Inflammatory bowel disease (IBD) is a term used to describe several types of chronic diseases of the intestine. Typically, IBD is characterized by recurrent GI signs such as vomiting, diarrhea, weight loss, anorexia, and/or reflux. The hallmark of inflammatory bowel disease is inflammation in the GI tract, diagnosed via biopsy, cytology, or by the presence of certain markers in the blood. All of these tests may be recommended by your family veterinarian to confirm a diagnosis of IBD in your pet, and to determine which intestinal disease it is.
What causes IBD?
The cause of IBD is currently unknown; some agent triggers the immune system to produce an inflammatory response in the intestinal tract. The agent could be a genetic factor, the unique microorganisms of the gut, the immune system itself, an environmental trigger, or something else entirely.
Bacteria in the intestinal microbiome are commonly implicated as playing a role in the development of chronic intestinal diseases in both humans and animals, but it is unknown as to which bacteria provoke the inflammatory response.
How can changing my pet’s diet improve my pet’s IBD symptoms?
Studies appear to demonstrate that diet has an influence on IBD; about 50% of dogs respond well to a change in diet with no other treatment. Limited ingredient diets, diets with a hydrolyzed protein, and highly digestible diets are all touted as being effective. Studies show that diets with a hydrolyzed protein demonstrate a longer remission from symptoms, although recent data also indicates it’s not always the protein that is the culprit. Strong evidence supports using an elimination diet for chronic intestinal diseases; an elimination diet involves removing ingredients from your pet’s diet that it is suspected he or she can’t tolerate. The ingredients are later added back to the diet, one at a time, while closely watching your pet for signs to return.
So what can be done about this persistent and troubling problem?
Treatment goals for pets with confirmed IBD are to correct any existing nutritional deficiencies and address the inflammation and microbial imbalance (if present) within the body. Treatment, therefore, may include deworming to ensure there are no intestinal parasites like giardia present. A dietary trial is often prescribed, and if improvement from the diet is going to occur, it should take place within roughly two weeks of the diet change. If a diet change is unsuccessful, your veterinarian may prescribe an antibiotic trial that could last a month or more. There have been no randomized controlled trials to determine whether or not probiotics play a role in long-term remission of disease, so their effectiveness is currently unknown.
As newer therapies are produced in the human world and become more affordable, veterinarians may have additional treatment options available with greater efficacy and fewer side effects. One of the therapies in which there is much interest is fecal microbiota transplantation (FMT). FMT is a procedure in which stool from a healthy donor is placed into the patient’s intestine, with the goal of improving the intestinal microbiome in the patient. FMT has been successfully used to treat clostridium difficile (c. diff) in humans, but no studies have been conducted on pets with IBD, so many questions remain. Intestinal stem cells are another area that has been evaluated and may serve as an option in the future.
If you suspect your pet has IBD, your first call should be to your family veterinarian. Vomiting, diarrhea, weight loss, and anorexia can indicate other disease processes, or even that your pet may have eaten something, like a toy, that has become stuck in the GI tract. Either way, those symptoms merit attention and your pet should visit the vet, right away. Your veterinarian can rule out other problems and may be able to confirm that a chronic intestinal disease is present. He or she may prescribe a diet change or other treatment option, or your vet may recommend referral to a board-certified veterinary internist.