IBD a rising public health issue
What seems to be frequent bouts of hyperacidity and hemorrhoidal bleedings which I endured for years turned out to be something else. Being in my mid-20s with no previous record of hospitalization, I brushed it off — until mid-February 2019 when a stabbing pain in my right lower abdomen finally pushed me to take my symptoms seriously and consult a doctor. Many doctors were puzzled, as my tests produced mixed results. It took many consultations with different specialists in both small and well-known hospitals in Manila to find the correct diagnosis.
It was Crohn’s Disease. Something I have never heard about. Many doctors told me they only read about it in books.
Crohn’s Disease, together with Ulcerative Colitis, are types of inflammatory bowel diseases (IBD). Its exact cause remains unknown to science. The common understanding among scientists is that IBD is an autoimmune condition where one’s immune system attacks your own digestive system. Some studies point to different culprits such as genetics, lack of bacterial exposure as a child or the hygiene hypothesis, urbanization, Western diet, and globalization, wherein consumption of foreign cuisines causes imbalances in the gut microbiota.
The main difference between the two types of IBD is that Crohn’s Disease can affect any part of the gastrointestinal tract from the mouth to the anus, while ulcerative colitis is confined to the large intestine or the colon. The diagnosis of indeterminate colitis, in rare cases, is given when it is difficult to determine whether it is Crohn’s Disease or Ulcerative Colitis. The common symptoms include diarrhea, abdominal pain, rectal bleeding, tenesmus or the constant urge for bowel movement, fever, loss of appetite, weight loss, fatigue, night sweats, and disruptions in menstrual cycle for women, among others.
The diagnosis for IBD is given by a gastroenterologist, a specialist on digestive diseases. A colonoscopy or endoscopy is often performed where a long flexible tube with a video camera at its tip is inserted in the anus or the mouth to detect changes or abnormality in the intestinal lining. Usually a biopsy is done from tissues taken during the procedure for doctors to come up with a diagnosis. While there is no cure for IBD, there are different treatment options available to manage it. Medications such as steroids, mesalazine, immunosuppressants, and biologics are being used. Some patients complement these with alternative medicine such as dietary modifications and acupuncture, among others. Surgery may be needed in severe cases.
IBD comes with high financial costs, given the lifelong need for expensive medications and regular medical tests. It is a pressing public health issue in many Western countries such as the United States, where 3 million people or 1.3 percent of the adult population have IBD. While the rate is stabilizing in the West, Asia is experiencing a steep increase in cases driven by rapid industrialization and urbanization. In the Philippines, Crohn’s and Colitis Philippines has more than 100 members, and the numbers are steadily increasing.
Looking back at my diagnosis a year ago, having the right doctors and proper treatment helped me immensely, along with the knowledge that many patients lead normal lives and can even pursue successful careers. IBD patients have similar life expectancies with the rest of the population. However, more work is needed. Today, World IBD Day, we call for policy support in IBD research, diagnosis, and treatment to help patients to not just live but thrive in our society.
For inquiries, message us on Facebook at Crohn’s and Colitis Philippines, or via email at [email protected].
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Ron Jay P. Dangcalan is vice president of Crohn’s and Colitis Philippines and assistant professor at the Department of Social Development Services, CHE, UPLB. The medical data in this article have been validated by Jose D. Sollano Jr., MD, president of IBD Club of the Philippines and professor of medicine at UST.
