Inflammatory Bowel Disease (ibd)
Dr Sharad Shah
Consultant Gastroenterologist
Ex Head Department of Gastroenterology, Sir J J Hospital & Grant Medical College
Hon Gastroenterologist - Sir H N Hospital, Jaslok Hospital, Breach Candy Hospital, Mumbai

First Created: 02/23/2001  Last Updated: 02/23/2001

Patient Education

My child aged 12 years old has bloody stools for the past 2 months. He had been treated for diarrhea, dysentery, but to no avail. What to do?

The bloody stools which have remained for two months in a 12-year-old child is a matter of concern, particularly so because he has clearly been treated for diarrhea and dysentery. In such a situation one should make a determined effort to make the diagnosis.

One of the common conditions that mimic this would be POLYP. Sigmoidoscopy/colonoscopy will definitely give the diagnosis.

If truly the bloody stools have not subsided in spite of routine treatment, the child must be examined (by sigmoidoscopy) to exclude inflammatory bowel disease.

What is Inflammatory Bowel Disease?

Inflammatory bowel disease is a chronic condition where there is inflammation of the large and or small intestine without a definite cause, which has a tendency to recur. The commonest finding on sigmoidoscopy is granularity, and a tendency to bruise and bleed to touch.

When do you suspect a child has IBD?

One should suspect a patient to have IBD:

Ulcerative Colitis: Child will complain of diarrhea, rectal bleeding, the passage of mucus, and abdominal pain. Children can also have nausea, anorexia and in severe cases may even vomit. There may also be fever, anemia, and weight loss.

Crohn's disease: Child may have pain in right lower Quadrant which is recurrent and colicky in nature. There may also be pain during defecation and pain may increase after defecation. Diarrhea, fever, weight loss, bleeding PR may be other manifestations.

What are the causes of IBD?

The exact cause of IBD is not known. However, are the pointers towards these hypotheses. It may be that there is no single cause, and there may be more than one cause, acting in unison.

The cause of IBD are

ULCERATIVE COLITIS

  • Infection
  • Food allergy
  • Environment

CROHN'S DISEASE

  • Infections
  • Diet
  • Genetics
  • Psychosocial

What is the treatment of IBD?

The treatment of IBD consists of using 5-ASA and if necessary steroids. These drugs have had excellent results and have saved the lives of thousands of patients.

Can IBD be cured? Does it require life long treatment?

The word "cured" may not apply. However, the patient remains symptom-free or in remission for a long time. Theoretically, patients would require life long treatment.

How often does a patient require to undergo endoscopy (colonoscopy/sigmoidoscopy)?

After the initial endoscopy (sigmoidoscopy or colonoscopy), the patient would require undergoing repeat endoscopies in the initial stages every 3-6 months or depending on the clinical course (improvement of the disease).

When is surgery required? What is the surgery done?

Surgery is necessary if the disease does not come under control with medical treatment and or there are life-threatening complications.

Surgical treatment consists of removing the large intestine in Ulcerative colitis and or affected part of the large or small intestine in Crohn's disease.

If the intestine is removed, can the patient survive?

The patient can survive very well when the large intestine is removed and can also survive if a small portion of the small intestine removed.

Does a special diet help in IBD?

There is no special diet that can help IBD. However, it is prudent to avoid chilies, fried feeds, and outside food.

What is the prognosis of a patient with IBD?

By and large prognosis of IBD is reasonably good. If a patient understands the illness and accepts the illness, they remain happy.


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