The increasing incidence of Inflammatory Bowel Disease (IBD) worldwide is causing concern among medical professionals. Early diagnosis of IBD is often lacking, and diagnosis can be challenging due to the similarity of symptoms with other conditions.
IBD is a significant problem, consisting of Ulcerative Colitis and Crohn’s Disease, which are characterized by inflammation. It is different from Irritable Bowel Syndrome, which is predominantly non-inflammatory. According to Jonathan Leighton, President at the American College of Gastroenterology, both Ulcerative Colitis and Crohn’s Disease are complex immune-mediated diseases, with a dysregulated immune response.
The prevalence of IBD is increasing across the globe, including in North America and Western Europe. From 0.5% currently, the prevalence is expected to increase to 0.6% in America. This trend is also being observed in India, where lifestyle changes, including a Westernized diet with high fat and high sugar, processed and packaged food, are contributing to the rise in IBD cases.
Moreover, there is a rise in early onset cases among those under 18. In India, the challenge in diagnosing Crohn’s Disease is that it can resemble intestinal tuberculosis, a common condition in the country. This similarity in phenotype and clinical presentation makes diagnosis more challenging.
Diagnosis of IBD is often delayed, particularly among the young. The symptoms of IBD can overlap with Irritable Bowel Syndrome, causing a delay in diagnosis. Other diseases can also mimic IBD, and infections need to be ruled out. A combination of physical, laboratory, and endoscopy tests is used for diagnosis.
Environmental factors play a significant role in IBD. Smoking and antibiotics can contribute to the development of IBD. While human studies have not 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, there is still no cure for IBD, and it is a lifelong disease. In India, low-cost therapy, such as faecal microbiota transplantation along with regular medication, is being explored. Biological therapy, using monoclonal antibodies specifically directed at inflammatory pathways, has emerged as an effective treatment option. Small molecules that can be given orally have also had a significant impact on controlling the disease.
In conclusion, the rising incidence of IBD is a global concern. While diagnosis can be challenging, a combination of physical, laboratory, and endoscopy tests can be used. Environmental factors, such as smoking, antibiotics, and diet, play a significant role in IBD. Although there is no cure for IBD, effective treatment options, such as biological therapy and faecal microbiota transplantation, are available.
