A flare-up of inflammatory bowel disease (IBD) can happen just about any time. Why do flare-ups happen? It could be for a number of reasons, such as stopping a medication, a stressful event or becoming run down from another illness or condition. In some cases, there may not be a ready explanation.
Some people with IBD notice that they have a flare when the weather changes in the fall or in the spring. There is a controversial theory that links these seasonal flare-ups to an Immunoglobulin E (IgE)-mediated allergic response.
IgE is a special type of protein, called an immunoglobulin, which can help the body fight off disease. The purpose of IgE is to bind itself to an antigen (a substance that activates the production of antibodies). By doing so, IgE will cause the inactivation or removal of the offending toxin, microbe or foreign substance.
IgE tends to attach itself to receptors on mast cells. If these mast cells are activated by an allergen, such as pet dander, they release histamine, heparin, cytokines, leukotrienes and other chemicals. The end result is an allergic response with allergy symptoms, such as a runny nose.
The presence of leukotrienes attracts a type of white blood cell called an "eosinophil." These cells fight off the allergic response, but the chemicals that they use to do so are toxic to the body as well as to the invading allergen.
Eosinophils have a connection to IBD. Three of the four toxic compounds that are released by eosinophil cells are found in greater amounts in the stool of people with active IBD than in controls. Some researchers think that allergens in the environment lead to the IgE-mediated response, which triggers an IBD flare. It’s still a controversial theory, because while some researchers have found an increase in IBD patients reporting flare-ups in the spring or fall, others have shown that there is no seasonal trend in IBD flares.
Tips to prevent a flare-up
- Avoid nonsteroidal anti-inflammatories (NSAIDs).
- See your doctor regularly.
- Stop smoking if you have Crohn's Disease.
- Take your medication as prescribed.
Sources:
Al-Haddad S, Riddell RH. “The role of eosinophils in inflammatory bowel disease.” Gut;54 2005. Nov 3 2008.
Schaus BJ, Shen B. “Eosinophils in Inflammatory Bowel Disease.” US Gastroenterology Review 2007 March 2007. Nov 3 2008.
Soncini M, Triossi O, Leo P, Magni G, et al. “Seasonal patterns of hospital treatment for inflammatory bowel disease in Italy.” Digestion Jan 2006. Nov 3 2008.
Sonnenberg A. “Seasonal variation of enteric infections and inflammatory bowel disease.” Inflamm Bowel Dis Jul 2008. Nov 3 2008.
