Inflammatory Bowel Disease (IBD): Frequently Asked Questions
Q: How long will I have IBD? Can I be cured?
A: There is no cure for IBD. Patients will have periods of remission when the disease is not active and periods when the disease is active, also commonly known as flares. The goal of treatment is to reduce the duration and frequency of flares, limit the development of complications and improve quality of life.
Q: Will I have to take medicine for the rest of my life?
A: Because there is no cure for IBD, most patients do need to take medications to ease their symptoms and reduce the number and severity of flare episodes.
Q: Why should I keep taking the medication when I feel good and do not have symptoms?
A: Medications are needed to reduce the number and severity of flares. If you stop taking your medication when you feel well, the chance of developing a future flare increases. Also, the medication you were taking may not work the next time you want to take it due to the formation of antibodies in your system against that medication. It is important that you keep taking the medication as ordered even when you feel well.
Q: If I have surgery, will that cure my disease?
A: No, surgery does not cure the disease. It can be very helpful in reducing symptoms. For patients with ulcerative colitis, removal of the colon will greatly reduce symptoms. For patients with Crohn’s disease, surgery can remove the parts of the intestine that are scarred or are not extremely inflamed. These areas cause many of the symptoms of Crohn’s disease. After surgery, medications often need to be restarted to prevent the disease from coming back and prevent further surgery.
Q: My doctor started me on an immunosuppressant. What does this mean about my ability to fight infection?
A: Some medications for IBD suppress the immune system. Although this can help the IBD get better, it does increase the risk for certain infections. Some viruses stay in your body, like the chicken pox virus, which also causes shingles. The virus may become activated when the immune system is depressed. Some bacterial infections of the respiratory tract, skin and soft tissue are more likely to happen. In addition, certain infections such as tuberculosis (TB) and Hepatitis B can become activated once the immune system is suppressed. Your doctor may screen you for these infections before starting you on a medication. He or she may also recommend you get vaccinated for infections which are preventable, such as influenza and certain types of pneumonia. However, it is important to remember that the risks and complications of IBD are usually greater than the problems with infections.
Q: When I have pain, why can’t I take strong pain pills (narcotics) to feel better?
A: Your doctor may prescribe short-term use of a narcotic pain reliever. Using narcotics long-term for pain from IBD carries risk. Narcotics can slow down the bowel and cause constipation. While this may be seen as a relief for some, it can cause serious problems for others. Other side effects from narcotics include nausea and sedation. Some research has shown a possible association between narcotic use and serious infections. For some patients, the narcotic can actually worsen the abdominal pain.
Q: Can I get pregnant and have a normal delivery?
A: In general, most women with IBD can get pregnant and deliver a healthy infant. However, it is best to begin a pregnancy when the IBD is in remission. If a woman becomes pregnant during a flare, disease-related symptoms can increase and complication rates for the infant and mother are higher. Many medications can and should be continued during pregnancy and during breastfeeding.
Q: What is the risk of getting colon cancer because of my IBD?
A: Patients that have had colitis, either ulcerative colitis or Crohn’s disease of the colon (also called Crohn’s colitis) for many years and have one third or more of their colon involved are at a higher risk for getting colon cancer compared to the general population. Other factors that increase the risk of colon cancer in patients with IBD include:
- Family history of colon or rectal cancer
- Developing IBD at a younger age
- Patients with long periods of active disease
- Patients with an inflammatory condition of the bile ducts, called primary sclerosis cholangitis (PSC)
Q: How often should I have a colonoscopy?
A: Initially after being diagnosed with IBD, your doctor may order a colonoscopy to see if you are responding to treatment and/or to see if your disease is changing in any way, like a change in severity or in the disease location. After you have had the disease for 8-10 years, your doctor may recommend you start undergoing colonoscopies every two years even if your disease is well controlled to look for pre-cancer and cancer of the colon. Several factors influence whether you will need colonoscopies every two years or if they can be done less frequently. Contact your doctor for more details about the frequency of your colonoscopy.