JOHANNESBURG – Inflammatory bowel disease (IBD) is characterised by chronic inflammation of the gastrointestinal (GI) tract , which will affect the comfort, and therefore quality of life, of patients with the condition.
Apart from the pain and ongoing inconvenience experienced by patients, these differences from one’s peers could lead to a negative self-perception and fear of stigmatisation. The self-imposed limitations of social participation could lead to total social isolation. Unpredictability of symptoms such as incontinence, and feelings of vulnerability, insecurity, and limited perceived attractiveness, can negatively affect one’s sense of personal autonomy, and would make the patient reluctant to enter situations of intimacy, and even the everyday workplace. In addition, the burdensome but necessary adjustments to diet and lifestyle could lead patients to a position of resignation.
Vanessa Snow, Head of Medical Affairs at Janssen South Africa, said that people often confuse IBD with IBS (irritable bowel syndrome). Both are common illnesses that affect the gut, she points out, but despite their similar acronyms and symptoms, they are very different. Prolonged inflammation brought on by IBD, if left unchecked, results in damage to the gastrointestinal tract and can even be life-threatening if not treated early.
“Along with late diagnosis, there is also the very real possibility of misdiagnosis,” warns Snow. Several diseases mimic IBD clinically, which calls for careful and repeated evaluations, if necessary. A cautious consideration of the patient’s clinical, radiographic, endoscopic, and histopathologic features needs to be undertaken, to establish a correct diagnosis.
Understanding the differences between IBD and IBS is important for an accurate diagnosis and effective treatment plan. It’s even possible to have both conditions concurrently, which is why a thorough diagnosis is crucial.
The umbrella term “IBD” breaks down into two main categories: Crohn’s Disease and Ulcerative Colitis: (1)
Crohn’s Disease:
If you have Crohn’s Disease (CD), you can experience swelling of any part of the gastrointestinal system, from the mouth all the way to the anus. (5) People of any age can have CD, but most people start experiencing symptoms between the ages of 20 and 30.
“People living with Crohn’s Disease,” says Snow, “will experience several symptoms, although not necessarily concurrently, and in different combinations from one patient to another. The signs to look out for,” she cautions, “include ongoing diarrhea, unnatural weight loss, stomach pain or cramps, and blood in stools. The patient could also feel ongoing exhaustion or low-grade fevers.”
Crohn’s is a chronic disease, which means that it’s incurable, and can only be treated symptomatically. Patients will have periods during which the symptoms are active (which are known as ‘flares’) followed by periods of complete remission, during which the patient experiences no symptoms.
Ulcerative Colitis:
Ulcerative Colitis (UC) only affects the large intestine (colon) and rectal area, the lowest part of the intestine. Inflammation in these zones can result in small ulcers or sores, which would, in time, become swollen and infected.
“Symptoms that could be expected with this condition,” explains Snow, “include diarrhea; frequent trips to the toilet; blood, mucus, or pus in the stool; and stomach pains. (9) As it is with the symptoms of Crohn’s Disease, they’re uncomfortable, and can also be socially embarrassing.”
The outlook for patients
Snow reminds us that UC, like its companion CD, is a chronic condition of the gastrointestinal system that never goes away completely and can be unpredictable. Just as CD patients can expect stretches of good health (remission) along with flares (relapses), people with UC have a similar journey to travel.
“At Janssen,” Snow reassures us, “our research and development keep us at the forefront of developing medication to alleviate these unpleasant symptoms, and we take comfort in knowing that these interventions, along with surgery in some cases, will keep patients feeling better, and for longer periods.” (10)
