The global incidence of Inflammatory Bowel Disease (IBD), comprising Ulcerative Colitis and Crohn’s Disease, has become a significant concern for medical professionals. The complex immune-mediated diseases are characterized by inflammation, differentiating them from Irritable Bowel Syndrome, which is predominantly non-inflammatory.
Jonathan Leighton, President at the American College of Gastroenterology, U.S., highlights the challenges in diagnosing IBD, “Early diagnosis is lacking, and diagnosis in itself is challenging considering that other conditions could mimic IBD.” Both Ulcerative Colitis and Crohn’s Disease are influenced by genetic markers and a synergy between the external environment and gut bacteria.
The prevalence of IBD is increasing across the globe, including in North America and Western Europe. Leighton predicts that the prevalence in America will rise from 0.5% to 0.6%. In India, lifestyle changes and a Westernized diet have contributed to the increase in IBD cases.
The rise in early onset cases among those under 18 is another concern. Vineet Ahuja, Professor of Gastroenterology at the All India Institute of Medical Sciences, New Delhi, identifies a challenge in diagnosing Crohn’s disease due to the similarity in intestinal tuberculosis, common in India.
The delay in IBD diagnosis is another issue. The symptoms of IBD overlap with Irritable Bowel Syndrome, causing a delay in diagnosis. Dr. Leighton emphasizes the need for a complete evaluation for individuals with alarming symptoms such as bleeding and severe abdominal pain.
Environmental factors play a significant role in IBD. Dr. Leighton identifies smoking and antibiotics as contributing factors. While no human studies have proven the role of diet, some foods such as super-processed foods have the potential to be pro-inflammatory. A healthy diet, avoiding highly processed food and consuming wholesome food, is recommended.
In terms of treatment, both Dr. Leighton and Dr. Ahuja stress the importance of biological therapy that uses monoclonal antibodies specifically directed at inflammatory pathways. They have developed several biologics to target different parts of the inflammatory pathways to control the disease, thereby decreasing hospital stays and surgeries.
In India, where the incidence of IBD has almost doubled from 1990 to 2019, low-cost therapy such as faecal microbiota transplantation along with regular medication is being considered.
In conclusion, the rising global incidence of IBD, the challenge in diagnosis, and the need for effective treatment strategies emphasize the importance of further research and innovation in this field.
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