Inflammatory bowel disease: let’s talk about it!

Inflammatory bowel disease is the result of an over-reaction of the intestinal immune system. It include two pathologies:

These pathologies are diagnosed early, since they generally appear between the ages of 15 and 30, and in 80% of cases before the age of 25 in the case of Crohn's disease. Worryingly, these diseases have been on the increase for the last 40 years.

There are several factors to consider in this phenomenon, although the exact causes remain unclear. In addition to a genetic, but not hereditary, predisposition, diet, which plays an essential role in the composition of the intestinal microbiome, and behavioural factors such as smoking, and environmental factors (pollution, etc.) could explain the surge in cases.

IBD is also a major risk factor in the development of colorectal cancer, or cancer of the colon. A person suffering from IBD is 2 to 2.5 times more likely to contract this type of cancer after 10 years. This risk is multiplied by 5 after 30 years of IBD progression. This higher risk is determined by a series of factors such as the severity of the inflammation, the length of time the inflammation has accumulated in the past, and the patient's age.

Imagine a nasty stomach bug that goes on and on. In other words, you get:

In addition to intestinal manifestations, IBD sufferers may also experience symptoms such as mouth ulcers, skin lesions and ophthalmological lesions. While most of these symptoms are invisible from the outside, they have an extremely harmful impact, severely affecting patients' daily lives.

There is no cure for inflammatory bowel disease. However, the aim of treatment is to reduce symptoms by maintaining long periods of remission, and to prevent future inflammation. Patients are treated with medication. Surgery is used only as a last resort, and in the most extreme cases an external pouch may be inserted.

Research has established links between intestinal flora imbalance and the development of inflammatory diseases. The effects of restoring the intestinal flora in patients is one of the avenues being explored by researchers. The role of probiotics in rebalancing the intestinal microbiota is also being explored.

Diet plays a fundamental role in intestinal health. While no study has been able to demonstrate the efficacy of a particular anti-inflammatory diet, studies tend to show that a Mediterranean-style plant-based diet is beneficial in both preventing and managing IBD. In addition to this, each patient's condition must be taken into account, so that the diet can be adapted to meet specific needs. Indeed, during certain periods of the disease, whether in remission or during inflammatory flare-ups, a very specific diet may be prescribed. Specialist advice is therefore essential.
 

Generally speaking, it's important to eat a varied and balanced diet. Ultra-processed foods should be avoided at all costs. Fresh, minimally processed foods should be preferred, and avoid products that are too fatty, too salty or too sweet. It's also preferable to eat fish and other seafood rich in omega-3s, as well as white meat, reducing your consumption of red meat to once or twice a week. Cooking with less fat, such as steaming or baking, and opting for vegetable proteins are also good ways to go. Caffeine and spicy foods are not recommended, as they could aggravate IBD symptoms. Finally, hydration must be optimal at all times, especially for people with diarrhoea. Tobacco and alcohol should be avoided.

The main aim of diet is to reduce inflammation, and therefore symptoms, while preserving the necessary nutrients. There's no point in restricting yourself without knowing exactly what your needs are in agreement with your health professionals. Every patient is different and requires a dietary programme tailored to his or her situation. However, it is vital that eating remains a pleasure despite the illness.