Inflammatory Bowel Disease

source the hindu 

The rising incidence of Inflammatory Bowel Disease (IBD) 

There is an increasing incidence of IBD across the globe. including in North America and western Europe. “The prevalence is also rising… From 0.5% right now, the prevalence will increase to 0.6% in America,” he said.

 While early diagnosis is lacking. 

“IBD 

It comprises Ulcerative Colitis and Crohn’s Disease and is characterised by inflammation. 

It is different from Irritable Bowel Syndrome which is predominantly non-inflammatory,” 

“Both Ulcerative Colitis and Crohn’s Disease are complex immune-mediated diseases; there is a dysregulated immune response. 

We do believe there are genetic markers that contribute to the disease but not in isolation. There is a synergy between the external environment and gut bacteria,” he added.

Early onset

Indian perspective 

There is also a rise in early onset cases among those under 18. For the Indian perspective we have  challenge in diagnosing Crohn’s disease. “We have peculiar issues such as intestinal tuberculosis, which is common in India and resembles / जैसा दिखता है Crohn’s disease. 

On incidence in India

1 Changes in lifestyle, a Westernised diet with high fat and high sugar, processed and packaged food cause an insult to the gut epithelium, precipitating inflammation.”

 

2 the incidence of IBD has almost doubled in India from 1990 to 2019, with a rise in the death rate as well.

3 A study in Tamil Nadu showed that there were more cases of Crohn’s Disease than Ulcerative Colitis.

 4 Nearly 50% of IBD were Crohn’s Disease and 40% were Ulcerative Colitis. It is important to catch patients early so treatment is better, he said.

 delay in diagnosis

particularly among the young. “The symptoms of IBD overlap with Irritable Bowel Syndrome. 

This does delay diagnosis. Individuals with alarming symptoms such as bleeding and severe abdominal pain need a complete evaluation,” he said.

other diseases that mimic IBD

1 There is no single diagnostic test for Ulcerative Colitis or Crohn’s Disease.

2 It is a combination of a physical, laboratory, and endoscopy. We have come a long way in the treatment of IBD. 

3 Over the last 25 years, biological therapy has emerged that uses monoclonal antibodies directed at inflammatory pathways. 

 we have developed small molecules that can be given orally that have had a significant impact.”

faecal microbiota transplantation

 cost was a challenge. “There is no cure. It is a lifelong disease. So, in India, we are looking at low cost therapy such as faecal microbiota transplantation along with regular medication,

Reason and what to do ? 

1 Environmental factors play a big role in IBD

“This includes smoking and antibiotics. There are no human studies that have proved the role of diet, 

2 but we do think some foods such as super processed foods have the potential to be pro-inflammatory. 

3 A healthy diet avoiding highly processed food, and consuming wholesome food — for instance a Mediterranean diet — is recommended.”

4 patients are advised to avoid being restrictive about their diet as they could become malnourished. 

5 “Avoid processed foods. We have an anti-inflammatory diet of curd and buttermilk, and less milk, more rice and millets, fruits, and vegetables. Avoid red meat and consume fish. This seems to be helpful,”