health for your
Inflammatory bowel disease:
Breaking
the silence
By Rita Colorito
THE FIRST WEEK of December marks Inflammatory Bowel Disease (IBD) Awareness Week. Many
diseases are the focal point for an awareness period,
but few need a public-relations blitz more than IBD.
Not only does the nature of this chronic disease
often keep patients suffering in silence, but IBD also
gets confused with irritable bowel syndrome, or IBS.
IBD or IBS: What’s the difference?
IBD encompasses Crohn’s disease, which is
an inflammatory disease that affects anywhere
from the mouth all the way to the anus, and
ulcerative colitis, an inflammatory disorder that
always affects the rectum and then advances up
the colon to include the large intestine.
IBD symptoms include frequent and
ongoing diarrhea, bloody stools and
abdominal cramping and pain.
While abdominal cramping
and abnormal bowel movements
occur in both IBD and IBS, the
disease process differs greatly.
A gastrointestinal disorder
associated with anxiety and
mood disorders, IBS doesn’t visibly damage the digestive tract,
unlike IBD. “Irritable bowel syndrome is not an inflammatory
disorder, and somebody [with
IBS] would have a normal
endoscopy and normal laboratory findings, whereas
the opposite is true with
IBD,” says Dr. David
Kerman, a gastroenterologist and assistant professor of
clinical medicine at the
University of Miami Leonard M.
Miller School of Medicine.
IBS flare-ups are generally treated
through dietary changes, fiber supplements, anti-diarrheal drugs, and stress-reduction therapies, including
counseling or prescription antidepressants. IBD management involves lifelong pharmacological, medical and even
surgical therapies.
Approximately 1. 4 million Americans
have IBD, which puts them at a greater risk
for developing colorectal cancer, heart disease, asthma and arthritis. IBS affects an
estimated 35 million Americans.
IBD symptoms and risks
Researchers suspect a disruption of bacteria in
the gut for causing the inflammation and damage to
the intestines. Genetics and the environment remain
the biggest risk factors. People with a first-degree
family member with IBD are three to 20 times more
likely to develop Crohn’s disease or colitis.
Researchers continue to study other risk factors (see
“IBD risk factors”).
Other IBD symptoms include fever, fatigue,
night sweats, constipation, bowel urgency, a feel-
ing of incomplete evacuation and losses of appe-
tite, weight or normal menstrual cycle.
Patients with IBD have a higher incidence
of vitamin D deficiency than the general pop-
ulation. Crohn’s patients can develop B- 12
deficiency.
Failure to grow remains the
hallmark of pediatric IBD. “While
malnutrition affects everyone with
IBD, it’s something we need to
monitor closely in the pediatric
population,” says Dr. Andrew
Grossman, a pediatric gastroenterologist at The Children’s Hospital
of Philadelphia, one of the few
centers in the country to use
nutritional therapy—giving
patients a specific formula for up
to 90 percent of their caloric
intake—to move pediatric
patients into remission.
•Age: IBD most often
develops between ages 15
and 40, with a second peak
from age 50 to 80. Twenty percent of all new IBD diagnoses
occur in children.
•Gender: IBD affects
men and women equally.
•Genetics and environment: IBD is more prevalent in
North American and Northern
European whites and particularly people of Ashkenazi
Jewish descent.
•Smoking: Compared
to nonsmokers, smokers are
more than twice as likely to
develop Crohn’s disease.
IBD risk
factors
Potential risk factors
DECEMBER 2012 The Costco Connection 59
Diagnosis and
treatment options
If you have been experiencing
these symptoms, experts suggest
seeing your doctor as soon as possible to
get a proper diagnosis.
An IBD diagnosis is made through
laboratory tests looking for anemia and
inflammatory markers, followed by diagnostic tests, including an upper endoscopy
and colonoscopy. A firm diagnosis can be
made within two weeks.
Medication remains the first line of
defense against IBD to get patients into
remission and keep them there. First-line
therapies include anti-inflammatories and
certain antibiotics. Immunomodulators and
biologics are used if the disease advances or
changes course. Because steroids can cause
CONTINUED ON PAGE 60
The Costco
Connection
Costco members will find
fiber and protein supplements,
anti-diarrheals, vitamins and
healthy foods at Costco, plus
prescriptions may be filled at
their Costco pharmacy.
