IBD. What Is It?
Inflammatory bowel disease, or IBD, affects children, adolescents and adults. Crohn’s disease and ulcerative colitis (U.C.) are the most common members of this family of disorders, although there are other forms of this autoimmune disease. (An autoimmune disease is one in which the body’s immune system attacks itself). IBD is an unfortunate fact of life, seen frequently by colon and rectal surgeons (proctologists). Although IBD seems to be more common in large cities such as Los Angeles, there is no evidence that living in the large city actually causes IBD.
Symptoms can be non-specific and similar to other illnesses. Symptoms include:
- Abdominal pain
- Nausea and vomiting
- Diarrhea, with or without bleeding
- Weight loss
- Failure to grow appropriately
- Involvement of areas outside of the gastrointestinal tract.
If Symptoms Are Non Specific, How Is The Diagnosis Obtained?
Symptoms alone may point the physician in the right direction, Endoscopic evaluation with biopsies usually help to give the diagnostic answer. In the case of ulcerative colitis, colonoscopy is performed. During the procedure, the colon and rectal surgeon will take many biopsies which are then evaluated under the microscope by the pathologist. If Crohn’s disease is suspected, the physician can pass the scope into the small intestine to obtain additional biopsies (Crohn’s often affects the terminal ileum, which is the anatomic end of the small intestine). Gastroscopy (endoscopy) can be used if disease is suspected to exist in the esophagus, stomach or duodenum (the beginning of the small bowel).
What About Blood Tests?
The CBC blood test allows doctors to evaluate your blood for infections (white blood cell count, WBC) and for the presence of anemia (low red blood cell count). However, these tests are relatively non-specific and may point toward many diseases.
There are two blood tests which are helpful to the physician in diagnosing IBD:
- pANCA (Perinuclear Anti-Neutrophil Cytoplasmic Antibodies) stains areas around the nucleus of the cell. This is more helpful in diagnosing ulcerative colitis.
- ASCA (Anti-saccharomyces cerevisiae antibodies)evaluates yeast colonization in Crohn’s disease.
These two tests are usually used together and are highly specific but not very sensitive. This means that if the tests are positive, you are not assured that you have the disease. If they are negative however, you more than likely do not have IBD. The diagnosis of IBD involves evaluating the patient history, a physical examination, an endoscopic exam and blood tests.
Los Angeles Colon and Rectal Surgical Associates.
Inflammatory bowel diseases are a common and potentially debilitating group of illnesses. They are also illnesses which can be brought under control through appropriate diagnosis and treatment. At Los Angeles Colon and Rectal Surgical Associates, board certified surgeons, specially trained in the diagnosis and treatment of IBD will help you and answer your questions in a calm and confidential setting. Your first appointment can be made by calling (310)273-2310. There is pre-appointment literature and appointment forms available online on the office website.