Factors that lead to the development of IBD are complex but immune dysregulation, gut dysbiosis, a nutritionally poor diet, environmental factors (such as mould, lead and other toxin exposure), stress, inadequate sleep, and family history are contributing factors.

The symptoms of both UC and CD can be similar and may include abdominal cramps and pain, diarrhoea, constipation, urgency for bowel movements, incomplete bowel evacuation, rectal bleeding, mucus in stools, fever, reduced appetite, weight loss and fatigue.

In both conditions, symptoms follow a pattern of flare and remission, with severity ranging from mild to severe.

Despite sharing these characteristics, Ulcerative Colitis and Crohn’s Disease are different conditions.

Ulcerative Colitis causes swelling and ulcers on the mucosal surface of the lining of the colon and rectum. These ulcers may cause bleeding and discharge mucus or pus. This loss of blood in the stools can lead to Iron Deficiency Anaemia.  UC causes a continuous area of damage along, the large intestine beginning at the anus and spreading upward along the colon, rather than appearing as patches of damage.

Crohn’s Disease causes inflammation in the deeper layers of the mucosal tissue of the intestine and can extend through the entire thickness of the bowel wall. CD can affect several patches along the length of the colon and extend into the small intestine. Inflammation in the small intestine disrupts the proper absorption of nutrients from food and can cause elimination of fats and nutrients due to diarrhoea.

How is IBD diagnosed?

Diagnosis begins with a detailed case history exploration to understand when and how symptoms began, assess the severity of the symptoms and identify factors that exacerbate and alleviate the symptoms.

Tests used to diagnose IBD include:

Blood Tests may be used to detect inflammation, autoimmune antibodies, nutrient deficiencies (eg iron, vitamin B12, vitamin D etc).

Stool Tests for the presence of blood, pathogens or inflammation markers.

Gastroscopy

• Colonoscopy to identify inflammation, bleeding or ulcers in the large intestine.
• Sigmoidoscopy is similar to a colonoscopy but only examines the rectum and lower part of the colon.
• Upper Endoscopy is used to examine the small intestine for inflammation, bleeding or ulceration.

Biopsy: tissue may be removed during a gastroscopy to help differentiate between CD and UC.

Imaging Tests such as X-ray, CT scan or MRI may show inflammation, bleeding or ulcers and are often used to differentiate between UC and CD.

Is IBD different from IBS?

Yes!

Though the symptoms may appear to be the same, IBS and IBD are distinctly different conditions.

Inflammatory Bowel Disease is an immune-mediated disease that causes inflammation and damage to the gastrointestinal tract which can be seen during diagnostic imaging.

Irritable Bowel Syndrome is a syndrome, or group of symptoms, that are not caused by the immune system. They may develop due to food intolerances, microbial infection, family history or mood disorder (anxiety/depression).  There is no apparent inflammation in IBS and it does not cause any visible damage or abnormality to the gastrointestinal tract.

Managing Inflammatory Bowel Disease with AIP

While autoimmune diseases cannot be cured, careful diet, nutritional supplementation and lifestyle planning can help to improve your symptoms, reduce the severity of IBD flares and maintain longer periods of remission.

The Autoimmune Protocol (AIP) is a complementary approach to chronic disease management which focuses on healing the gut to improve immune regulation and reduce the chronic inflammation that causes tissue damage. Trigger foods are eliminated until symptoms resolve and then slowly reintroduced to determine what foods are causing your symptoms. Healing is supported by improving lifestyle factors such as stress reduction, exercise and improved sleep quality.

Recent studies have shown that the AIP diet is an effective adjunct to medical treatment of Inflammatory Bowel Disease. (Clinical Course and Dietary Patterns Among Patients Incorporating the Autoimmune Protocol for Management of Inflammatory Bowel Disease (P12-010-19) | Current Developments in Nutrition | Oxford Academic (oup.com))

You can read more about the AIP here: Healing Autoimmune Disease Naturally | The Nutrition Factor – Vicky Ellenport | Clinical Nutritionist Melbourne

If you have been diagnosed with IBD and would like to know more about the Autoimmune Protocol or how I can help you manage your autoimmune symptoms, book in for a complimentary Discovery Session here: Book Appointment (thenutritionfactor.com.au)

The process of getting an AID diagnosed can be so long, drawn out and frustrating that it is not uncommon for people with AID to be labelled a hypochondriac – a person who fears they are living with a serious, undiagnosed medical condition despite diagnostic tests showing that there is nothing wrong with them – especially in the early stages of illness.

On average, a person will see 5 doctors over the course of several years to finally receive an autoimmune disease diagnosis.

Autoimmune Disease Symptoms

While different autoimmune diseases affect different organs and systems in the body, what they all have in common is that they occur when the body’s immune system mistakenly attacks its own cells.

Autoantibodies are immune proteins that target the body’s own healthy tissue when the immune system fails to distinguish between “self” and “non-self”.

The continual attack on the body’s cells causes inflammation and sufficient tissue damage that symptoms of disease begin to emerge.

People with an autoimmune disease may describe long-term struggles with a wide range of symptoms such as: fatigue, gastrointestinal issues, joint pain, recurring infections, skin problems, allergies, migraines, unexplained weight changes, anxiety/depression, low/high blood pressure and more.

Why does it take so long to get an autoimmune disease diagnosis?

• Common, non-specific symptoms. The symptoms of autoimmune conditions vary widely and are generally non-specific, that is, symptoms that may describe any one of a variety of conditions. In the early stages of the illness people will usually present to their doctor or health professional for help with one, primary complaint (e.g., recurring urinary tract infection or persistent acne or inability to lose weight) and many of the other symptoms they are experiencing do not get mentioned. It is not until the practitioner has a full picture of ALL the symptoms, together with a full health history, that the connection between the symptoms becomes clearer, and that the possibility of an AID may become apparent.
• Remission/flare pattern. It is possible for an AID to enter a period of remission, where a person may have very mild symptoms, or even be asymptomatic, for a period. At this time, for an undiagnosed person, it may seem that the illness has resolved and is all but forgotten about. However, when triggered, AID can enter a flare phase when symptoms return suddenly and severely leaving the sufferer exhausted, depleted and in pain.
• Asymptomatic or slow to develop signs and symptoms. Not all Autoimmune Diseases cause symptoms immediately. It is possible to live with an AID for many years before symptoms become apparent or before an incident occurs that leads to an AID diagnosis. For example, ankylosing spondylitis symptoms may develop very gradually and often goes undiagnosed for several years, before it becomes visible on an x-ray. Likewise, Type 1 diabetes involves a gradual destruction of the pancreatic beta cells and it is only diagnosed once 90% of the cells have been destroyed.
• Co-Conditions. It is possible to have more than one AID, in fact having one AID increases the chances of you developing another. When there is more than one AID present, it is possible for one to mask the other. For example you may have been diagnosed with Rheumatoid Arthritis, but in actual fact you also may have Coeliac Disease, the symptoms of which contribute to joint pain, but remains undiagnosed if there are no other obvious symptoms.
• Every person is different and, with AID affecting a wide variety of organs and causing such varied symptoms, each presentation of each condition can be different. It is possible that two people may be diagnosed with the same condition with very different symptoms. Alternatively, two people with the same symptoms may be affected by different conditions.

Risk Factors for Autoimmune Disease.

Certain risk factors are known to increase the chances of developing an autoimmune disorder. The presence of any one of these risk factors, along with a description of all the symptoms, can help to get closer to an AID diagnosis.

• Genetics. While members of the same family may suffer from different autoimmune conditions, a predisposition to autoimmune disease does appear to run in families.
• Excess weight is associated with increased risk of developing an AID that affects the joints such as Rheumatoid and Psoriatic Arthritis. In addition, adipose tissue, or fat, secretes pro-inflammatory compounds that cause low-grade chronic inflammation and dysregulation of the immune system.
• Smoking. The toxic chemicals that are released when tobacco is burned impacts the immune system by causing inflammation, suppressing immune function, and stimulating the production of autoantibodies.
• Certain medications. The side effects of some pharmaceuticals that are widely used daily can have side effects that involve the immune system and can lead to an autoimmune reaction.
• Infection with a virus, such as Epstein Barr Virus (EBV), or bacteria, such as Streptococcus, can turn on genes that impede the immune system’s ability to differentiate between self and non-self, initiating an autoimmune reaction.

Are there tests for Autoimmune Disease?

There is no single test to diagnose AID but rather a selection of markers in blood or urine samples which, when put together with the presenting symptoms can lead to an AID diagnosis.

• Autoantibodies: The presence of autoantibodies may indicate an autoimmune disease.
  • Antinuclear Antibody (ANA) Test. A high level of these autoantibodies may be used to diagnose a systemic AID such as lupus and may be used to rule out other conditions with similar symptoms
  • Rheumatoid Factor (RF) is used to diagnose Rheumatoid Arthritis (RA). A positive test for RF differentiates RA from osteoarthritis and other connective tissue disorders.
  • Thyroid Antibody test (TPO) is used to diagnose Hashimoto’s or Graves disease in conjunction with other thyroid testing.
• Inflammation Markers: C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) are used to detect the presence of inflammation, a common characteristic symptom of all AID’s.
• X-Rays, Gastroscopes and Biopsies: may be used to confirm or support an AID diagnosis.

Why do you need a diagnosis?

• Many people suffer with symptoms for many years and finally having a diagnosis can be a validation that it was not just in their mind.
• Knowing what is causing your symptoms allows your health practitioner to tailor a treatment plan specific to your needs.
• Having a diagnosis means that your health care team can anticipate, and help to reduce the risk, of disease progression or future complications.
• It helps you educate yourself and gain a better understanding about your condition and how to manage it.
• It reminds you that you are not alone, and that you can reach out and connect with others with the same condition so that you may support one another.

You have been diagnosed with an autoimmune disease, so what now?

Once you receive an AID diagnosis, the treatment approach is up to you. As there is no proven cure for AID, treatment is aimed at improving symptoms and promoting remission.

One option is the conventional medicine approach which prescribes pharmaceutical medications to manage symptoms and induce remission.

The other option is the natural medicine approach which aims to determine the underlying cause of your AID and to tailor a treatment plan to improve your symptoms and reduce the frequency of flare-ups.

As a natural medicine practitioner Vicky works in conjunction with your medical team, using a holistic approach to managing AID that encompasses thorough testing, identification of nutritional deficiencies, lifestyle and dietary recommendations and stress management techniques.

If you have been struggling with a long-term, undiagnosed health issue, or if you have recently been diagnosed with an AID, book in for a complimentary Discovery Session with Vicky to discuss the best options for managing your health.