Living with inflammatory bowel disease: how to manage chronic bowel conditons

Written by: Professor Ailsa Hart
Edited by: Top Doctors®

A change in bowel movements can indicate the presence of an inflammatory bowel disease, such as ulcerative colitis. Professor Ailsa Hart, a highly experienced London-based gastroenterologist, explains that early diagnosis and careful monitoring are essential to maximise quality of life for sufferers.

What is inflammatory bowel disease?


Inflammatory bowel diseases, which include ulcerative colitis and Crohn’s disease, are chronic lifelong and life-limiting diseases which affect the gastrointestinal tract. They may be diagnosed in childhood, in young people or indeed at any age.  The diseases are increasing in prevalence across the world, particularly in newly industrialised countries whose societies have become more 'westernised'.

What are the symptoms of inflammatory bowel disease?


The symptoms include altered bowel habits or diarrhoea, sometimes with faecal urgency or incontinence which can impact in a major way on quality of life. Other symptoms include abdominal pain, weight loss and often fatigue, which again impacts upon a person’s ability to pursue their day to day activities and achieve their goals. Not only is the intestine affected, but patients may also experience joint pains, skin issues or painful eyes. In some patients fistulas, or communications, develop from the intestinal lumen to the skin surface or to other organs. The ability to enjoy food can be compromised.

How is inflammatory bowel disease diagnosed?


Prompt diagnosis is important to optimise outcomes and ensure good education about the disease and plan a strategy for management.

Investigations to diagnose inflammatory bowel disease include blood tests, stool tests, endoscopy examinations (often colonoscopy to assess the large bowel or colon) and radiological tests (often magnetic resonance imaging to assess the small bowel or ileum).

How is inflammatory bowel disease treated?


A key principle of managing inflammatory bowel disease is careful monitoring of the disease to assess how active and extensive the disease is, as this guides the ongoing strategy of therapy. Goals of therapy are to ameliorate symptoms, improve quality of life and achieve mucosal healing (and probably histologic healing as well in the case of ulcerative colitis).

Therapies involve drugs called induction agents to gain control of the disease and maintenance therapy to ensure the disease is kept under control.

Joint decision making, with patients actively participating in the plan for their management and allowing them to make fully informed decisions at particular times when changes in therapy are necessary, are key to management.

Professor Ailsa Hart

By Professor Ailsa Hart

Professor Ailsa Hart is an internationally-renowned leading consultant gastroenterologist in London with over 20 years experience. Having trained in medicine at Oxford University, being awarded a First Class Honours Degree, she completed her PhD at Imperial College in London in 2005. She received further clinical training in gastroenterology at the renowned  St Mark's Hospital, Barts Health NHS Trust and University College Hospital, as well as the Academic Medical Centre in Amsterdam.

At the forefront of her field, she is Fellow of the Royal College of Physicians, a member of the British Society of Gastroenterology, particularly contributing to the Clinical Research Group, and on the Governing Board of the European Crohn’s and Colitis Organisation, to name a few. She has been awarded numerous prizes for her outstanding work in medicine.

Prolific in all aspects of gastroenterology, she takes a special clinical interest in inflammatory bowel disease (Crohn's Disease and ulcerative colitis). She works closely with the national charity for inflammatory bowel disease (Crohn's and Colitis UK) and is the UK Lead for Patient and Public Involvement and Engagement in gastroenterology.

She has written two books, publishes extensively in renowned peer-reviewed journals (with over 130 publications) and is Associate Editor of the well-respected journal Alimentary Pharmacology and Therapeutics. She lectures extensively sharing best practice principles around the world and also featured on the BBC documentary “Guts: the strange and mysterious world of the human stomach” on 12th July 2012, presenting research data on faecal transplantation for treatment of inflammatory bowel disease.


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