1. What is inflammatory bowel disease (IBD)?
Inflammatory bowel disease is an autoimmune disorder in which the body's own immune system attacks cells within the bowel.
2. What causes IBD?
IBD is thought to be a genetic disorder and is hereditary. It also can be triggered by environmental factors, medication use and lifestyle choices.
3. Is there a cure for IBD?
No, there is no cure at the present time for inflammatory bowel disease. Treatment consists of finding appropriate medications, based on each patient's symptoms, to control inflammatory episodes and improve quality of life.
4. How is IBD diagnosed?
Your gastroenterologist may suspect an inflammatory bowel condition based on your medical history and a review of your symptoms. He or she will have you undergo one or more endoscopy procedures — small bowel enteroscopy to view the esophagus, stomach and part of the small intestine, as well as a colonoscopy to view the colon and rectum — and may take a tissue sample (biopsy). Other tests and procedures include blood tests, a stool sample and imaging studies such as CT scans.
5. How is IBD treated?
Medications, and in severe cases surgery to remove the colon, are the mainstay of treatment for patients with chronic ulcerative colitis and Crohn's disease. Because these diseases are disorders of the immune system, in which the body attacks cells within the colon, the goals of treatment are to suppress inflammatory episodes (causing the disease to go into remission) and to improve quality of life. Unfortunately, as patients know all too well, the disease can flare up (relapse) repeatedly, the reason why treatment is usually life long.
Prescription anti-inflammatory medications, immune system modulators, and medications coming onto the market available within clinical trials, are all being used to treat patients with IBD.
The Digestive Disease Institute at Virginia Mason is at the forefront in immune system research, specifically at Benaroya Research Institute at Virginia Mason, where scientists are unlocking the genetic causes of immune system disorders that includes rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease.
6. Will I always be on treatment for IBD?
Yes. IBD requires adopting healthy lifestyle choices along with life-long medical management and regular clinic visits.
7. Why am I undergoing treatment for IBD with several different medications?
Not all patients with IBD have the same symptoms. Crohn's disease, for example, can affect any or all areas of the digestive tract from the mouth to the anus. Based on the type of IBD you have, as well as its location and intensity, your physician may try several different medications in an effort to find the appropriate therapy that is right for you.
8. Are TNF-alpha blockers safe to use for treatment of IBD?
TNF inhibitors (infliximab, adalimumab, certolizumab pegol) prevent the body from using tumor necrosis factor-alpha, a natural protein made by white blood cells to fight infection or cancer. Patients with IBD have been found to have unusually high levels of TNF-alpha. Because these drugs block TNF-alpha in the body, patients are at higher risk of bacterial, viral and fungal infections. Tuberculosis, for example, has developed in some patients taking this class of drugs. Your gastroenterologist will talk with you in more detail about risks associated with TNF-alpha blockers.