Questions & Answers

25.

I have heard that patients with colitis have a greater risk of developing bowel cancer. What can I do to prevent this?

The extra risk associated with long standing colitis is small, but recognised. It is usually related to how long you have had IBD for and how severe it has been. Bowel cancer in people who do not have colitis is becoming more widespread and probably has a genetic link.

Regular visits to the doctor for disease follow up; making sure that you take your medication regularly; and attending a regular colonoscopy examination are the most effective ways to reduce the risk. Research has shown that some of the medications used for treating IBD can reduce the risk of bowel cancer by up to 75%.

For more detailed information see the leaflet on 'Colorectal cancer and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

26.

How can I tell the difference between my colitis symptoms and cancer symptoms?

You cannot usually tell the difference between the two. If you are worried that your symptoms are related to cancer, then consult your doctor at once.

For more detailed information see the leaflet on Colorectal cancer and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

27.

My colitis has not responded to medication and I am now thinking of having my bowel removed. I have read about a 'pouch' operation which means you don't need a 'bag'. Can you tell me more about this?

A pouch operation (or ileal anal anastamosis) involves the removal of the colon and formation of a reservoir (or artificial rectum) out of loops of the small intestine. It is usually performed as a two-stage operation, during which a temporary ileostomy or 'bag' is formed to reduce the risk of pelvic infection, particularly in cases of severe disease. Pouch operations can also be performed in a single stage.

Bowel frequency may not be reduced significantly but medications can be taken to thicken the stools and give greater control.

For more detailed information see the leaflet on 'Surgery and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

28.

I have just had an operation to remove part of my bowel due to Crohn's disease. Why do I need to keep taking my medication?

It is important to keep taking medication after surgery to reduce the risk of a post-operative relapse. IBD can return fairly soon after surgery even though you may not have any visible symptoms. Surgery does not provide a cure but is sometimes necessary to remove the worst parts of the disease. The medication needs to be continued in order to keep the disease dampened down.

For more detailed information see the leaflet on 'Surgery and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

29.

I have been getting painful and stiff joints lately - is this related to my IBD?

Yes, it could be related to your IBD. Painful and stiff joints are symptoms of arthritis, which can be associated with IBD (particularly with types of IBD that affect the large intestine). Around 30% of IBD patients are affected by arthritis, mainly when the disease is active; the arthritis then improves when the bowel is treated. Arthritis often occurs at the same time as other non-intestinal symptoms of IBD. Talk to your doctor or IBD nurse for further advice.

Although joints may become swollen, stiff and painful, destruction of the joints does not usually occur as may happen with other forms of arthritis. A combination of painkillers, gentle exercise and rest will usually provide some relief. Ice packs can relieve the swelling but sometimes steroid injections may be needed. You should generally avoid using regular anti-arthritis drugs, as these can make your IBD worse. Your doctor will be able to advise you about appropriate treatment.

For more detailed information see the leaflets on 'Extra intestinal manifestations of IBD' and 'Complications'.

Don't worry if you haven't got these leaflets - just click here to find out how you can order it or read a summary online.

30.

Can other parts of the body be affected by IBD?

Parts of the body other than the intestine can also be affected by IBD, for example the eyes, joints, skin and liver. Gallstones may form in the gall bladder and kidney stones can form in the kidneys. Some of these effects may be related to periods of disease activity and will therefore improve once the bowel symptoms are treated.

For more detailed information see the leaflet on 'Extra-intestinal manifestations of IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

31.

I have Crohn's disease affecting the anus and have just developed a fistula that goes to the vagina. Is it safe for me to have sex or is it likely to cause any damage?

One of the complications of Crohn's disease is the development of fistulae or abnormal tracts that connect one part of the intestine to another or adjacent structures, such as the vagina. Although these can often be difficult to manage it is possible to carry on with a normal sex life, as long as you do not experience any pain.

It is also normal for there to be some discharge from the fistula. Indeed, problems such as abscess formation can develop if it becomes blocked. However, if this causes concern, you might like to use a condom.

For more detailed information see the leaflets on 'Sexual health and IBD' and 'Complications'.

Don't worry if you haven't got these leaflets - just click here to find out how you can order them or read a summary online.

32.

I have IBD and have needed steroids in the past to control my disease. I am now getting worried about osteoporosis. How will I know if I have got it and how can I prevent it?

Both active IBD and repeated doses of steroids (or simply the need for long-term steroid treatment) can increase the risk of osteoporosis and the subsequent risk of fractures. If you are taking continuous doses of steroids you might need to take additional treatment to minimise the risk of developing osteoporosis. Your doctor will be able to prescribe you with an appropriate bone-strengthening drug and can arrange for you to have a bone density scan, to check for evidence of bone thinning.

Diet, regular exercise (particularly weight bearing) and in the case of postmenopausal women, HRT (hormone replacement therapy) can all help in preventing excessive bone loss.

For more detailed information see the leaflet on 'Osteoporosis and IBD'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

33.

My child's teacher doesn't understand what IBD is. How should I explain it?

Although IBD is increasing, it is still relatively uncommon and the teacher may be unfamiliar with the distressing symptoms of the condition, or even feel that your child is being deliberately disruptive.

It will be helpful to get a letter from your doctor or IBD nurse listing some of the common effects of IBD and explaining that on occasions your son or daughter may need to leave the classroom frequently to use the toilet. The patient support group National Association for Colitis and Crohn's disease (NACC) has produced a helpful leaflet for teachers, which you may wish to obtain for your child's teacher.

For more detailed information see the leaflet on 'IBD in children and adolescents'.

Don't worry if you haven't got this leaflet - just click here to find out how you can order it or read a summary online.

34.

Can exercise help control my IBD?

Exercise itself cannot control IBD, but it is essential to keep fit in order to be able to cope better with future flare-ups. Although you may not always feel like exercising, it can often improve energy levels and help to relieve the depression sometimes associated with IBD. Exercising doesn't have to be strenuous and doesn't necessarily mean regular trips to the gym. Walking or cycling instead of using the car, or using the stairs rather than the lift, are good ways of getting some exercise.

Although most exercises are suitable for people with IBD, you should consult your doctor or IBD nurse before embarking on any serious exercise programme, as there may be some important considerations.

For more detailed information see the leaflets on 'Sport, exercise and IBD' and 'Osteoporosis and IBD'.

Don't worry if you haven't got these leaflets - just click here to find out how you can order them or read a summary online.