Understanding Inflammatory Bowel Disease (IBD): Symptoms, Causes, and Treatment Options with Dr. Natalie Scheeler
0:15 Who is Dr. Natalie Scheeler
3:00 What is inflammatory bowel disease (IBD)?
3:50 How common is IBD?
4:45 What are the main symptoms of IBD?
5:15 What is the difference between IBS and IBD?
6:35 What are the risk factors for IBD?
7:20 What is the effect of smoking on ulcerative colitis?
8:30 How does fiber effect the risk for IBD?
9:10 How do antibiotics effect the risk for IBD?
10:23 What are the scoring systems for IBD?
13:35 What are the stages of treatment for IBD?
19:35 What are the treatment for IBD?
21:55 What diets are useful for IBD?
25:45 What Dr. Scheeler does in addition to a gastroenterologist?
27:34 What is the role of colonoscopy in IBD?
In this interview, we introduce the newest member of the modrn med team: Dr. Natalie Scheeler.
Dr. Scheeler is a Naturopathic Medical Doctor who specializes in integrative treatments of gastrointestinal conditions and has a special interest in inflammatory bowel disease.
Notes from this interview:
What is inflammatory bowel disease (IBD)?
Inflammatory bowel disease (IBD) is an umbrella term for three conditions: ulcerative colitis, Crohn's disease, and indeterminate colitis. These conditions are characterized by chronic inflammation in the digestive tract, with ulcerative colitis showing inflammation in the large intestine, and Crohn's disease showing inflammation anywhere throughout the digestive tract. Indeterminate colitis is diagnosed when there are features of overlap between UC and CD, and it is not clear which form of IBD it is. Both conditions typically present with frequent, urgent diarrhea, blood in the stool, mucus full stools, and can have abdominal pain and extra-abdominal symptoms like fever, weight loss, low appetite, joint pain, inflammation of eyes (uveitis), and rashes.
What causes IBD?
The exact cause of IBD is unknown, but complex interactions between genetics, environmental factors, and the immune system can lead to abnormal immune responses triggering chronic intestinal inflammation. Environmental factors include diet and microbiome, smoking, infection, stress, and air pollution.
Smoking is protective for ulcerative colitis but a risk factor for Crohn's disease.
Sometimes the trigger is clear for patients, while other times it is not.
IBD is a lifelong condition with no known cure, and the goal is to control symptoms and inflammation levels.
IBD can lead to complications such as strictures, fistulas, infections, and cancer.
North America and China have the highest number of cases, with North America having the highest prevalence (422.0 cases per 100,000). Previously considered a disease of the Western world, the incidence of IBD is growing in newly industrialized countries in the Middle East, Asia, and South America, supporting the idea that environmental factors may play a role with the immune system and genetics.
5 Stages of treatment for IBD
Dr. Scheeler uses five stages of treatment for IBD:
Ensuring the patient is safe in an outpatient setting
Resolving symptoms of IBD (controlling diarrhea, no blood in the stool etc)
In this stage inflammatory markers (calprotectin, SED rate, CRP) are all in a normal level.
Someone is in histologic remission when they get a colonoscopy and no active inflammation can be seen.
The final step is maintenance and running biomarkers every 3-6 months or so, to try to catch a flare before it occurs, often times fecal calprotectin can rise well before symptoms.
Treatment options for IBD
Current treatments for IBD include 5-ASA drugs, steroids (prednisone, budesonide), biologic medications (remicade etc). The drug choice is based on disease severity, disease location, and drug response.
Integrative options for treatment include reducing inflammation with anti-inflammatory herbs like artemisia absinthium, or wormwood, which has been shown to reduce TNF-alpha, an inflammatory cytokine that many IBD drugs target.
Fecal microbiota transplant for the treatment of IBD
The microbiome is also important for the development and regulation of the immune system, and fecal microbiota transplantation (FMT) is a promising treatment option for IBD.
Visit the link below to become a patient of Dr. Natalie Scheeler:
We are going to discuss FMT in greater depth in future videos, makes sure you are following us on social media to get notified: