فاس نيوز ميديا جريدة الكترونية جهوية تعنى بشؤون و أخبار جهة فاس مكناس – متجددة على مدار الساعة
On the occasion of the world’s commemoration of World Inflammatory Bowel Disease Day, which falls on May 19th of each year, we present an introductory paper on the subject as well as treatment methods. Inflammatory bowel diseases are considered a group of autoimmune diseases that affect the digestive system, characterized by the occurrence of chronic inflammation in the intestinal wall, repeatedly or continuously, and primarily affect the small and large intestines. However, they can affect any part of the digestive system from the mouth to the anus.
These diseases are not contagious but are chronic, and they go through stages of relapse and remission.
There are two main types:
-Crohn’s Disease:
-Can affect any part of the digestive system, from the mouth to the anus.
-Characterized by discontinuous inflammation (presence of affected areas and healthy areas).
-Affects all layers of the intestinal wall, from the mucous membrane to the serosa.
-Complications: fistula, strictures, abscesses.
-Ulcerative Colitis:
-Affects only the colon and rectum.
-Inflammation is continuous, starting from the rectum and extending upwards.
-Affects only the superficial mucous layer of the colon wall.
-Causes bloody stools and bloody diarrhea.
-These diseases often appear between the ages of 15 and 35, but they can appear at any age.
The causes of these diseases are considered to be the result of a complex interaction between:
-Genetic factors: Due to the presence of some genetic mutations, they increase the susceptibility to the disease, and there is a family history of the disease.
-Autoimmune disorder: The immune system mistakenly attacks the intestinal cells due to excessive stimulation by bacteria or environmental factors, and the body produces inflammatory cytokines that destroy tissues.
-Environmental factors: The impact of diet, smoking, psychological stress, and pressures.
Among the symptoms:
-Chronic diarrhea accompanied by bleeding.
-Recurrent abdominal pain.
-Anal bleeding and blood in the stool.
-Loss of weight and appetite.
-Feeling of urgency to defecate with incomplete emptying.
-Gas, bloating, constipation.
Non-digestive symptoms: such as joint pain (axial or peripheral arthritis), skin problems (such as erythema nodosum or skin ulcers), eye inflammation (iritis or scleritis), inflammation of the bile ducts…
Diagnosis is made through integrated steps, starting with a clinical examination:
-To analyze chronic symptoms and family history.
-Looking for signs of wasting, abdominal masses.
-Laboratory tests: Blood tests, which are elevated during flare-ups, anemia due to iron deficiency or chronic inflammation, vitamin B12 deficiency due to ileal involvement.
-Stool tests: To rule out the presence of parasites or bacterial infections.
-Endoscopy: Colonoscopy with biopsies to accurately determine the inflammatory pattern, capsule endoscopy in some cases.
-Computed tomography (CT scan): To identify strictures and fistulas and evaluate the small intestine.
Among the complications:
-Intestinal obstruction, especially in Crohn’s disease due to fibrosis.
-Fistulas and abscesses.
-Malabsorption and vitamin deficiencies, anemia.
-Increased risk of colon cancer.
-Osteoporosis.
-Hepatobiliary failure.
-Impact on fertility.
-Growth failure in children and adolescents.
Regarding the goals of treatment, they aim to achieve remission, prevent complications, and improve quality of life.
It mainly relies on drug treatment:
-Mesalazine, which are anti-inflammatory drugs.
-Corticosteroids in acute cases to reduce inflammation quickly, taking into account not using them long-term due to side effects.
-Immunosuppressant drugs: For chronic cases and to prevent relapses after achieving remission.
-Biologic drugs that target specific components in the immune system.
-Antibiotics in cases of abscesses or secondary bacterial infection.
-Surgery in refractory cases or the presence of complications such as obstruction, fistula, or bleeding.
-Nutritional supplements: Iron to treat anemia, vitamin D, calcium.
The medication is chosen according to the type of disease, the location of the inflammation in the intestine, the severity of the symptoms, and the previous response to treatment.
Treatment is carried out under the supervision of a specialist doctor only, and the patient should not stop treatment suddenly. They must have regular follow-ups and adopt a healthy lifestyle by following a balanced diet, reducing stress, and quitting smoking.
Inflammatory bowel diseases are complex conditions that require accurate understanding, early diagnosis, and continuous treatment, aiming to control symptoms, prevent complications, and improve quality of life.
Dr. Najat Khalil
Specialist in Gastroenterology and Hepatology
