Sunday, June 16, 2024 | 12:05 WIB

IBD knows no borders


World IBD Day 2024

Jakarta, IO – Every year on May 19, World Inflammatory Bowel Disease Day is celebrated, this year themed “IBD Has No Borders”. Throughout the world, IBD is often overlooked, because its symptoms are frequently confused with those of diarrhea. This is serious, because the IBD death rate is calculated at 17.1 per 1,000 people per year, compared with that of a control group at 12.3 per 1,000 annually. 

IBD is an autoimmune disease characterized by inflammation of the small and large intestines. Elements of the digestive system are attacked by the body’s immune system, with multifactorial causes. IBD is divided into three types, namely, Ulcerative Colitis (UC), Crohn’s Disease (CD) and Indeterminate Colitis (Unclassified). 

UC is characterized by inflammation and injury along the superficial layer of the large intestine and rectum; sufferers feel pain in the lower left part of the stomach; 5% of severe UC cases are at risk of evolving into colorectal cancer. In CD, inflammation occurs in the deeper layers of the digestive tract; those afflicted feel pain in the lower right part of the stomach, while there is little bleeding from the rectum. 

“Until now the cause of IBD is not known. IBD can affect anyone, regardless of age. Medical literature proposes that an extreme diet or excessive stress may work as triggers for IBD. Hereditary factors may also play a role,” explained Prof. dr. Marcellus Simadibrata, Sp.PD, KGEH, FACG, FINASIM, Ph.D., from Abdi Waluyo Hospital Jakarta, in a World IBD Day commemoration, and the launch of his hospital’s IBD Center, which was held on Monday (20/5/2024). 

The internal medicine specialist and hepatology gastroenterology consultant added that if IBD is left unchecked, it can degrade a patient’s condition, with complications. “UC patients can suffer toxic megacolon, perforated colon and severe dehydration. CD patients can experience bowel obstruction, malnutrition, fistulas and anal fissures. If these two types of IBD are left untreated, they can generate complications, in the form of blood clots and inflammation of the skin, eyes and joints,” he warned. 

Prof. dr. Marcellus Simadibrata, Sp.PD, Ph.D.
Prof. dr. Marcellus Simadibrata, Sp.PD, Ph.D. (Source: Private Doc.)

Recurrent Abdominal Pain 

An IBD diagnosis begins with patient complaints: recurring abdominal pain, changes in bowel movements, bloody stools and weight loss. “The doctor will carry out physical and supporting examinations, including stools, blood, radiology (CT scan and MRI of the abdomen, according to indications) and gastrointestinal endoscopy. Patients who have been diagnosed with IBD are then assessed for the severity of the disease, using a scoring system. Therapy may be prescribed in the form of medications, namely, tablets and injections, but in some cases surgery may be required,” said dr. Marcell, his nickname. 

Chronic IBD may require surgery to remove a damaged part of the digestive tract. “However, due to advances and innovations in drug treatment, surgery is rarely performed in recent years. Multidisciplinary collaboration is required, because of its multiorgan manifestations; thus, it may involve specialists in gastroenterology, digestive surgery, nutrition and psychosocial care, aiming to improve a patient’s quality of life.” 

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On the same occasion, dr. Nathania S. Sutisna, Sp.GK, a consultant in clinical nutrition, mentioned that one of the risks of contracting IBD is poor dietary habits: consuming ultra-processed food and food additives. Thus, the diet of IBD patients must be changed and adjusted to accord with treatment. When symptoms appear, patients should pay attention to higher calorie and protein requirements than when they are healthy, as well as fluid balance. When there are no symptoms (remission), nutrition needs to be adjusted to restore the patient’s nutritional status, and food is administered gradually while still monitoring symptoms. 

“When patients are diagnosed with IBD, they need to understand that inflammation can subside, if they commit to undergoing treatment and lifestyle modifications, one of which is adjusting their diet to IBD levels and exercising regularly. Families and caregivers need to receive education about IBD, so they can provide support and maintain patient compliance, as well as psychosocial support to avoid depression and anxiety,” dr. Nathania concluded. (est)


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