Can You Prevent Inflammatory Bowel Disease?

A young man lies on a sofa, clutching his stomach and forehead and grimacing in pain.

In recognition of World Inflammatory Bowel Disease (IBD) Day, Ashwin Ananthakrishnan, MBBS, MPH, answers patients’ most commonly searched questions about IBD prevention and treatment.

Dr. Ananthakrishnan is a Mass General Brigham gastroenterologist. He treats patients at Massachusetts General Hospital and is an Associate Professor of Medicine at Harvard Medical School. Dr. Ananthakrishnan and other investigators at Mass General’s Center for the Study of Inflammatory Bowel Disease conduct cutting-edge research to identify new treatments and ways to prevent IBD. 

“With effective treatment, IBD can be in remission for years and even decades,” said Dr. Ananthakrishnan. “It’s important to diagnose it early, and get on the right treatment for you early, so that IBD can have as little impact on your life as possible.”

What is inflammatory bowel disease?

IBD commonly consists of two different conditions: Crohn’s disease and ulcerative colitis. These are inflammatory conditions that affect the lining of the intestines. They can cause permanent bowel damage through disease progression. IBD is different from other gastrointestinal conditions like irritable bowel syndrome (IBS). They have similar symptoms, but IBS isn’t caused by inflammation in the bowel and it doesn’t result in permanent damage.

What causes inflammatory bowel disease?

IBD develops due to an inappropriate immune response in the body. Experts believe a change in intestinal bacteria triggers this immune response. Both genetics and factors in the environment can lead to this change.

IBD symptoms and diagnosis

Patients with IBD often have these symptoms:

  • Belly pain
  • Diarrhea
  • Fatigue
  • Rectal bleeding or blood in stools
  • Swelling in the joints
  • Urgency in going to the bathroom
  • Weight loss

If you have symptoms that include weight loss and large amounts of blood in stools, contact your doctor right away. Early diagnosis may help prevent permanent bowel damage. 

IDB prevention and risk factors

There’s no known way to prevent IBD. But there may be things you can do to help reduce your risk. IBD develops due a combination of four factors:

  • Genetics
  • Environment
  • Microbiome of the intestinal tract
  • Immune system

The microbiome consists of microbes, including bacteria and fungi. These microbes reside in our bodies. In the digestive system, the microbiome influences our metabolism, immune system, and other body functions.

“For most people who develop IBD, it’s a mix of several of these factors that then leads to chronic inflammation,” explained Dr. Ananthakrishnan.

It’s possible that these things may increase your chances of having IBD:

  • Antibiotics
  • Foods you eat
  • Poor sleep
  • Stress

How can IBD be prevented?

To help reduce your risk of developing IBD:

  • Avoid processed food and additives.
  • Eat a Mediterranean-style diet rich in fruits and vegetables.
  • Get enough sleep.
  • Limit exposure to antibiotics.
  • Don’t smoke.
  • Reduce stress and anxiety.

Breastfeeding during infancy has been shown to reduce risk of IBD in children. Studies also have shown that people who exercise regularly may have a lower risk of developing IBD.

Treatment options

If you have IBD, there are different treatment options depending on the severity of the disease:

  • For patients with mild inflammation: There are medications to treat the inflammation in the colon and intestine. These include the drug 5-ASA and corticosteroid therapies.
  • For those with moderate to severe disease: There are medications that target the immune system and dampen the overactive immune response that damages the bowel. These medications include immunomodulators (like azathioprine and 6-mercaptopurine) and biologics (like infliximab, adalimumab and certolizumab pegol).

For some patients, surgery to remove damaged bowel tissue is the best option to restore quality of life. 

These treatments can help patients control symptoms and improve their quality of life.

Both Mass General and Brigham and Women’s Hospital have dedicated centers for the treatment of Crohn’s disease and colitis, offering comprehensive, multidisciplinary care for patients with IBD.