Inflammatory Bowel Disease (IBD)

Written by A/Prof Viraj Kariyawasam, Gastroenterologist

1. What is Inflammatory Bowel Disease (IBD)?

Inflammatory bowel disease (IBD) is a term used to describe chronic conditions that cause inflammation of the gastrointestinal tract. The two main types of IBD are Crohn’s disease and ulcerative colitis. Unlike functional bowel disorders, IBD causes visible inflammation and damage to the bowel lining.

IBD can affect people of all ages and is increasingly common in Australia. It often begins in adolescence or early adulthood, but may also present later in life.

2. Causes & Risk Factors

The exact cause of IBD is not fully understood. It is thought to result from an abnormal immune response to normal gut bacteria in genetically susceptible individuals.

Risk factors include a family history of IBD, living in developed countries, and environmental influences. Smoking increases the risk and severity of Crohn’s disease, while its relationship with ulcerative colitis is different. Diet and stress do not cause IBD but may worsen symptoms.

3. Symptoms & How It May Present

Symptoms vary depending on the type of IBD and the part of the bowel affected. Common symptoms include chronic diarrhoea, abdominal pain, fatigue, weight loss, and urgency to open the bowels.

Some people may experience blood or mucus in the stool, fever, anaemia, or symptoms outside the bowel such as joint pain, skin rashes, eye inflammation, or liver problems.

4. How Is It Diagnosed?

Diagnosis involves a combination of clinical assessment and investigations. Blood tests may show inflammation or anaemia, and stool tests help distinguish IBD from infection or functional conditions.

Endoscopic procedures such as colonoscopy or flexible sigmoidoscopy allow direct assessment of the bowel and biopsy sampling. Imaging studies including MRI or CT scans may be used to assess the small bowel or detect complications.

5. Treatment & Management Options

Treatment aims to control inflammation, relieve symptoms, and prevent complications. Management is tailored to disease type, severity, and individual patient factors.

Medications may include anti-inflammatory drugs, corticosteroids for short-term flare control, immune-modifying therapies, and biologic or targeted treatments. Some patients may require surgery, particularly in Crohn’s disease or severe ulcerative colitis.

6. Living With / Managing IBD

IBD is a lifelong condition characterised by periods of remission and flare-ups. With modern treatments, most people can achieve good disease control and maintain a high quality of life.

Long-term management includes medication adherence, regular follow-up, monitoring for complications, good nutrition, and support from a multidisciplinary healthcare team.

7. Prevention & Risk Reduction

There is no known way to prevent IBD. However, early diagnosis and effective treatment reduce complications and hospitalisations.

Avoiding smoking, maintaining a healthy lifestyle, and attending recommended surveillance colonoscopy help reduce long-term risks.

8. When to Seek Medical Advice

Medical review is recommended for persistent diarrhoea, abdominal pain, rectal bleeding, unexplained weight loss, or ongoing fatigue.

People with known IBD should seek urgent medical attention for severe pain, high fever, significant bleeding, vomiting, or signs of bowel obstruction.

Complete Health Australia is registered as an IBD provider with NSW Health
https://aci.health.nsw.gov.au/networks/transition-care/resources/ibd-services/complete-health-australia