Inflammatory Bowel Disease Stages & Development

IBDs - Ulcerative Colitis & Crohn's Disease Development, Stages & Symptoms

To understand Inflammatory Bowel Disease stages and development, it is important to have an overview of healthy small intestine and large intestine.

Never Lose Focus of Healthier You - The Small Intestine:

Small intestine runs after stomach to the large intestine or colon. It is a long tube of about 22 to 25 feet long coiled and convoluted tube, having a diameter of about 1 inch. You can call it truly the principal seat of digestion and absorption as all the main part of the food - protein, fat and carbohydrates - are digested and absorbed from here.

The small intestine is supported by mesentary, a wall of fat, blood vessels, nerves and lymph glands, that suspends small intestine. You can find peristaltic movements and churning  (intestinal movements to mix food and juices and to move it forward) happening throughout the small intestine.

Small intestine is divided into 3 parts. Duodenum is the first part of small intestine, about 9 to 11 inches long. It receives the secretion of liver, gall bladder and pancreas through ducts and these are primarily responsible for digestion of proteins, fats and carbohydrates. Here, the strong acid of stomach is also neutralized and the pH starts to become alkaline. This part has the widest lumen.

The 2nd part of small intestine is Jejunum. It is about 40% of small intestine. It is deep red in color due to extensive blood supply and has strong peristaltic movements.

The 3rd part of small intestine is Ileum and is the narrowest of all the three. It lies in lower abdomen and peristaltic movements are also slow here.

The mucus membrane or inner lining of the lumen is thrown into transverse folds, called plicae circulares. Additionally, there is velvetty projections called villi (like in a new towel) on to this layer. These two enhance the surface area of small intestine so that digested food is absorbed properly.

Besides these two structures, there are numerous secretory glands that help to secrete protective juices for the inner lining of small intestine.

Small & Large Intestine or Colon

Wall of Small Intestine

Wall of Small Intestine in Detail....Just Give a Look

The Healthy Colon or Large Intestine or Gut:

Large bowel or intestine is made of Cecum and has four parts. These are ascending colon, transverse colon, descending colon and sigmoid colon. The first three parts make an inverted U shape in your abdomen. You also remember colon for its beaded look as it houses ‘the stool or feaces’.

Colon's importance and role is often ignored by healthy persons as they think that it can be involved only in minor problems like constipation, gas or bloating and diarrhea.

Large intestine has a very important role in digestive system. It extracts minerals and water from digested food that reaches here. About 10% of all water is absorbed in here.

Large intestine is acclaimed worldwide for its synergistic WIN-WIN association with Gut Flora or Healthy Microbes. You might be familiar with them as Probiotics. These microbes help in fermentation of undigested fiber and produce some substances that are used by Colon cells for nourishment.

The Healthy Microbial Flora is also responsible for production of vitamins and play an important role in our immune function. Their presence is extremely significant for regional as well whole body health.

Many medical researchers all over the world found greater significance of Gut for human health, as much as that some claim it as the brain of immune system.

Use of Antibiotic drugs and westernized diet (refined flours, fast foods, soft drinks) directly destroys or incapacitates the healthy microbes and predisposes us to many deficiencies and problems. So always insist your medical doctor for advice about Probiotics when he or she prescribes you antibiotics.

People who are suffering from IBDs and IBS can tell you how much havoc these disorders can bring into their lives.

Large Intestine or Colon

Large Intestine or Colon

Large Intestine or Colon

IBDs or Inflammatory Bowel Diseases Development - Ulcerative Colitis & Crohn's Disease?

We need to understand several points here.

Inflammation is a general term that signifies redness, swelling, raised temperature or heat, pain and loss of normal function.

These two disorders - Ulcerative Colitis and Crohn's Disease -  have inflammation of small and large intestine coupled with ulceration and bleeding. 

The more serious issue here is that these inflammatory changes are produced by Autoimmune reaction or Autoimmunity. Immune system stands for fighting or defence system of body against outside factors like bacteria, virus and fungi.

In Autoimmune disorders, there are more than 80 of these, some body parts are being attacked by immune system. You can say that it is kind of wrong identification of the some of body's own parts as foreign and start attacking these. 

You have employed some guards for the society where you live in with other neighbors. Autoimmune disorders are the conditions when these guards turn offensive against some of you and start to harm you. 

Celiac Disease is another autoimmune disorder of intestine due to gluten sensitivity but doesn't involve bleeding and ulceration. Other common Autoimmune disorders are Rheumatoid Arthritis, Psoriasis, SLE and Multiple Sclerosis.

Medical researchers are trying to find out what causes these autoimmune disorders, but there is no single opinion and more studies are going on all over the world.

Inflammatory Bowel Disease Stages depends upon few factors...

  1. Type of IBDs - Ulcerative Colitis or Crohn's Disease or Indeterminate
  2. Length of affected part
  3. Duration of Disease
  4. Its tretment, management, remission and flare ups
  5. Presence of complications due to IBDs or other disorders

There is way to histopathologically grade their severity and a system should also be utilized to assess their severity, condition and flareups during regular clinical assessments and simple and noninvasive tests.

Difference Between Ulcerative Colitis & Crohn's Disease Symptoms:

sYMPTOMS 

Ulcerative Colitis

Crohn's Disease

Onset of Age

15-35

15-35

Can Occur Later

Yes

Yes

Mainly Affects

Colon or Large Intestine

Pattern is Continuous

Mouth to Anus

Has Normal Parts between Affects Parts

Key Symptoms

Frank Blood in Stool with Mucus

Frequent Diarrhea

Loose Motion

Abdominal Pain

Strong Urge for Bowel

Severe Abdominal Pain, Cramps

Diarrhea

Occasional Rectal Bleeding

Nausea, Vomiting with  or without Bleeding (If affects stomach, Food Pipe or 1st part of Small Intestine)

Black / Dark Brown Stool (When bleeding is from upper parts of intestine)

Strictures are common

Other Symptoms

Weakness

Anemia

Loss of Appetite

Weight Loss

Fever

Weakness

Anemia

Loss of Appetite

Weight Loss

Fever

Others

Autoimmune Disorder

Chronic & Progressive

Recurring

Triggering Factors

Hereditary Element

Environmental Factors

Chronic Stress

Food Sensitivity

Might Require Surgery

Autoimmune Disorder

Chronic & Progressive

Recurring

Triggering Factors

Hereditary Element

Environmental Factors

Chronic Stress

Food Sensitivity

More Prone to Require Surgery

What are the Symptoms of Ulcerative Colitis based upon affected part?

Mild symptoms can be present when rectum (Ulcerative Proctitis) is affected. These include…

  1. Rectal bleeding
  2. Rectal pain
  3. Feeling of Urgency for Bowel

When Sigmoid Colon is affected along with Rectum (Ulcerative Proctosigmoiditis), the above symptoms become worse with…

  1. Bloody Diarrhea
  2. Abdominal cramps and pain
  3. Tenesmus (Inability to pass stool despite urgency)

When Descending Colon (Left-sided Ulcerative Colitis) is also involved along with above parts, other symptoms are also present as…

  1. Abdominal Cramps and Pain on Left side
  2. Weight Loss

Whole of Colon (Pancolitis) might be affected and all the above symptoms are present…

  1. Severe Bloody Diarrhea
  2. Abdominal Cramps and Pain
  3. Fatigue
  4. Significant Weight Loss
  5. Fever
  6. Night Sweats
  7. Difficulty in Medical Treatment

Sometimes, a rare form of Ulcerative Colitis (Fulminant Colitis) might occur and it has severe symptoms and complications…

  1. Severe Diarrhea, Bleeding, Pain
  2. Dehydration leading to Shock
  3. Risk of developing Toxic Megacolon and Rupture of Colon

Ulcerative Colitis Types based upon Places

Crohn's Disease Prefered Places

Some Sites of Crohn's Disease

About Crohn's Disease:

As you can see, the patchy inflammation is found in Crohn's Disease. There is normal patches in between affected parts. There is more chance of strictures and hence intense cramps and pain might be present in advanced condition.

If the bleeding is from upper parts of small intestine, there is presence of dark black / brown stool as well.

It can also affect the entire thickness of intestinal wall.

Indeterminate IBDs:

Roughly, there are 10% persons affected with IBDs where it has both Ulcerative Colitis and Crohn's Disease features or you can say that it could be put into any one of these two have same symptoms. 

Complications of IBDs - Ulcerative Colitis & Crohn's Disease:

  1. Anemia and Weakness
  2. Weight Loss
  3. Need for Urgent Hospitalization in Acute Stage
  4. Need for Surgical Intervention in Chronic and Progressive Stages

Ayurveda and Inflammatory Bowel Disease Stages & Development

Right now, there is no consensus regarding the cause of IBDs. Some possible causes are suggested…

Autoimmunity: Most doctors think Ulcerative Colitis to be an autoimmune disorder. It means that body starts to identify part of colon (affected part) as foreign and immune system starts to attack it, causing symptoms.

Some authorities also attribute bacteria and virus to be the cause or starting point of Autoimmune reaction, even though no such microbe is found out with certainty.

Stress-Induced or Triggered: Earlier, many people considered Ulcerative Colitis to be stress induced. Currently, stress is not counted as the cause but is a significant cause or risk factors for flare ups.

Genetic Predisposition: Many doctors start to think of a hereditary link or predisposition for IBDs to the extent of 20-35%. 

The actual cause is not known even in medicine. But the changes and risk factors are studied in depth and some useful information is coming out of it.

In Ayurveda, there is a clear Vata-Pitta-Rakta Dhatu connection with Ama dosha. The variation of symptoms can guide easily which one is predominant at which time.

In Ayurveda, it is also clearly mentioned that all Ama dosha related disorders have origin in Abdomen - Gut.  This is also one of the most prevalent views even in modern medicine about all Autoimmune disorders.

Many medical doctors claim Gut to be Another Brain, or Brain of Immune System. The research and association of Autoimmunity and Gut Health have started to emerge and it could support the Ayurvedic perspective in coming times. 

The Ayurvedic viewpoint of Aama Dosha - one of the factors of Autoimmune Disorders - and its origin and association with Intestine is being accepted and endorsed by leading medical researchers all over the world.

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Real Case Study of IBDs - Ulcerative Colitis

Fast forwarding the story and battle of Mr. Balbir Negi with Ulcerative Colitis after more than 7 years is...He is a wonderful husband and father and...

  1. He never had any flare ups or required hospitalization during these long 7 years, except in first year due to normal infection.
  2. He didn't lose weight or felt weakness and is leading an active, busy and hectic life of IT professional.
  3. He is relying always on our Herbal Products as the only means of intervention from medical point of view.

Now, with better lifestyle and exercise intervention, he is all set to lead almost normal quality of life.


And, I am happy to equally share the credit to Our Herbal Products and Dedication and Compliance of Mr. Balbir Negi.

About Next Unit:

In the next training session, you will learn about...

  1. Ayurvedic Treatment plan for IBDs - Ulcerative Colitis & Crohn's Disease adopted by Dr. Vikram Aditya Tomar
  2. How everything fits in generating a synergistic approach

This will help you to understand the landscape of Ayurvedic treatment and holistic management of IBDs - Ulcerative Colitis & Crohn's Disease.

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