So what is IBD?

Ulcerative colitis was first described in 1875 by Wilks and Moxon who were able to separate it from dysentery and infectious diarrhoea.It is a disease in which there is inflammation of the lining (mucosa) of the large intestine causing diarrhoea and rectal bleeding.

The rectum is always affected and is called proctitis.

It may extend further along the left side to the splenic flexure, when it is know as distal colitis.

The whole of the large intestine may be affected and the condition is known as pancolitis.

Ulcerative colitis is a chronic disease with periods of remission, in which patients are symptom-free, and relapses in which symptoms flare-up.

The onset may be gradual or sudden.

Medical treatment is successful in keeping most patients in remission until the disease slowly burns itself out. However, occasionally, surgery may be necessary.


IBD Investigations

Investigations (tests) are necessary to reach the correct diagnosis and to check on the progress of the disease.

After an initial examination in the clinic, some of the following tests may be performed:

1. Blood tests
a) to check for anaemia. Full blood count – FBC)
b) to check the proteins in the blood
(i) a low level of albumin in the blood suggests severe ulceration
(ii) a raised ‘C’ reactive protein reflects inflammation
c) to check the state of the liver. (Liver function tests – LFTs)
d) to see if there is an imbalance of salt and water due to diarrhoea. (Urea and electrolytes)

2. Stool tests
A relapse may be due to infection and this can be excluded by looking for bacteria in the stool.

3. Sigmoidoscopy

An examination of the lower bowel with a rigid metal tube that has a light on the end. Small pieces of tissue called biopsies may be taken for examination under the microscope.

4. Plain abdominal film
Straight Xray of the abdomen may show swelling and obstruction of the bowel or constipation.

5. Barium Xrays

Barium sulphate is a liquid which shows up on Xray and can therefore be used to demonstrate the bowel which is otherwise poorly seen. It may be given by mouth to examine the small intestine or by enema to examine the large intestine.

6. Colonoscopy
An examination in which the large intestine (colon) is examined by a long, flexible, fibre optic (fibres which carry light) telescope called a colonoscope.
Biopsies may be taken for examination under the microscope.

7. White cell scan (leucocyte scan)
A scan in which the patients’ own white blood cells, labelled with a tiny amount of radioactivity, are used to show the extent and severity of inflammation.



2 thoughts on “IBD

  1. Imelda McCann says:

    Hi all. Looking for some advice if possible. After initially being thought to have appendicitis back in Sept 2011(due to the site of the pain) and being admitted to hospital, this was dismissed and I was referred to a gastroenterologist for further investigation. After various scans, a colonoscopy and an MR Enterography, I was advised that I have “proximal constipation with overflow which masquerades as diarrhoea”. I have been told to take Picolax, 1 sachet followed 2 hours later by Moviprep every 2-4 weeks. In between, I should take Dulcolax (2 tablets) alternating with Movicol (1-6 sachets) every few days. I have been doing this since Feb 2012 and quite honestly it’s killing me! I’m permanently tired and lacking energy, whilst trying to maintain a full time job and family commitments.

    I suppose I have 2 questions. Firstly, every bit of research I have attempted to look up proximal constipation refers to Colitis, though I have not been diagnosed with this. Do I (or could I) have Colitis??? Secondly, as the medication is so debilatating, are there any alternatives? I have recently stopped taking it to see how it would go, but the diarrhoea (and sometimes constipation, even within the same motion) is relentless. I really don’t know what to do for the best. Should I perhaps seek a second opinion, or go back to the gastroenterologist I saw initially for further advice? All replies gratefully received. Cheers, Mel.

    • Hi there – sorry for this later reply, it’s been a while since I have been on this blog and thought new year better clean it up!! It took over two years for me to be diagnosed before Doctors started paying attention then it was nearly another 2 years before I got the pouch. I was advised on the following, if you feel your quality of life is suffering and you find it hard to physically get through day to day activities (going to the toilet counts as one of these) then you need to get a second opinion and get the matter addressed.

      I was on constant medication for 20 months and it never made me better, it just got me through the day. The over all effect of the medication after the 20 months were I went from a size 10 (UK) to a size 22 and weighed over 18 stones and my mobility was poor and over all health physically and mentally was poor. I had to fight and speak up to Doctors quite a lot which was usual as I was brought up to believe and respect the medical profession.

      Speak with your Doctor, ask for an examination like a colonoscopy and try and determine if you have IBD as it might not necessary Colitis. If it is IBD then see if a cause of drugs like steroids might calm it down or at least control it to find a better solution. Have you checked for food intolerance? Have you had bloods done to see if you have immune problems?

      Let me know how you get on and if you want more help let me know.

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