IBD Treatment in Indore

What Is Inflammatory Bowel Disease?

Inflammatory bowel disease (IBD) is a collection of chronic diseases characterized by the immune system’s ongoing attack on the digestive tract, leading to chronic inflammation. Inflammation injures the lining of the intestine, creates ulcers, and disrupts the process of digesting and absorbing food. IBD is not contagious and cannot be passed from one person to another. It is also not the same thing as irritable bowel syndrome, in which the bowel appears normal.

There are two major forms of IBD . Ulcerative colitis only affects the colon and rectum . Crohn ‘s disease can affect any part of the digestive tract . A smaller group of patients have features of both, and are labeled as IBD-unclassified. On this website there is a page for each form but this page covers the general features, how IBD is investigated and how long term care is planned.

IBD often starts in young adulthood, between the ages of 15 and 35, but it can also occur in childhood and in people over 60. It tends to follow cycles of flare-ups, when symptoms are active, and remission, when the disease is quiet. Diagnosis & Long Term Supervision of IBD by Dr. Kriti Bansal to keep the patients in remission and to protect the bowel from damage. looking for IBD treatment in Indore will first be diagnosed to confirm what type of IBD do they have.

Symptoms of IBD

Features of IBD depend on the location of the inflammation in the bowel and the activity of the disease. The following are the most common.

• Persistent diarrhea: The commonest symptom is loose stools for more than four weeks, sometimes ten or more times a day.
• Blood and mucus in stool: If you notice blood, jelly-like mucus or pus in your stool, it may be a sign of inflammation of the lining of your colon.
• Abdominal pain and cramps: Pain may be felt in the lower right abdomen, the left side or all over, often before passing stool.
• Urgency and tenesmus: A sudden, strong urge to go and a feeling that you cannot completely empty your bowels.
• Weight loss and poor appetite: Weight loss may be the result of ongoing inflammation, reduced food intake and poor absorption, and in children poor growth and delayed puberty.
• Fatigue and fever: Tiredness is one of the most troublesome complaints, and there is a mild fever during flare-ups.
• Anemia: Blood loss, poor absorption of iron and inflammation lower the level of hemoglobin.
• Other features outside the gut: IBD can be associated with joint pain and stiffness, mouth ulcers, painful or red eyes, and skin conditions like painful nodules on the shins and occasionally these come before bowel symptoms.

Causes and Risk Factors of IBD

The exact cause of IBD is still not completely understood. The current thinking is that it develops in a genetically susceptible person, whose immune system reacts abnormally to bacteria living in the gut, perhaps triggered by an environmental factor.

• Immune system: In IBD immune cells mistake harmless gut bacteria or food particles for harmful and initiate an inflammatory response that continues.
• Genetics: Having a parent, brother or sister with IBD increases your risk many-fold, but most people with IBD do not have a family history.
• Gut microbiome: IBD patients often have less diversity in the bacteria in their gut.
• Environment: Urbanization, processed foods, low fiber intake, reduced exposure to infections in early life and pollution have been associated with increasing number of cases in India.
• Smoking: Smoking increases the risk and severity of Crohn’s disease. Interestingly, it is more prevalent in ex-smokers in ulcerative colitis.
• Medicines: In some people, the regular use of antibiotics and anti-inflammatory painkillers over the long term can sometimes cause or worsen flares.

Stress and diet don’t cause IBD, but they can affect how a person feels during the disease.

Complications of Untreated IBD

Uncontrolled inflammation can cause permanent damage. Complications include severe bleeding, narrowing of the bowel (strictures), abnormal connections between the bowel and nearby organs or skin (fistulas), abscess formation and a dangerous widening of the colon called toxic megacolon . A long-standing inflammation of the colon predisposes to colorectal cancer and therefore periodic colonoscopy is advised after 8–10 years of disease.

Common nutritional deficiencies include iron, vitamin B12, folate, calcium and vitamin D which can lead to anemia and thinning of bones. Children can be stunted in their growth. The joint, liver and eye may also develop problems. The best way to prevent these outcomes is to treat early and consistently.

How IBD is Diagnosed

There is no one test for IBD. Diagnosis is made by a combination of symptoms, examination, laboratory results, endoscopy and imaging, as well as by excluding conditions that mimic it, particularly infections and intestinal tuberculosis which is common in India. These results are collected by a specialist of inflammatory bowel disease in Indore before starting any treatment.

• Blood tests: Hemoglobin, white cell count, platelets, CRP and ESR, albumin, iron, vitamin B12 and vitamin D levels give information on inflammation and nutritional status.
• Stool tests: Stool culture and parasite checks can exclude infection and fecal calprotectin is a sensitive marker of bowel inflammation and helps to monitor treatment response.
• Colonoscopy with biopsies: The doctor looks at the lining of the colon and the very end of the small intestine and takes small samples of tissue. Appearance and biopsy pattern help to distinguish ulcerative colitis, Crohn’s disease and infection.
• Imaging: CT enterography, MR enterography or small intestine ultrasound allows visualization of the small intestine and any complications such as strictures or fistulas. In selected cases, capsule endoscopy may be used.
• Tuberculosis screening: Chest X-ray, Mantoux or interferon-gamma test and tissue testing are performed before starting immune-modifying treatment.

Treatment for IBD

IBD is a long term disease, and treatment is planned over years. The aims are to reduce inflammation, relieve symptoms, repair the lining of the bowel, avoid dependence on steroids and prevent complications. The treatment plan for inflammatory bowel disease in Indore is designed to be followed over years with regular reviews to ensure that the disease remains in remission.

Anti-inflammatory medications

Aminosalicylates like mesalamine are commonly used in ulcerative colitis and mild disease; They work on the surface of the bowel and can be bought as tablets, granules, enemas, and suppositories.

Steroids – Corticosteroids

Flare-ups are controlled very quickly by steroids, such as prednisolone or budesonide. They are used for short periods and slowly tapered, and not as maintenance treatment, because of unwanted effects with prolonged use, including weight gain, bone thinning, raised blood sugar and mood changes.

Immunomodulators

Azathioprine, 6-mercaptopurine and methotrexate calm down the immune system over weeks to months and help maintain remission. You need regular blood counts and liver tests while you are taking them.

Targeted and biologic therapies

These are biologic drugs that target specific inflammatory proteins, like anti-TNF agents, vedolizumab and ustekinumab, and are used for moderate to severe disease or when other medicines fail. Oral targeted treatments (tofacitinib and novel agents) are options in selected patients. Before starting these medicines, it is mandatory to screen for tuberculosis and hepatitis B and update vaccinations.

Supplements & Nutrition

When low replaces iron, vitamin B12, vitamin D, calcium and folate. In some cases, especially in children, remission occurs with exclusive enteral nutrition. Dietary advice is individualized with the main aim of maintaining weight and protein intake.

Surgical Management

Surgery may be needed for complications such as strictures, abscesses, perforation, severe bleeding, or disease that does not respond to medications. In ulcerative colitis, the disease can be eliminated from the colon by removing the colon, but it is only considered when other options are not suitable.

Long-term Care and Monitoring

The key to good IBD care is regular review. Symptoms alone do not always indicate how active the disease is, so the doctor monitors blood markers, fecal calprotectin and, at intervals, colonoscopy or imaging to ensure that the bowel has really healed. When symptoms improve, medicines should never be stopped on one’s own as this is a common cause of relapse.

Vaccinations for influenza, pneumococcus, hepatitis B etc. are recommended, preferably before the immune suppressing medicines are started. Bone health should be checked and women planning pregnancy should discuss this prior to conception as keeping the disease in remission prior to conception leads to better outcomes for both mother and baby. Eye, skin and joint symptoms should be discussed at every visit.

Diet, Lifestyle and Emotional Wellbeing

No single diet will work for everyone with IBD. Soft foods with a low residue in small amounts may be more comfortable during a flare. A varied diet with fruits, vegetables, whole grains, lean protein, and adequate hydration is encouraged during remission. A food journal can help identify personal triggers. Patients with strictures might be advised to avoid foods high in fiber and difficult to digest.

Especially for Crohn’s disease, quitting smoking is important. Regular physical activity, enough sleep and stress management support good overall health. Living with a long-term condition can make you anxious and lower your mood. It is important to share these feelings with your doctor, family or a support group.

IBD in Children, Teens, and Older Adults

The picture of IBD in children and teenagers may be different from that in adults. A child may have poor weight gain, slow height growth, delayed puberty, recurrent fever or persistent tiredness instead of obvious diarrhea. Children’s bones and bodies continue to grow, so nutrition and growth are carefully watched and treatment is planned so children can grow normally. Another choice is exclusive enteral nutrition, a liquid formula diet given over several weeks, which can induce remission without steroids.

In older adults IBD may be confused with diverticular disease, reduced blood supply to the bowel or infection. Other illnesses and medicines are considered in treatment decisions. Screening for infections before immune-modifying therapy is even more important in this age group.

IBD and Intestinal Tuberculosis: Why the Distinction Matters

In India, intestinal tuberculosis is a common mimic of Crohn’s disease. Both cause abdominal pain, weight loss, diarrhea and ulcers in the ilium and caecum. The treatments are pretty different. Tuberculosis needs a long course of anti-tubercular medicines while Crohn’s disease needs anti-inflammatory and immune-modifying therapy which can actually worsen tuberculosis. In a patient with undiagnosed tuberculosis, initiating steroids or biologics can pose a risk.

The doctor will look at the pattern of ulcers on colonoscopy, biopsy findings, imaging, chest studies, blood tests and sometimes a trial of anti-tubercular therapy with close follow-up to arrive at a firm conclusion. Such a careful approach avoids delay or wrong treatment.

Frequently Overlooked Parts of IBD Care

Parts of IBD Care That Often Get Missed

• Bone health: The use of steroids and inflammation weaken bones so calcium, vitamin D and bone density scans are considered.
• Mental health: Patients with chronic illness have higher rates of anxiety and depression, and treatment can help patients to cope with the disease.
• Skin and eye checks: Treat red eyes or painful skin nodules early to avoid lasting problems.
• Travel and infection planning: People taking immune-suppressing medicines are more vulnerable to infection so it is useful to give advice about vaccines and food hygiene before travel.
• Work and school: Letters and understanding from the doctor can help patients set up flexible schedules during flares.

Why Choose Dr. Kriti Bansal

“IBD is a long-term partnership,” Dr. Kriti Bansal says. She establishes a treatment goal with the patient, monitors it using symptoms, blood markers and endoscopy, and modifies the plan before a flare becomes an emergency.

Getting the diagnosis right is a major part of care in India because IBD, intestinal tuberculosis and infections look alike. Here she takes great care that patients receive the treatment their disease truly needs.
Her consultations are for the things that patients have to look for themselves otherwise – diet, vaccinations, pregnancy planning, bone health and what to expect from each medicine. This means easy and continuous follow-up for the one who is looking for an IBD doctor in Indore.

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Phone: +91-7610102710

Email: drkritigastro@gmail.com