Let’s talk Shit!

May is IBD Awareness Month

Poo was not high up on my word use list until I was diagnosed with Ulcerative colitis, a debilitating bowel disease that not only stopped my heart twice but literally flipped me inside out and made me the person I am today.

What is IBD?

Irritable Bowel Disorder or Disease (IBD) is a group of autoimmune diseases that affects over 11million people worldwide. It causes the immune system to incorrectly attack healthy tissue and cause inflammation of the digestive tract, sometimes to the extent that the bowel can perforate and sepsis can set in.

How does this differ from IBS?

IBS or Irritable Bowel Syndrome causes no damage to the bowel, it is more of a functional disorder that can be remedied by diet and/or stress management.

People with IBD may also have IBS but it’s important to note that they are two separate conditions.

What are the types of IBD?

There are two main types of IBD. Crohn’s and Ulcerative Colitis and due to the use of social media and brave advocates these and many more previously hidden disease are becoming much more familiar and less fearful.

Poo is no longer taboo!

Crohn’s

Inflammation can appear in any part of the digestive tract from the throat to the anus. It is often found sporadically throughout and can have further complications such as fistulas.

Ulcerative Colitis (UC)

Inflammation is limited to the large bowel and is often starting from the rectum and can continue to affect the whole colon. It’s limited to the inner lining whereas Crohn’s can occur in all layers. Due to its continuous nature and location, rectal bleeding is much more common in UC.

Symptoms common to both

• Diarrhea (including bloody stool)/Constipation _{Sometimes at the same time} 
  — If you can imagine that, no stool but loads of blood.
• Bloating/Abdominal pain
  — So much pain, I lived on Fentanyl for months and it took many more months to wean myself off.
• Vomiting/Loss of appetite/Weight Loss
  — I lost 20kgs (44pounds) in a month before getting admitted to hospital and a further 10kgs (22pounds) while in hospital. At my lightest I was 45kg (99 pounds) at 175cm (5’9’).
• Fatigue/Anemia
  — I had to have iron injections and a blood transfusion due to low blood pressure and anaemia.
• Depression/Anxiety
  — This is a huge part of IBD as it’s a hidden disease, not often talked about for obvious reasons, poop is not cool, but since talking more openly about these things my mental health has improved significantly.
• Erythema nodosum
  — Less than 2% of patients present with this, I had one of the worse cases they had ever seen. I couldn’t walk at the age of 29 due to the pain.

How is IBD diagnosed?

In my case, I went in for a colonoscopy. If you haven’t had one before it’s a procedure where they make you eat boring food for days, then drink a gallon of nasty flavoured drink the night before to the point where you end up on the toilet with a bucket in front of you as you throw up while dealing with the other end, all before they partly sedate you and insert a camera into your bum.

This then gets feed through the 1.5meters (5 feet) of the large colon, an uncomfortable feeling as they make their way around the bend, taking bioscopy’s and pictures as they see fit. Lucky for me I only need one of these before my bowel perforated and was taken out for good. But that’s another story.

The other way would be to do an endoscopy which goes in the other end, a similarly unpleasant feeling as you swallow the tube gagging the whole way even after the numbing cream that is supposed to stop it.

The biopsies are then sent off to the labs for diagnoses, it’s important to note that misdiagnosis is still possible at this point, I was diagnosed with both UC and Crohn’s by different doctors, the third one said it was severe UC with Crohn’s tendencies as I also had persistent fistulas.

Bloods can be taken to monitor inflammatory markers once diagnosed but further colonoscopies and endoscopies will be required.

Treatments

There is no current cure for Crohn’s only effective management through medications, the degree these work is completely up to the individual and many can go into remission, however, long-term use of many of these medications is not recommended and re-occurrences are common. While surgery is an option, the likelihood of the joined areas becoming diseased again can be high.

UC can often be successfully managed in the same manner however in severe cases surgery may be required to remove the large bowel and rectum, a proctocolectomy, effectively curing the UC as it has nowhere else to attack. This would effectively make you an Ostomate.

Note that if the large bowel is not removed the chances of bowel cancer are higher, this is in the case of UC and Crohn’s.

After two years and ten surgeries later I succumbed and consented to the removal of my anus, the last connection to my chance at reversal and life without an ostomy bag. If I have agreed to a permanent ostomy first round I would have saved myself from many of these, but mental health plays a hand in these choices and I was not mentally ready to accept that fate. Today life is awesome and well worth living!

So I think that is enough shit talk for today, if you have any questions please don’t hesitate to ask in the comments section or the contact me section for a direct email.