IBD: Understanding the Gastrointestinal System

Q & A with Dr. William Sandborn on Inflammatory Bowel Disease

It’s estimated that roughly 100 trillion micro-organisms reside in our intestines, about 10 times more than the total number of human cells comprising our bodies. By and large, we share space amicably. It’s a mutually agreeable and biologically necessary relationship. Beneficial gut flora help us digest foods, train the immune system, produce vitamins and prevent pathogenic microbes from taking root.

Sometimes, though, things go wrong, resulting in conditions like inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). More than 1 million Americans are affected. We asked Dr. William J. Sandborn, chief of the Division of Gastroenterology at the UC San Diego School of Medicine and director of the UC San Diego Health’s IBD Center, to explore the condition.

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Q: Does medical science have a pretty good understanding now of how a healthy intestinal system works or, more specifically, what causes a problem like inflammatory bowel disease?

Q: What’s the difference between inflammatory bowel disease and irritable bowel syndrome? Can the latter lead to the former?

Q: Current treatments for IBD seem to mostly involve suppressing the inflammatory immune response through antibiotics, but the result is often long-term adverse side effects and diminishing effectiveness. Do you see more promise in tweaking current approaches or in something new altogether?

Q: What are your thoughts about some of the more unusual or exotic treatments being proposed or tested for IBD, such as “helminthic therapy” (imbibing whipworm ova) or using cannabis?

Q: What’s the connection between IBD and colon cancer? Does the risk vary with the type of IBD?