Dr. Anthony Rozario

It is important for you to know about inflammatory bowel disease or IBD, it is a group of intestinal disorders, which leads to prolonged inflammation of your digestive tract. The digestive tract is made of the mouth, stomach, oesophagus, small intestine and large intestine. It performs the task of breaking down food, removing unusable materials and waste products, and for breaking down nutrients from food. Inflammation along with the digestive tract causes disruption in this process. IBD is a fatal condition which can be life threatening in some cases.

Major types of inflammatory bowel disease
The term inflammatory bowel disease is an umbrella term under which many diseases are included. The two major and most common diseases under IBD are ulcerative colitis and Crohn’s disease. Crohn’s disease (a chronic inflammatory disease of the intestines, especially the colon and ileum, associated with ulcers and fistulae) can lead to inflammation in any part of your digestive tract. It commonly affects the small intestine’s tail end. In case of ulcerative colitis, inflammation takes place in the large intestine.

Causes of IBD
Although the exact cause of IBD is not known, several factors may lead to this condition. They are as follows:

1. Genetics: You are more likely to develop IBD if someone in your family has the disease. This is because of the genetic component of IBD.
2. The immune system: The body’s immune system plays a role in IBD. Usually, your immune system defends your body from pathogens. A bacterial or viral infection in the digestive tract may lead to an immune response. The digestive tract becomes inflamed as the body fights against the bacteria or viruses. The inflammation goes away when the infection is gone.

However, in the case of IBD, the digestive tract inflammation may occur without any infection. Your immune system attacks your body’s cells. This is called an autoimmune response. IBD can also occur when the infection is cured, but the inflammation remains.

Symptoms
The various symptoms of IBD depend on the severity and location of the inflammation. They are as follows:

1. Diarrhoea which occurs when the bowel cannot reabsorb water.
2. Bleeding ulcers which cause blood to show up in your stool.
3. Stomach pain, bloating and cramping because of bowel obstruction.
4. Weight loss and anaemia, which leads to delayed development and growth in children.
5. In patients with Crohn’s disease, canker sores may develop in the mouth.
6. Ulcers and fissures may appear on the anus or genital area.
7. IBD may also be associated with problems such as eye inflammation, arthritis and skin disorders.

The major complications which may arise from IBD include colon cancer, malnutrition with weight loss, fistulas, intestinal rapture and bowel obstruction. It is important for you to consult a doctor on noticing any of the IBD symptoms.

Tokophobia

Tokophobia is an extreme and uncontrollable fear of childbirth or pregnancy. While pregnancy is expected to be a time when women experience long bouts of anxiety, when they develop a fear of childbirth so intense that it disrupts their ability to lead normal lives or have a normal birth, they very likely have tokophobia.

Symptoms of tokophobia

If left untreated, tokophobia can only become more intense and damaging. Not only can this disorder lead to an elective termination of some pregnancies because of fear, but the psychological stress attendant with the disorder can often be damaging to a pregnancy even if the woman does not elect to terminate it. Furthermore, tokophobia may only be a byproduct of other emotional and behavioral disorders such as clinical depression. Some of the more apparent indicators of tokophobia include:

• Feelings of dread or panic when the idea of childbirth or pregnancy arises
• Refusing to go through with childbirth unless elective caesarean section can be guaranteed
• An intense increase in anxiety or depression while pregnant
• Expressing a strong desire to have children while also refusing to become pregnant
• Previous terminations of apparently healthy pregnancies
• Intense fear that childbirth will result in maternaldeath, stillbirth, miscarriage or birth defects

Common facts about tokophobia

Women who have this disorder will likely refuse going through childbirth without some kind of sedative and they will often be very adamant about wanting a caesarean section. Still, other women will avoid becoming pregnant altogether, despite their strong desire to have children. These women will often have very stringent contraceptive strategies, using several methods at once. In tokophobic women who went through normal pregnancies, as well as those who had caesarean sections, some suffered further problems after childbirth such as postnatal depression and delayed bonding with their infants.