the intestinal wall. Over time, parts of the intestine can thicken and narrow, which can block the flow of digestive contents. You may need to have surgery to remove the diseased part of your intestine.


Diarrhea, abdominal pain, and cramps can prevent you from eating or prevent your gut from absorbing enough nutrients to feed you. It is also common to develop anemia due to a lack of iron or vitamin B-12 caused by the disease.

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Sometimes the inflammation can break through the intestinal wall completely, creating a fistula, an abnormal connection between different parts of the body. Fistulas near or around the anal (perianal) area are the most common. In some cases, a fistula can become infected and form an abscess.

anal fissure

This is a small tear in the tissue lining the anus or in the skin around the anus where infections can occur. It is often associated with painful stools and can lead to a perianal fistula.

Complications of ulcerative colitis can include:

A toxic megacolon

Ulcerative colitis can cause rapid enlargement and swelling of the colon, a serious condition known as toxic megacolon.

A hole in the colon (perforated colon)

Colon perforation is most commonly caused by toxic megacolon, but it can also occur spontaneously.

Severe dehydration

Excessive diarrhea can lead to dehydration.

Lifestyle and diet with inflammation of the intestines

You can sometimes feel helpless against inflammatory bowel disease. But changes in your diet and lifestyle can help control your symptoms and lengthen the time between flare-ups.


There is no definitive evidence that what you eat causes inflammatory bowel disease. But certain foods and drinks can make your signs and symptoms worse, especially during a flare-up. It can be helpful to keep a food diary to record what you eat and how you feel. If you find that certain foods are causing your symptoms to flare up, you can try eliminating them.

Here are some general dietary suggestions that can help you manage your condition:

– Limit dairy products. Many people with inflammatory bowel disease find that problems such as diarrhea, abdominal pain, and gas improve by limiting or eliminating dairy products. You may be lactose intolerant, which means your body cannot digest the milk sugar (lactose) found in dairy products.

– Eat small meals. You may feel better eating five or six small meals a day rather than two or three large meals.

– Drink plenty of fluids. Try to drink plenty of fluids each day. Water is the best solution. Alcohol and caffeinated drinks stimulate your bowels and can make diarrhea worse, while carbonated drinks often produce gas.

– Consider multivitamins. Because Crohn’s disease can interfere with your ability to absorb nutrients and your diet can be limited, multivitamin and mineral supplements are often helpful. Consult your doctor before taking any vitamins or supplements.

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To smoke

Smoking increases the risk of developing Crohn’s disease, and once you have it, smoking can make it worse. People with Crohn’s disease who smoke are more likely to have relapses and need medications and repeat surgeries. Smoking can help prevent ulcerative colitis. However, its negative effects on general health outweigh its benefits, and quitting smoking can improve the overall health of your digestive tract, as well as provide you with many other health benefits.


The link between stress and Crohn’s disease is controversial, but many people with the disease report flare-ups of symptoms during times of intense stress. If you have trouble dealing with stress, try one of these strategies:

– Exercise. Even light exercise can help reduce stress, relieve depression, and normalize bowel function. Talk to your doctor about an exercise program that’s right for you.

– Biofeedback. This stress reduction technique can teach you how to reduce muscle tension and slow your heart rate using a feedback device. The goal is to help you enter a state of relaxation so you can better manage stress.

– Regular relaxation and breathing exercises. One way to manage stress is to relax regularly and use techniques such as slow, deep breathing to calm down.

alternative medicine

Many people with digestive disorders have resorted to some form of complementary and alternative medicine. However, there are few well-designed studies on the safety and effectiveness of complementary and alternative medicine.

Researchers believe that increasing beneficial bacteria (probiotics) normally found in the digestive tract may help fight IBD. Although research is limited, there is some evidence that adding probiotics along with other medications might help, but this has not been proven.

* The information and services available on in no way replace the consultation of competent health professionals. []

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