SHAH ALAM - According to data from the United States (US) Centres for Disease Control and Prevention, in 2015, 1.3 per cent or three million adults suffered from inflammatory bowel disease (IBD).
Meanwhile, in 2011, the Crohn's & Colitis Foundation in the US disclosed that about 1.6 million Americans, including approximately 80,000 children, suffered from IBD which was a condition involving inflammation in the digestive system.
Annually, there were 70,000 cases reported.
In a more straightforward definition, this health issue involved persistent inflammation that caused irritation, resulting in pain and swelling in the intestines, according to information from the Cleveland Clinic.
Unlike irritable bowel syndrome (IBS), IBD was more complex.
"IBS is a syndrome involving several symptoms and affecting the function of the intestines and stomach. However, it will not cause damage to the intestines like IBD," according to the medical source.
The Cleveland Clinic also said that a person can experience both IBD and IBS simultaneously.
It said although IBD patients may exhibit similar symptoms to IBS, there was no strong evidence suggesting that IBS increases the risk of IBD.
Universiti Sains Islam Malaysia General Surgeon and Medical Associate Professor Dr Razrim Rahim said fundamentally, intestinal inflammation was divided into two categories which were acute and chronic.
"Acute intestinal inflammation usually occurs due to viral or bacterial infections. The cause of chronic intestinal inflammation is still under study and it may be related to damage to the immune system," he said.
Chronic intestinal inflammation was further categorised into Ulcerative Colitis (UC) and Crohn’s.
He said UC can occur in the large intestine, while Crohn’s can occur anywhere in the gastrointestinal tract from the mouth to the rectum.
Both of these inflammatory conditions can affect the digestive system, he added.
Bloody Stools
Dr Razrim said a weakened immune system can be one of the contributing factors to IBD.
"The immune system should respond to infections. However, the immune system of IBD patients has mistakenly attacked cells in the body itself," he explained.
When asked if the disease was genetically related, Dr Razrim said it was possible because the risk of developing IBD was higher among close family members.
In addition to immunity, environmental factors such as smoking and the use of certain medications can contribute to the development of the disease, he said.
He also dispelled the myth that the speed of chewing food was linked to the disease as IBD symptoms varied for each individual.
What are the signs?
Dr Razrim said the symptoms of IBD varied for each individual. However, generally, abdominal pain, diarrhoea, vomiting, dizziness, persistent mucus and bloody stools were warning signs.
In some cases, patients also experienced itchiness in the eyes and joint pain.
"Chronic inflammatory bowel disease patients may experience significant weight loss because the food they consume cannot be digested.
"This situation will lead to dehydration and malnutrition," he said.
Diagnosis
KPJ Tawakkal Specialist Hospital Consultant General and Colorectal Surgeon Dr Nurhashim Haron said acute intestinal inflammation was temporary and patients could recover after some time.
However, chronic inflammation was a condition that will be experienced throughout life.
He said nevertheless, the treatment provided can help control symptoms and accurate detection will facilitate the treatment process.
As mentioned earlier, chronic intestinal inflammation consisted of UC and Crohn’s.
Dr Nurhashim said because the symptoms of both diseases were similar, a diagnosis must be carried out to detect swelling.
Additionally, he said patients were advised to undergo blood tests and stool samples, followed by colonoscopy and endoscopy procedures before confirming the type of IBD they have.
At the same time, he said they needed to undergo magnetic resonance imaging scans.
Dr Nurhashim also explained that IBD treatment varied depending on the type and symptoms experienced by the patient.
"Infections caused by viruses usually recover on their own after three to five days. Medications such as pain relievers and anti-diarrheal drugs can help control pain to a manageable level," he said.
Sharing his experience, he said patients usually come to the hospital after experiencing repeated abdominal pain and some have abscesses in the rectum.
"This situation can lead to more severe complications. Medication needs to be given to prevent the abscess from spreading," he said.
Risk of colon cancer
In addition to similar symptoms between UC and Crohn’s, complications affecting patients were also almost the same and among them was that it could increase the risk of developing colon cancer.
Moreover, severe intestinal inflammation could trigger conditions such as:
- Anal fistula (an opening between the skin and rectum).
- Blocked intestines.
- Swollen intestines or known as toxic megacolon.
- Intestinal leakage.
Dr Nurhashim explained that blocked intestines were an example of inflammation that required surgical treatment. This procedure needed to be undertaken when the provided medical treatment no longer providesd relief.
"Surgery to remove part of the large intestine will be performed when the symptoms worsen," he said.
Elaborating further, the specialist said swollen intestines could also lead to death.
Therefore, patients facing continuous or recurrent symptoms should immediately consult a specialist. The earlier they consult a specialist, the higher the healing rate.
Dr Nurhashim said there was no evidence to suggest that food can trigger inflammation. Even so, patients were usually advised to avoid spicy foods, caffeine, or fruits that could cause discomfort in the stomach.
He said patients were also advised to follow a low-fibre diet and some patients will be recommended to take supplements to aid nutrient absorption.
He said a person needed to maintain a healthy lifestyle by engaging in physical activities and exercise.
"Generally, there is no restriction for patients to engage in physical activities. However, it depends on their abilities.
"Most importantly, quit smoking, avoid alcohol, and reduce stress. Patients can also try meditation techniques," he said.