Ask the Doctors

Ask the Doctors: Inflammatory Bowel Disease (IBD)

IBD Matthew Silviera

In 2015, about 3 million adults reported being diagnosed with inflammatory bowel diseases, or IBD, in the United States.

To increase informational awareness on the diseases, Washington University colon and rectal surgeons answer patient questions regarding IBD.

“Inflammatory bowel diseases can often be unpredictable in terms of when patients experience flare ups,” says Matthew Silviera, MD, MS, an Assistant Professor of Surgery in the Section of Colon and Rectal Surgery. “This is why it’s important for patients to stay in communication with an expert on these conditions.”

IBD: Frequently Asked Questions

What is an inflammatory bowel disease? 

Inflammatory bowel disease is a broad term that includes both Crohn’s disease and ulcerative colitis (UC). In general, patients with inflammatory bowel disease develop inflammation of certain portions of the intestinal tract. Depending on the type of inflammatory bowel disease, this inflammation may involve the small intestine, the colon (large intestine), rectum or anus. 

What causes an inflammatory bowel disease?

The cause of inflammatory bowel disease is uncertain. Most patients develop inflammatory bowel disease during the course of their life, suggesting that a combination of genetic and environmental factors contribute to developing it. Certain ethnicities are more prone to developing inflammatory bowel diseases, and the conditions are more common in industrialized nations such as the United States.

What are the symptoms of an inflammatory bowel disease?

Patients with inflammatory bowel disease have symptoms based on the location of the inflammation their intestine. Some common symptoms include frequent or loose bowel movements (e.g. diarrhea) that does not resolve over a short time, cramping abdominal pains, specific infections or changes in weight. Blood in bowel movements may also be a sign of inflammatory bowel disease, although there are other causes as well. Some patients with inflammatory bowel disease repeatedly develop an abscess or boil near the anal opening. On occasion, a patient may not have any symptoms due to inflammatory bowel disease but it is diagnosed during evaluation for other diseases (for instance, during routine colonoscopy). 

How is IBD diagnosed?

IBD is diagnosed using a combination a various tests performed by healthcare providers, including endoscopies, colonoscopies and imaging studies, such as contrast radiography, magnetic resonance imaging (MRI), or computed tomography (CT).

How do I treat an inflammatory bowel disease?

Patients with inflammatory bowel disease benefit from a team-based approach that focuses on collaboration between the patient, the gastroenterologist and the colorectal surgeon. The specific combination of medical and surgical treatment is tailored for each patient based on his or her symptoms, extent of disease, overall health and other medical conditions. The goals of medical therapy is to decrease the level of inflammation and consists of simple anti- inflammatory medication, steroids, immunosuppression and biologic agents directed at specific targets. Surgery is typically indicated for complications of the disease such inability to control symptoms with medications, obstruction, perforation or infection.

How do I manage an inflammatory bowel disease?

Inflammatory bowel disease is often a lifelong condition. Managing inflammatory bowel disease requires a team of well-trained specialists who adjust medications and recommend surgical intervention based on judgment and expertise. Most of the time, inflammatory bowel disease is managed as an outpatient through scheduled clinic visits or infusions of medication, but there are times when hospitalization is required. 

What does an inflammatory bowel disease feel like?

How inflammatory bowel disease “feels” varies based on the patient and the extent of disease. Many patients describe cramping abdominal pains, particularly with eating. Some will experience diarrhea, weight loss, or specific infections.

What is the difference between IBD and IBS?

IBD is classified as a disease because it can cause destructive inflammation and permanent harm to the intestines, whereas irritable bowel syndrome (IBS) is a syndrome because it is defined as a group of symptoms and does not cause inflammation. IBS and IBD have similar symptoms, as they are both gastrointestinal disorders, but they are not the same condition and require very different treatments.

Why should I choose the Washington University colon and rectal team for IBD?

“We are experts at inflammatory bowel diseases; this is what we do,” states Matthew Mutch, MD, Chief of the Section of Colon and Rectal Surgery. “We have a very close relationship and collaborative effort with our gastroenterologists that specialize in IBD, so you’ll get a team approach.”

To make an appointment with a Washington University colorectal surgeon, please call 314-454-7177 or fill out the online appointment form.