Constant abdominal pain and diarrhoea could be due to inflammatory bowel disease

16 July 2019: Contributed by Dr. Lorance Peter, Senior Consultant – HOD & Chief of Gastroenterology,

Columbia Asia Hospital, Sarjapur Road : Are your bowel habits experiencing a constant shift? Do you frequently suffer from diarrhoea, fever,
abdominal pain and often feel fatigued? If so then you must get it checked with your doctor as you
might be suffering from the Inflammatory Bowel Disease (IBD).
Inflammatory Bowel Disease is the common term used for disorders related to chronic or ongoing
inflammation of the entire or a part of the digestive tract. IBD comprises of ulcerative colitis and Crohn's
disease.  Prolonged inflammation also results in damage to the gastrointestinal (GI) tract.
TYPES of Inflammatory Bowel Disease (IBD)
 Ulcerative colitis leads to long-lasting inflammation and sores (ulcers) in the innermost
lining of the large intestine (colon) and rectum.
 Crohn's disease is marked by inflammation of the lining of your digestive tract, which often
spreads deep into affected tissues.
Symptoms of Inflammatory Bowel Disease usually vary depending on the extent and intensity of
inflammation and the area of occurrence. Accordingly, the symptoms can range from mild to severe
including periods of active illness followed by periods of remission.  The signs that are commonly
observed in Crohn's disease, as well as ulcerative colitis, are:
 Severe diarrhea
 Fever and fatigue
 Abdominal pain and cramping
 Blood in your stool
 Reduced appetite
 Unintended weight loss
Inflammatory Bowel Disease usually drains the person off a lot of strength and energy and sometimes
leads to life-threatening complications.
WHAT CAUSES Inflammatory Bowel Disease?
 While the specific cause of IBD has not been deciphered as yet, it is expected to occur due to a
defective immune system. This has been so because, in IBD, the immune system does not
correctly respond to environmental triggers, which further leads to inflammation of the GI tract.
When the immune system tries to fight off an invading virus or bacteria, an abnormal immune
response results in the immune system attacking the cells in the digestive tract as well.
 IBD also has a genetic cause and is more likely to develop in someone with a family history of
the disease

 Diet and stress were also suspected to be causing IBD earlier, however, doctors have now noted
these to be aggravating factors in someone with IBD but not necessarily the causes
While there haven't been fixed reasons for IBD, there are some risk factors which might increase the
chance of someone getting the disease. Some of the risk factors of IBD include:
 Age: Quite many people who develop IBD are diagnosed before they hit the third decade in
their life i.e. the age of 30. But some people don't even develop IBD until they are 50 or 60
years old
 Heredity: A person who has a close relative like a parent, sibling or child with the disease,
are more likely to develop IBD
 Smoking: Cigarette smoking is among the most major and yet controllable risk factor for
developing Crohn's disease. Although in the case of ulcerative colitis, the data regarding
smoking is not clear and due to overall health benefits of not smoking make it important to
 Nonsteroidal anti-inflammatory medications: These consist of ibuprofen (brufen,
combiflam), naproxen sodium (naprosyn), diclofenac sodium (Voveran, diclofenac, nac) and
others. Such medications tend to increase the risk of developing IBD or worsen disease in
people who already have it
 Location: Living in an industrialized country is more likely to lead to IBD. Environmental
factors, including a diet high in fat or refined foods, also contribute

While Inflammatory Bowel Disease might not appear to be so severe initially, if not treated timely, it can
cause some serious health complications.
 Colon cancer
 Skin, eye and joint inflammation in the form of arthritis, skin lesions and eye inflammation
 Medication side effects which involve small risk of developing certain cancers
 Primary sclerosing cholangitis, where in inflammation causes scars within the bile ducts,
eventually making them narrow and causing liver damage
 Blood clots in veins and arteries
The above mentioned complications are found commonly in both ulcerative colitis as well as Crohn's
disease. However, each of the two also have some individual complications:
Complications of Crohn's disease may lead to the following:
 Bowel obstruction, which may block the flow of digestive contents.
 Malnutrition
 Fistula. Sometimes ulcers can extend through the intestinal wall, creating a fistula — an
abnormal connection between different body parts.
 Anal fissure
Complications of ulcerative colitis may include:

Toxic mega colon in which the colon can rapidly widen and swell
 A breach in the colonic wall.
 Severe dehydration
Even though IBD care are rising in the community, the treatment options and result are equally
encouraging. Proper evaluation by a GI expert doctor and continuous proper follow up ensure good