You can manage inflammatory bowel disease with diet, lifestyle changes

Inflammatory bowel disease (IBD), a chronic condition once common in developed countries but fairly uncommon in Asia, has been growing in incidence in Singapore in the past two decades because of changes in diet and lifestyle. The two primary types of IBD are Crohn’s disease and ulcerative colitis.

IBD is characterised by chronic inflammation of the gastrointestinal (GI) tract. It is caused by an interaction between genetic and environmental factors and a malfunction of the immune system.

Ulcerative colitis typically involves inflammation in the innermost lining of the large intestine and rectum; in Crohn’s disease, inflammation commonly affects the ileum or last part of the small intestine and/or the large intestine.

“If not treated, inflammatory bowel disease can be debilitating and sometimes leads to life-threatening complications,” says Dr Ang Tiing Leong, Chief and Senior Consultant, Department of Gastroenterology and Hepatology, Changi General Hospital.

Complications include anal fissures, and ulcers and abscesses in the GI tract. IBD, particularly ulcerative colitis, increases your risk of colon cancer.

Symptoms of IBD include:

  • Diarrhoea

  • Abdominal pain, severe internal cramps

  • Rectal bleeding

  • Weight loss

  • Fever

  • Fatigue

  • Loss of appetite

The difference between IBD, IBS and celiac disease

IBD should not be confused with other gastrointestinal conditions such as irritable bowel syndrome (IBS) or celiac disease, although all three conditions have some symptoms in common. Inflammation of the GI tract and tissue damage do not occur in IBS.

In celiac disease, inflammation of the intestines occurs in response to gluten, a group of proteins found in wheat and grains. Celiac disease symptoms recede with a gluten-free diet.

How is IBD diagnosed and treated?

IBD is diagnosed by a gastroenterologist with the help of a colonoscopy and biopsies. Since there is no cure for IBD, treatment involves managing the symptoms with diet, lifestyle changes, and medication.

“The initial aim of treatment is to induce remission and this is then followed by maintenance of remission,” says Dr Ang.

IBD medications include steroids to induce remission and immunosuppressants to maintain remission. Some patients may require more potent drugs such as biologic therapies, which are antibodies targeting specific parts of the inflammatory processes. Surgery may be required if medication is not effective.

You can live normally if you manage your IBD symptoms with dietary and lifestyle changes, including:

  • Quitting smoking

  • Managing stress

  • Eating 4-5 small meals daily

  • Limiting dairy products, spicy/fried foods

  • Limiting intake of fibre foods

  • Drinking plenty of water and other fluids

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