What is IBD, and what causes it? Inflammatory bowel disease (IBD) refers to diseases that involve chronic inflammation of tissues in the digestive tract. This article looks at the relationship between inflammation, both types of IBD, and Laboratory Markers (CRP) utilized in monitoring IBD.

What Are The Types Of IBD?

Ulcerative colitis is one type of IBD. This condition causes inflammation and sores (ulcers) in your large intestine (colon) and rectum's lining. Crohn's disease, the other type of IBD that involves inflammation of the gut mucosa, which can extend into the deeper layers of the digestive tract.

The symptoms of Ulcerative Colitis and Crohn's disease typically include diarrhea, rectal bleeding, abdominal pain, fatigue, and weight loss. While IBD is only a mild illness for some people, others experience such debilitating conditions that life-threatening complications could occur.

What Is Inflammation?

Regarding the inflammatory response, when your body is met with an infection or a foreign invader-like bacteria, it will immediately activate the immune system. The deployed cells are referred to as first responders and include inflammatory cells and cytokines.

These cells respond to infection by releasing chemicals that attract bacteria and other pathogens or start the healing process. Pain, swelling, bruising, or redness are all possible results. Inflammation has effects outside of your vision.

The common types of inflammation:

  • Acute inflammation is the body's reaction to a sudden injury. Your body utilizes inflammatory cells to heal.
  • Chronic inflammation is when your body produces inflammatory cells even when there is no outside danger. For example, in rheumatoid arthritis, these cells and substances attack joint tissues, causing inflammation that comes and goes. This can lead to severe damage to joints, including pain and deformities.

What Are Laboratory Markers or CRP?

Lab markers have been studied in inflammatory bowel disease (IBD) for diagnostic and differential diagnostic purposes, as well as disease activity and risk of complications, prediction of relapse, and monitoring of the effect of therapy. Given their potential to identify responders to these medicines, renewed interest has emerged in inflammatory biomarkers (particularly C reactive protein (CRP)) following the introduction of biological therapies in IBD.

The most researched laboratory marker, CRP, has the best overall performance and is highly effective. In Crohn's disease (CD), CRP is an objective inflammation indicator that corresponds well with disease activity. Although CRP levels are associated with better response rates in clinical trials that use biologics, and normal CRP levels can predict high placebo response rates, CRP is still far from being an ideal marker. Additionally, the correlation between CRP and disease activity is weaker in patients with Ulcerative Colitis than in those with Crohn's disease.

Based on promising results, fecal markers may be more successful in detecting gut inflammation for patients who have established IBD. Fecal calprotectin has had success rates in Crohn's disease and Ulcerative Colitis cases. Newer data indicates that the fecal calprotectin test performs better with ulcerative colitis patients than with Crohn's Disease.

In short, laboratory markers are beneficial and should be part of the general care plan for IBD patients. They aren't miraculous, though, and until more data is collected, CRP and other laboratory markers should be supplemental to patient observation and physical examination rather than a replacement. So, how do they help?

According to IBD, the disease course is variable, and Crohn's Disease and ulcerative colitis are both characterized by periods of remission interrupted by flares. Flares occur randomly and often unexpectedly. However, if a relapse could be predicted reliably, patients could try to avoid or treat them with early and more aggressive therapies.

In summary, multiple laboratory markers have been investigated in IBD, though none of them have managed to beat our current diagnostic tools. CRP might not be perfect, but it should still be the go-to marker for Crohn's Disease since its activity corresponds well with the disease. However, the situation is different for ulcerative colitis, as CRP correlates less well with disease activity when compared to Crohn's Disease.

Fecal calprotectin is a practical, non-invasive stool marker that can help detect gut inflammation. Erythrocyte sedimentation rate (ESR) provides reliable information about disease activity. Their longer half-life and interference with other factors make them less useful in clinical practice than CRP. In conclusion, laboratory markers are helpful and should be integrated into the overall management of IBD patients.

When Should You See A Gastroenterologist For IBD?

Those with chronic illnesses, such as inflammatory bowel disease (IBD), require frequent interactions with healthcare providers and other caretakers. Chronic diseases, on the other hand, are permanent. A chronically ill person's health will fluctuate, and it's not always clear how "down" one needs to be before seeking medical help.

Below are a few signs and symptoms, other than the regular ones, that should prompt you to call the gastroenterologist. However, if there are any new symptoms related to IBD or things generally seem to be worsening, always consult a healthcare provider.

  • Spiking a Fever
  • Losing Weight
  • Excessive Bleeding
  • Dizziness or a Rapid Heartbeat
  • Signs of Dehydration
  • Severe Abdominal Pain

Needham Gastroenterology Associates Can Help With IBD

Needham Gastroenterology Associate professionals are here to help when diagnosed with either type of IBD. We encourage you to contact us and set up an appointment for screening, diagnosis, and treatment. Remember your gut health affects more than just your digestion and to live a healthy life it can begin in the bowls.