Inflammatory Bowel Disease
Introduction
Inflammatory Bowel Disease (IBD) is a relatively common condition affecting both cats and dogs, involving inflammation of the small (duodenum) or large (colon) intestine leading to chronic diarrhoea and occasionally vomiting. The condition is sometimes known by more technical names, which include lymphocytic-plasmacytic enteritis, eosinophilic enteritis or granulomatous enterocolitis. The underlying causes are not known, but are likely to involve problems with the immune system, genetic factors, viral, bacterial or parasitic infections as well as problems with allergic reactions to individual food ingredients. The condition sometimes occurs where there are concurrent liver or pancreatic problems, particularly pancreatitis.
Signs & Symptoms
The signs and symptoms are fairly easy to spot, but are not exclusive to IBD and may be seen in a variety of other conditions. The symptoms of IBD may come and go and can vary in severity. However, in a fair proportion of animals, the symptoms do not abate and are present more or less, every day. In such cases, affected animals can become debilitated, lose weight and often appear miserable. Common signs to look out for include:
- Chronic or recurrent diarrhoea often with loose, watery stools
- Odd coloured stools, often mustard yellow in colour
- Mucus coated or slimy stools
- Blood coated stools, usually with fresh looking, bright red streaks of blood
- Straining (tenesmus) or spasms of the bowel
- Gurgling noises from the abdomen
- Gas production and distension of the bowel or abdomen
- Abdominal pain which may cause the back to arch (colic) or lead to abnormal behaviour
- Vomiting, sometimes blood tinged
- Weight loss
- Lethargy
- Increased or loss of appetite
Diagnosing IBD
If you think that your dog or cat has IBD, then you should consult your vet. The clinical signs and history alone may well be enough to arrive at a definite diagnosis. However, there are a few other conditions which present similar symptoms to IBD. These include:
- Intestinal parasites
- Colitis and diarrhoea(due to reactions to food, bacterial infection and parasites)
- Food intolerances or allergies
- Pancreatic disease, specifically pancreatitis
- Small intestinal bacterial overgrowth (SIBO)
- Malabsorption syndrome
- Bowel cancer
To help rule out these conditions, a variety of other procedures may be carried out. These may include X-rays, blood tests, analysis of stool samples and endoscopy. However the definitive and most accurate way of diagnosing the condition is to by taking a biopsy section of the wall of the bowel and looking at it under a microscope.
Treating IBD
Dietary measures
In most cases, treating this condition involves altering the diet and the use of additional supplements where appropriate. The main dietary measures involve:
- Feeding hypoallergenic diets, particularly avoiding wheat gluten. This reduces the level of antigenic triggers which may underlie the illness triggering bouts of IBD
- Increasing the fibre content of the diet to provide more bulk. This can be done by using specialised diets or by adding fibre in the form of oat or what bran to the food. A plant based bulking agent based on psyllium husk, also known as ispaghula, is another alternative to consider and stocked by many vets
- A moderate reduction in the amount of fat in the diet
Conventional drug treatment
Steroids are commonly prescribed to reduce inflammation and to control the symptoms. Large doses are often employed in the beginning and when the symptoms are under control the dose is then reduced. In some cases, long-term steroid use is required to control the disease. In cases where steroids do not seem to help, other immunosuppressive drugs are used such as azathioprine. Antibiotics are also commonly used. These include metronidazole, oxytetracycline and tylosin. Where vomiting is frequent symptom, antacids are useful in easing the symptoms.
Complementary therapies
There are a number of alternative approaches which can help.
Herbal Medicine
Herbal or plant based medicine is commonly used as a gentle and effective way of treating this condition providing it is not too severe. Herbs that are frequently used include:
- Agrimony and Bayberry, both astringents, which firm up the bowel contents and which help stop bleeding
- Marshmallow root and Slippery Elm bark, which soothe and protect the bowel lining thereby reducing inflammation
- Meadowsweet and Chamomile, which are anti-inflammatory. Chamomile also helps by reducing gas and can help with pain relief
- Barberry (Berberis vulgaris), which has antibacterial effects
- Peppermint, which helps with gas and is soothing to the bowel lining
- Valerian or Crampbark to reduce spasm and pain and to ease colic
- Garlic to minimise the growth of unwanted gut bacteria and to support the gut friendly bacteria
Supplements
Probiotics are often very useful in dealing with this condition. The role of “bad” or inappropriate bacteria in the gut which appear to trigger allergic responses on the surface of the gut has been highlighted as a factor in triggering and perpetuating the condition.
It would therefore seem sensible to both stabilise and support the good bacteria within the bowel which effectively can crowd out the bad bacteria and create an environment which is unfavourable for their survival.
Friendly gut bacteria also support the immune system and, in addition, enhance the ability of the bowel to digest and absorb food. Before using any probiotic however, it is best to check with your vet, as probiotics may not be suitable to use where severe pancreatitis is an additional problem.
Other supplements are also used, usually under the guidance of a vet specialising in complementary medicine. The amino acid L-Glutamine is sometimes used to help restore and repair the lining of the bowel as is a related supplement, N-acetyl glucosamine.
Homeopathic remedies
Homeopathic remedies can also used to help with more minor cases. Sulphur, Pulsatilla, Thuja or Mercury will sometimes help, but in reality, referral to a homeopathic vet is usually the best course of action, as this type of treatment is best tailored to the patient as an individual.
Flower Essences
Working from a behaviour perspective, flower essences can help by addressing some of the emotional issues which can underlie bouts of IBD by reducing stress and anxiety in particular.
How Denes can help
- Herbal Remedies
Denes Respiratory Support (Garlic Oil) Capsules, can be used to help support the health of the bowel by encouraging the growth of good (friendly) bacteria and by restricting the growth of potentially harmful bacteria.
- Supplements
Denes Gut Health Probiotic Powder and a prebiotic to help relieve the symptoms of IBD.
Denes Digestion Powder is another supplement that has proved beneficial. Based on Agrimony, Ginger, Slippery elm, Marshmallow root, Peppermint, Liquorice root and Kaolin (an absorbent clay), it has proved useful in controlling some of the signs of the illness in more minor cases.
Where anxiety or stress are underlying features or where colic is often a problem, Denes Tranquil & Calm Powder (based on the herbs Valerian, Skullcap and Vervain) can help by gently calming the patient and by easing any pain resulting from spasms of the bowel.
- Homeopathic Remedies
Sulphur 30c and Pulsatilla 30c are available from our range of homeopathic remedies in liquid form, providing a convenient and easy way of using these natural remedies.
- Oils and Liquids
The omega 3 fatty acids in Denes Skin & Coat Maintenance (Organic Omega 3 Oil) have anti-inflammatory effects which are known to help in some cases of IBD by reducing inflammation of the gut lining. Aloe vera is also useful, helping by protecting and soothing the lining of the bowel. In addition it supports the growth of gut-friendly bacteria and encourages the absorption of nutrients.
- Flower Essences
Where stress is a trigger for IBD, we have several flower essences which can help:
Highly Strung Essence is useful for overactive, nervous, hysterical, excitable or unpredictable animals.
Separation Essence is formulated for separation and associated anxiety helping where pining, grief and the stress of kennelling or cattery is a trigger for the illness.
Timid Essence can be used to help shy or timid animals, which lack confidence and which appear insecure or are easily spooked or upset.
Emergency Essence can be used for acute emergency situations, including shock and for the distress that can be apparent during some bouts of IBD.
- Diet
Dogs
Foods high in fibre, low in fat or which are hypoallergenic can be beneficial in controlling the symptoms of IBD. Denes Adult Light and Senior recipes have a lower fat (oil) content compared to some of our other recipes, whilst our Adult Chicken with Rabbit recipe has a higher fibre content than others in our range. Suitable hypoallergenic recipes include Denes Adult Sensitive Digestion rich in Lamb & Rice which is a dry food and Denes Adult Tripe Mix rich in Turkey (canned) which is free from all cereals.
Other useful Denes fact sheets to read include: