What they are and why they arise
Inflammatory bowel diseases (IBD) are a group of chronic inflammatory diseases, which electively affect the large intestine (ulcerative colitis) or any tract of the digestive tract, from the mouth to the anus (Crohn's disease).
There are several types of inflammatory bowel disease, such as ischemic and lymphocytic colitis, but Crohn's disease and ulcerative colitis are by far the most common conditions.
The etiology of these diseases, that is the cause of origin, remains unrecognized, while their evolution (pathogenesis) is considered autoimmune; probably, supported by a genetic predisposition, the immune system tends to "go crazy" - often already at a young age - throwing its own cells in an excessive and inadequate way against those of the digestive system, more frequently of the intestine. In response to this accumulation of immune cells in the walls of the digestive tract, a chronic inflammatory reaction arises which disrupts the normal anatomy and disturbs its function.
Symptoms and Diagnosis
Despite the adjective chronic, the manifestations of inflammatory bowel diseases are not uniform but typically marked by periods of remission and relapse. The most common symptoms that accompany them are: abdominal pain, vomiting, diarrhea, flatulence, blood in the stool, abundant presence of mucus in excrements, frequent urge to evacuate with a sense of incomplete intestinal emptying (tenesmus) and weight loss. The variations, even important ones, of the alvo create in many cases problems of adaptation and end up influencing social relations and work activities. However, all these symptoms are not exclusive to inflammatory bowel diseases, but common to various conditions - not necessarily morbid - affecting the intestine (spastic colitis, stress colitis, alterations of the microbial flora, etc.). Chronic inflammatory diseases of the intestine are therefore not the symptoms themselves, but the structural and biochemical alterations that more or less extensive tracts of the digestive system, in particular of the intestine, undergo. It is no coincidence that the diagnosis of inflammatory bowel disease generally cannot be separated from colonoscopy, during which a biopsy of the mucosa is carried out for the subsequent histological examination, previously accompanied by clinical tests (search for inflammatory markers in the blood, such as ESR and PCR, which, however, remain non-specific and scarcely sensitive). Other instrumental diagnostic tests, such as magnetic resonance imaging or small bowel enema, may be required, for example when Crohn's disease causes lesions of the digestive system that cannot be reached endoscopically.
Another distinctive feature between inflammatory bowel diseases and those without an inflammatory component is the frequent finding, in the former, of clinical manifestations also of an extraintestinal nature, especially at the skin level (erythema nodosum and granulomatous dermatosis), of the liver (primary sclerosing cholangitis) , joints (arthritis, anchiolosing spondylitis) and eyes.
Care and treatment
Currently there is no standardized and universally effective therapeutic protocol; in the acute phases, the most powerful anti-inflammatory drugs existing in therapy, cortisone drugs, are generally used, but they must be taken only for short periods of time. In the phases of remission, alternatively or in association with them, salicylates, immunosuppressive drugs or anti-TNF alpha antibodies (a molecule produced by immune cells) can also be used. In the most serious cases, surgery may be necessary, sometimes with a resolutive therapeutic effect.
To learn more, consult the articles dedicated to inflammatory bowel diseases: ulcerative colitis and Crohn's disease.
