To find out more about the Inflammatory Bowel Disease disorders, view this video:
http://www.youtube.com/watch?v=Lp-bqF1sjKw&feature=related
Between 1-1.5 million people have Ulcerative Colitis (UC) or Crohn's Disease (CD) in Europe. Exact figures cannot be formuated in Ireland at present but it is clear that the numbers are increasing.
The exact cause of IBD remains unknown. Genetic and Environmental factors seem to play a part as well as diet, infective agents, smoking and stress. Whilst risk factors such as appendectomy, oral contraceptives, diet, breastfeeding, infections/vaccinations, antibiotics and childhood hygiene have been explored they have demonstrated inconsistent findings.
Nutrition is especially important in CD as weight loss is a common symptom of the disease. Many patients experiment with their diet which may lead to excluding major food groups, for example, dairy products (Skelly, 2009). However, there is no empirical evidence for food exclusion and foods from all elements of the food pyramid are recommended. However, in times of flare-ups dieticians recommend resorting to a low residue diet. Residue is the total material that is left in the bowel after food has been digested and absorbed and therefore foods high in residue must be avoided in times of flare-up (Irish Nutrition and Dietetic Institution , 2005)
In CD, the most common initial presentation is chronic diarrhoea with abdominal pain, fever, anorexia and weight loss. The abdomen is tender and a mass of fullness may be palpable.
In Ulcerative proctitis inflammation is confined to the rectum and for some people rectal bleeding may be the only sign. Others may have rectal pain, a feeling of urgency or an inability to move the bowels in spite of the urge to (tenesmus) (MFMER, 2010). Procotosigmoiditis involves the rectum and the lower end of the colon, known as sigmoid colon. In left-sided colitis inflammation extends from the rectum up the left side through the sigmoid and descending colon. Pancolitis affects the entire colon causing bouts of bloody diarrhoea, abdominal pain, fatigue and weight loss. Fulminant colitis is rare, life-threatening and affects the entire colon. People affected by this may be at risk of colon rupture and toxic mega colon (MFMER, 2010).
In general, the traditional approach has been to palliate symptoms, to induce periods of remission and dampen the immune response component of inflammatory and autoimmune disease using anti-inflammatory agents such as steroids (Caffrey, 2009).
Chief Executive Officer of Crohns and Colitis Foundation of Canada (CCFC) (2010) proclaimed:
“...these are diseases that have an embarrassment factor and one of our challenges is to lift the veil of silence on these diseases and educate people because these are profound lifelong diseases”.
