Areas of Expertise
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) refers to chronic conditions that cause long-lasting inflammation in the digestive system. The two most common types are Crohn’s disease and ulcerative colitis. The disease can flare up and settle in phases; with regular follow-up and appropriate treatment, symptoms can be kept under control in most people.
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Crohn’s disease
Crohn’s disease is a chronic condition that can cause inflammation anywhere in the digestive tract, from the mouth to the anus.
In Crohn’s disease, the immune system causes long-lasting inflammation in the digestive tract. The end of the small intestine and the colon are most often affected, but any part of the digestive tract can be involved. Inflammation can reach all layers of the bowel wall. The disease comes in flares and quiet periods. Its cause is not fully known; genetics, the immune system and environmental factors are thought to act together.
Symptoms
- Ongoing diarrhea, sometimes with blood
- Abdominal pain, often in the lower right side
- Unintentional weight loss and poor appetite
- Tiredness and fever
- Pain, discharge or an abscess around the anus
- Symptoms outside the bowel, such as mouth sores, joint pain or red eyes
When to see a doctor
- Diarrhea or abdominal pain lasting more than four weeks (without waiting if bloody or with fever)
- Blood in the stool
- Unexplained weight loss or tiredness
- Pain, swelling or discharge around the anus
- If IBD runs in the family, symptoms should be shared with a physician early
How is it diagnosed?
Diagnosis relies on a physician’s examination, blood and stool tests, colonoscopy and biopsy. Imaging such as MRI, CT, ultrasound or capsule endoscopy may be needed to see the small intestine. Infections and similar conditions are ruled out separately. The physician decides which methods are used.
Treatment and lifestyle
- The aim is to control inflammation and prevent bowel damage
- Treatment is planned by the physician according to disease location and severity
- Corticosteroids may be used to control a flare for a short time
- Immunosuppressive, biologic and some targeted therapies can give long-term control
- Surgery may be needed for strictures, fistulas or abscesses
- Medicines are taken regularly and not stopped without medical advice
LifestyleSmoking worsens the course of Crohn’s disease, and quitting helps keep the disease under control.
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Ulcerative colitis
Ulcerative colitis is a chronic inflammatory condition that affects only the large intestine.
In ulcerative colitis, inflammation starts at the rectum and can extend upward through the colon for a varying length. It mostly affects the inner lining of the bowel and involves one continuous stretch. Sores form on the inflamed surface and bleeding may occur. The disease comes in flares and quiet periods. Its cause is not fully known; the immune system, genetics and environmental factors are thought to act together.
Symptoms
- Bloody diarrhea with mucus
- Frequent bowel movements and sudden urgency
- Abdominal cramps, especially before a bowel movement
- A feeling of incomplete emptying after the toilet
- Tiredness and weight loss
- Joint pain, skin or eye problems outside the bowel
When to see a doctor
- When blood or mucus appears in the stool, even if it is the first time
- Diarrhea or abdominal pain lasting more than four weeks (without waiting if bloody or with fever)
- Frequent, urgent toilet visits that disrupt daily life
- Tiredness, weight loss or looking pale
- Signs of a flare when the disease is already known
How is it diagnosed?
Diagnosis is made by reviewing the symptoms together with blood and stool tests, colonoscopy and biopsy results. Stool tests help rule out infections. The extent of the disease is determined by endoscopy. The physician decides whether additional imaging is needed.
Treatment and lifestyle
- The aim is to stop a flare and maintain remission
- In mild to moderate disease, 5-ASA (mesalamine) medicines taken by mouth or rectally may be used
- Corticosteroids may be used for a short time in a severe flare
- If needed, immunosuppressive, biologic or targeted small-molecule therapies (such as JAK inhibitors or S1P modulators) are added
- Surgery may be an option in severe disease that does not respond to treatment
- As the disease lasts longer, colonoscopy surveillance is done regularly
LifestyleEnough sleep, regular activity and stress management support general well-being, but they do not replace medical treatment.
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Living with IBD: nutrition, vaccines, follow-up and surveillance
IBD is a long-term condition; regular follow-up, suitable nutrition and vaccines help protect quality of life.
Living with IBD means getting to know the disease and keeping to a long-term follow-up plan. In adults, no diet treats IBD on its own; nutritional deficiencies are monitored and planned with a dietitian. Vaccination schedules matter in treatments that suppress the immune system. Regular check-ups, taking medicines as prescribed and emotional support are considered together. Bone health and colon cancer surveillance are also part of follow-up.
Common challenges
- Sudden urgency and limits on daily life during flares
- Fatigue and low energy
- Deficiencies such as iron, vitamin B12 or vitamin D
- Anxiety, low mood and stress about the illness
- Uncertainty about which foods are suitable
- Greater risk of infections with treatments that suppress the immune system
When to see a doctor
- If symptoms of a flare return
- If fever or signs of infection appear
- Before starting a new treatment, to review vaccination status
- If a pregnancy is planned, talk with the physician beforehand
- If low mood or anxiety lasts for a long time
How is it diagnosed?
During follow-up, symptoms, blood and stool tests (including markers of inflammation), and colonoscopy or imaging when needed are reviewed together. Blood tests track iron, vitamin levels and medicine safety. In people who have had the disease for a long time, regular colonoscopy surveillance for colon cancer is recommended. The physician decides how often.
Treatment and lifestyle
- Eat a balanced, varied diet; do not start restrictive diets without medical advice
- Deficiencies are tracked with blood tests; the dietitian and physician plan together
- Vaccines are ideally completed before immunosuppressive treatment; live vaccines are generally not given during these treatments, and the physician decides on vaccination
- Attend check-ups regularly; even when feeling well, do not stop medicines without asking your physician
- In long-standing disease, the colon is monitored with surveillance colonoscopy
- Psychological support can be sought when needed
- Ask your physician before using NSAID painkillers such as ibuprofen or diclofenac; they can trigger a flare
LifestyleQuitting smoking (especially in Crohn’s disease), regular activity and enough sleep support overall health and disease control.
