Learn to identify inflammatory bowel disease
Gastrointestinal symptoms such as diarrhea or abdominal pain are so common that we sometimes overlook them, however, it is important to pay attention to them, especially when you are living with HIV, as they may indicate a serious condition, such as Inflammatory Bowel Disease (IBD). ).
IBD is actually the name given to a group of diseases that cause inflammation at some point in the digestive system, and are chronic in nature, that is, they remain long-term. This condition is totally different, and much more serious, than irritable bowel syndrome.
It is thought that, like other diseases, IBD may affect people living with HIV differently, regardless of whether they are taking their antiretroviral treatment appropriately. That’s why it’s important to listen to your body’s signals and seek medical attention when certain digestive problems occur.
Red flags
Illnesses classified as IBD can vary in severity from person to person. While some have only mild discomfort, others may experience intense pain and swelling. It also often happens that the disease occurs in periods, alternating the acute manifestation with a stage of remission where there are no symptoms.
The main conditions of IBD are:
• Ulcerative colitis: Affects the large intestine and rectum. It causes inflammation and tiny wounds (ulcers) in the internal tissue of these ducts; those sores can bleed and become infected, producing pus.
• Crohn’s disease: It can affect any part of the digestive system, from the mouth to the anus, however, its presence is more frequent in the stomach and small intestine. It is characterized by inflammation of the lining of the digestive tract, usually in its deeper layers.
Both diseases can cause the same symptoms, which are:
– Diarrhea
– Fatigue
– Abdominal pain
– Blood in the stool
– Loss of appetite
– Unintentional weight loss
The inflammation caused by IBD makes it difficult for the digestive system to absorb all the nutrients the body needs, causing problems such as malnutrition or anemia, and may require surgery to remove the damaged parts of the intestines.
The intestine and the immune system
Although there are no studies yet showing how HIV affects the presentation of IBD in people with the virus, a recent study found that people living with HIV appear to be more likely to develop the disease.
The research analyzed the entire population with HIV in Denmark, reviewing data between 1983 and 2018, and also a cohort from the United States, with follow-up between 1999 and 2018. The results showed that, in Denmark, men with HIV had a higher risk of IBD than the general population, but this was not the case for women. In contrast, in the United States, women with HIV were at greater risk of IBD than men, although overall, men and women with HIV had a 41% higher risk of IBD than the general population.
It must be remembered that the digestive tract, especially the intestines, have an important role in the functioning of the immune system. As the HIV-specialized website Aidsmap.com explains, these organs have high concentrations of immune cells. Since HIV primarily attacks immune cells called CD4 cells, the walls of the intestines make up the largest reservoir area for HIV in the body.
Serious consequences
The complications of IBD can become serious. Among them, the following stand out:
– Increased risk of blood clots
– Severe dehydration (related to severe diarrhea)
– Intestinal obstruction (inflammation that blocks the passage of digestive contents)
– Malnutrition
– Fistulas
– Fissures in the anus
– Perforated colon
– Increased risk of colon cancer
This is why we must not miss the warning signs of this condition that requires medical control. In addition, in the case of people with HIV, the authors of the aforementioned study state that any new gastrointestinal symptoms should make health personnel suspect IBD as a possible cause, and carry out the corresponding studies.
If you have questions about this condition, talk to your HIV care medical team. If you are not yet receiving antiretroviral treatment, or you suspended it and want to resume it, at AHF Latin America and the Caribbean we can help you. Locate our offices in your country and learn about all our services.