TNF and inflammatory bowel disease: Small-bowel involvement in IBD can further cause disaccharide intolerance, leading to shorter gut transit times, pain, and worsening of diarrhea.32 Impaired linear growth in individuals with IBD may be caused by factors associated with weight loss, as well as by mediators derived from the intestine.33 For example, TNF-α inhibits chondrocyte activity in growth plates, while IL-6 may directly lead to growth failure.