Inflammatory bowel disease (IBD)
Inflammatory bowel disease comprises two diseases: ulcerative colitis, which primarily affects the mucosa of the colon; and Crohn's disease, in which inflammation can affect any part of the digestive tract, from the mouth to the anus, and can even affect other organs. It is a disease that has two age ranges for its onset, between 15 and 30, and between 50 and 80 years, but its appearance in children has increased. It is not hereditary, but there is a family predisposition. Its main symptoms are: abdominal pain, diarrhea, fever, weight loss, and intestinal bleeding; in children it affects the growth rate. Likewise, extraintestinal manifestations can occur, mainly in Crohn's disease, which affect the skin, eyes or joints.
What is its evolution?
It is a chronic disease, there is no cure but there is treatment, and the symptoms may even disappear for long periods of time. There are patients who experience episodes or crises of moderate or severe symptoms and who sometimes develop complications such as stenosis (narrowing of the intestine), abscesses or fistulas (communications or tunnels between organs) at the intestinal or perianal level; others remain asymptomatic. Adherence to pharmacological treatment favors the good evolution of the disease.
What therapeutic measures exist?
It depends on the severity and extent of the disease, that is, the degree of involvement of the intestinal mucosa. A diagnosis must be made based on ultrasound and magnetic resonance imaging, laboratory tests and endoscopic examinations to classify the disease and direct the treatment; in case of serious complications or lack of response to treatment, it may be necessary to
require surgery.
What are the treatment and medication alternatives?
The main objective is to control the inflammatory process of the intestinal mucosa, which triggers the symptoms. The treatment goals are disease control, symptom control and healing of the intestinal mucosa; disease-specific anti-inflammatory drugs are used,
Immune system inhibitors or modulators, biological therapy and/or antibiotics, depending on each particular case. Surgery is the last resort.
What quality of life is expected?
The results of treatment are more favorable when better eating habits and physical activity are incorporated into the patient's lifestyle. It is essential to maintain constant clinical monitoring and adhere to the pharmacological treatment. The life expectancy is the same as that of a person who does not suffer from the disease and with the available treatments, it is controllable.
What considerations should be taken into account for feeding?
There are differences in diet depending on whether the patient is experiencing a crisis or is in an asymptomatic phase. In general terms, a high protein diet is recommended to promote healing of the intestinal mucosa, low in fiber and fat and easy to digest. It is important to stay well hydrated, in order to replace the fluids and electrolytes lost during episodes of diarrhea, and to take extreme hygienic measures when preparing food, due to the compromised immune system and the consequent susceptibility to acquiring infections.
Anxiety and Stress
Physical, emotional or behavioural changes may occur in relation to the stress that the disease can generate or, on the contrary, episodes of stress and anxiety that worsen the symptoms or cause relapses. Some manifestations of this are headaches, insomnia, muscle tension, irritability, mood swings, compulsive behaviours, among others. Therefore, it is important to have a support network that accompanies the person during the stages of the disease, both in the close circle and in the health care setting. It is necessary to abandon negative thoughts, seek the support of trusted people, foster a positive attitude and stay active are strategies that favour the management of stress and anxiety during the course of the disease.