Inflammatory bowel disease


 

.Inflammatory bowel disease is a group of inflammatory conditions of the colon and small intestine. Crohn’s disease and ulcerative colitis are the principal types of inflammatory bowel disease. It causes inflammation and sores (ulcers) in the digestive tract.

Crohn’s disease is a chronic disease that causes inflammation and irritation in your digestive tract. Most commonly, Crohn’s affects your small intestine and the beginning of yourlarge intestine. However, the disease can affect any part of your digestive tract, from your mouth to your anus. Learn more about your digestive system and how it works.

Crohn’s disease is aninflammatory bowel disease (IBD). Ulcerative colitisand microscopic colitis are other common types of IBD.

Crohn’s disease most often begins gradually and can become worse over time. You may have periods of remission that can last for weeks or years.

Researchers estimate that more than half a million people in the United States have Crohn’s disease. Studies show that, over time, Crohn’s disease has become more common in the United States and other parts of the world. Experts do not know the reason for this increase.

Crohn’s disease can develop in people of any age and is more likely to develop in people

  • between the ages of 20 and 292
  • who have a family member, most often a sibling or parent, with IBD
  • who smoke cigarettes
  • What are the complications of Crohn’s disease?Complications of Crohn’s disease can include the following:
    • Intestinal obstruction.Crohn’s disease can thicken the wall of your intestines. Over time, the thickened areas of your intestines can narrow, which can block your intestines. A partial or complete intestinal obstruction, also called a bowel blockage, can block the movement of food orstool through your intestines.
    • Fistulas. In Crohn’s disease, inflammation can go through the wall of your intestines and create tunnels, or fistulas. Fistulas are abnormal passages between two organs, or between an organ and the outside of your body. Fistulas may become infected.
    • Abscesses. Inflammation that goes through the wall of your intestines can also lead to abscesses. Abscesses are painful, swollen, pus-filled pockets of infection.
    • Anal fissures. Anal fissures are small tears in your anus that may cause itching, pain, or bleeding.
    • Ulcers. Inflammation anywhere along your digestive tract can lead to ulcers or open sores in your mouth, intestines, anus, orperineum.
    • Malnutrition. Malnutrition develops when your body does not get the right amount of vitamins, minerals, and nutrients it needs to maintain healthy tissues and organ function.
    • Inflammation in other areas of your body. You may have inflammation in your joints, eyes, and skin.
  • What other health problems do people with Crohn’s disease have?
    If you have Crohn’s disease in your large intestine, you may be more likely to develop colon cancer . If you receive ongoing treatment for Crohn’s disease and stay in remission, you may reduce your chances of developing colon cancer.3
    Talk with your doctor about how often you should get screened for colon cancer. Screening is testing for diseases when you have no symptoms. Screening for colon cancer can include colonoscopy with biopsies. Although screening does not reduce your chances of developing colon cancer, it may help to find cancer at an early stage and improve the chance of curing the cancer.
    Even with medicines, many people will need surgery to treat their Crohn’s disease. One study found that nearly 60 percent of people had surgery within 20 years of having Crohn’s disease.8 Although surgery will not cure Crohn’s disease, it can treat complications and improve symptoms. Doctors most often recommend surgery to treat
  • fistulas
  • bleeding that is life threatening
  • intestinal obstructions
  • side effects from medicines when they threaten your health
  • symptoms when medicines do not improve your condition
  • A surgeon can perform different types of operations to treat Crohn’s disease. For any surgery,you will receive generalanesthesia . You will most likely stay in the hospital for 3 to 7 days following the surgery. Full recovery may take 4 to 6 weeks.
  • Small bowel resection. Small bowel resection is surgery to remove part of your small intestine. When you have an intestinal obstruction or severe Crohn’s disease in your small intestine, a surgeon may need to remove that section of your intestine. The two types of small bowel resection are
  • laparoscopic—when a surgeon makes several small, half-inch incisions in your abdomen. The surgeon inserts alaparoscope—a thin tube with a tiny light and video camera on the end—through the small incisions. The camera sends a magnified image from inside your body to a video monitor, giving the surgeon a close-up view of your small intestine. While watching the monitor, the surgeon inserts tools through the small incisions and removes the diseased or blocked section of small intestine. The surgeon will reconnect the ends of your intestine.
  • open surgery—when a surgeon makes one incision about 6 inches long in your abdomen. The surgeon will locate the diseased or blocked section of small intestine and remove or repair that section. The surgeon will reconnect the ends of your intestine.
  • Subtotal colectomy. A subtotal colectomy, also called a large bowel resection, is surgery to remove part of your large intestine. When you have an intestinal obstruction, a fistula, or severe Crohn’s disease in your large intestine, a surgeon may need to remove that section of intestine. A surgeon can perform a subtotal colectomy by
  • laparoscopic colectomy—when a surgeon makes several small, half-inch incisions in your abdomen. While watching the monitor, the surgeon removes the diseased or blocked section of your large intestine. The surgeon will reconnect the ends of your intestine.
  • open surgery—when a surgeon makes one incision about 6 to 8 inches long in your abdomen. The surgeon will locate the diseased or blocked section of large intestine and remove that section. The surgeon will reconnect the ends of your intestine.
  • Proctocolectomy and ileostomy. A proctocolectomy is surgery to remove your entire colon and rectum. An ileostomy is a stoma, or opening in your abdomen, that a surgeon creates from a part of your ileum. The surgeon brings the end of your ileum through an opening in your abdomen and attaches it to your skin, creating an opening outside your body. The stoma is about three-quarters of an inch to a little less than 2 inches wide and is most often located in the lower part of your abdomen, just below the beltline.
  • A removable external collection pouch, called an ostomy pouch or ostomy appliance, connects to the stoma and collects stool outside your body. Stool passes through the stoma instead of passing through your anus. The stoma has no muscle, so it cannot control the flow of stool, and the flow occurs whenever occurs.
  • If you have this type of surgery, you will have the ileostomy for the rest of your life.

No one diet is right for everyone with an inflammatory bowel disease. Foods that bother one person may not bother another. Your diet has to be tailored for you. But the following basic ideas can help you feel better and get the nutrition you need.

For many people, common problem foods include:

  • Dairy products for people who are lactose-intolerant.
  • High-fiber foods, such as raw fruits and vegetables, and whole grains. Often people have the most problems with gas-producing foods. These include beans, cabbage, broccoli, and onions, and foods with hulls, such as seeds, nuts, and corn.
  • High-fat foods, such as fried foods, butter and margarine, mayonnaise, peanut butter, nuts, ice cream, and fatty cuts of red meat.
  • Spicy foods.
  • Foods with caffeine, such as chocolate and coffee.
  • Carbonated drinks.
  • Alcohol.

Find out your problem foods by keeping a food diary. As soon as you know what foods make your symptoms worse, your doctor or dietitian can help you plan a diet that avoids problem foods but gives you plenty of nutrients and enough calories to keep you at a healthy weight.

To make a food diary, get a small notebook and keep it with you. Make notes after each meal or snack.

  • On the left side of the page, write down what you ate, about how much of each food you had, and what time you ate. Be honest—write down everything.
  • On the right side of the page, note any symptoms you had and what time they occurred.

If you notice certain foods make your symptoms worse, talk to your doctor about these foods at your next visit.

During a flare-up, avoid or reduce foods that make symptoms worse. But instead of cutting out a whole group of high-nutrient foods, try replacing them with healthy choices.

  • Choose dairy products that are low in lactose, such as yogurt or hard cheeses like cheddar. Or try drinking lactose-reduced milk.
  • If you are having fat in your stools, choose low-fat foods instead of high-fat ones. For instance, some cuts of red meat have a lot of fat. A low-fat choice would be lean beef (such as sirloin, top and bottom round, chuck or diet lean hamburger), poultry, or fish, such as cod. Instead of frying foods, try baking or broiling them.
  • Cook fruits and vegetables without hulls, skins, or seeds. Try different ways of preparing them, such as steaming, stewing, or baking. Peel and seed fresh fruits and vegetables if these bother you, or choose canned varieties

During a flare-up, avoid or reduce foods that make symptoms worse. But instead of cutting out a whole group of high-nutrient foods, try replacing them with healthy choices.

  • Choose dairy products that are low in lactose, such as yogurt or hard cheeses like cheddar. Or try drinking lactose-reduced milk.
  • If you are having fat in your stools, choose low-fat foods instead of high-fat ones. For instance, some cuts of red meat have a lot of fat. A low-fat choice would be lean beef (such as sirloin, top and bottom round, chuck or diet lean hamburger), poultry, or fish, such as cod. Instead of frying foods, try baking or broiling them.
  • Cook fruits and vegetables without hulls, skins, or seeds. Try different ways of preparing them, such as steaming, stewing, or baking. Peel and seed fresh fruits and vegetables if these bother you, or choose canned varieties.

Your body may not be able to absorb all the nutrients it needs from the food you eat. To stay as healthy as you can:

  • Eat a varied, nutritious diet that is high in calories and protein.
  • Try eating 3 meals plus 2 or 3 snacks a day. It may be easier to get more calories if you spread your food intake throughout the day.
  • Take vitamin and mineral supplements if your doctor recommends them.
  • Try adding high-calorie liquid supplements, such as Ensure Plus or Boost Plus, if you have trouble keeping your weight up.
  • Drink plenty of fluids. This can help you avoid dehydration, kidney problems, and gallstones.
  • See your doctor or dietitian if your diet feels too limited or you are losing weight
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