Questions to Ask the Doctor
If you have the above symptoms, a visit to your doctor is warranted. Although those symptoms can suggest that you may have inflammatory bowel disease, tests must first be performed to see if you do have IBD. The above symptoms are seen in several other disorders as well, and so the above symptoms alone do not necessarily mean that you have IBD. Irritable bowel syndrome (IBS) is a different disorder that may have symptoms similar to those of IBD.
It is important to eat a healthy diet. Depending on your symptoms, your health care provider may ask you to decrease the amount of fiber or dairy products in your diet.
Diet has little or no influence on the inflammatory activity in ulcerative colitis. However, diet may influence symptoms. For this reason, people with inflammatory bowel disease often are placed on a variety of diet interventions, especially low-residue diets. Evidence does not support a low-residue diet as beneficial in treating the inflammation of ulcerative colitis, though it might decrease the frequency of bowel movements.
Unlike ulcerative colitis, diet can influence inflammatory activity in Crohn disease. Nothing by mouth (NPO status) can hasten reduction of inflammation, as might the use of a liquid diet or a predigested formula. When you become extremely upset, your symptoms may get worse. Therefore, it is important that you learn to manage the stress in your life.
Persons with inflammatory bowel disease are prone to the development of malignancy (cancer). In Crohn disease, there is a higher rate of small intestinal malignancy. Persons with involvement of the whole colon, particularly ulcerative colitis, are at a higher risk of developing colonic malignancy after 8-10 years of the onset of the disease. For cancer prevention, surveillance colonoscopy every 1-2 years after 8 years of disease is recommended.
Use of corticosteroids may lead to debilitating illness, particularly after long-term use. You should consider trying more aggressive therapies rather than remaining on corticosteroids because of the potential for side effects with these drugs.
If you are taking steroids, you should undergo a yearly ophthalmologic examination because of the risk of development of cataract.
Persons with IBD have a reduction in bone density, either from decreased calcium absorption (because of the underlying disease process) or because of corticosteroid use. Crippling osteoporosis can be a very serious complication. If you have significantly low bone density, you will be administered bisphosphonates and calcium supplements.
No known dietary or lifestyle change prevents the development of inflammatory bowel disease.
Dietary manipulation may help symptoms in persons with ulcerative colitis, and it actually may help reduce inflammation in Crohn disease. However, there is no evidence that consuming or avoiding any particular food item causes or avoids flare-ups of IBD.
Smoking cessation is the only lifestyle change that may benefit persons with Crohn disease. Smoking has been linked to increases in the number and severity of flare-ups of Crohn disease. Smoking cessation occasionally is sufficient to make a person with refractory (not responding to treatment) Crohn disease go into remission.
The typical course of the inflammatory bowel diseases (for the vast majority of persons) includes periods of remission interspersed with occasional flare-ups.