The Malaysian Medical Gazette

Download PDF
20 downloads 0 Views 311KB Size Report
Comment
Mar 29, 2017 - Medication/Ubat-ubatan. ▫ Lifestyle/Gaya Hidup. ▫ Research/Kajian Saintifik o Ministry of Health/Kementerian Kesihatan Malaysia. • Opinions.
The Malaysian Medical Gazette Your Online Source of Health Education and Medical News

Main menu Skip to content  o o o o o o o o  

About MMGazette Director General of Health, Malaysia Patron Founder & Advisor Editors Columnists Translators Young Columnists Announcements Articles

o    o    o o o o o o o o o       o   o          o   

Internal Medicine/Perubatan Dalaman Infectious Diseases/Penyakit Berjangkit Non-communicable Disease/Penyakit Tidak Berjangkit Cancer/Barah Public Health/Kesihatan Awam General/Umum Occupational Health/Kesihatan Pekerjaan Women’s Health/Kesihatan Wanita Orthopaedics/Ortopedik Obstetric/Obstetrik Paediatrics/Pediatrik Psychiatry/Psikiatri ENT/Telinga, Hidung & Tekak Surgery/Surgikal Opthalmology/Opthalomologi Emergency Medicine/Perubatan Kecemasan Allied Health/Kesihatan Bersepadu Dental/Pergigian Physiotherapy/Fisioterapi Sonography/Sonografi Medication/Ubat-ubatan Lifestyle/Gaya Hidup Research/Kajian Saintifik Ministry of Health/Kementerian Kesihatan Malaysia Opinions Feature Articles Current Issues #ForMedicalStudents #MsiaEndsDengue #SmokeFreeMY #HealthyRamadhan World Breastfeeding Week 2014 Breast Cancer Awareness Floods & Health Back to School Heart Awareness Month Early Career Psychiatric Chapter (ECP) Young Columnists Program Contact Us Terms of Use

HEALTH EDUCATION

Knowing and Living Better With Inflammatory Bowel Disease – Dr. Chieng Jin Yu by Hidayah • March 29, 2017 • 0 Comments

What is Inflammatory Bowel Disease?

Inflammatory bowel disease (IBD) represents a group of intestinal disorders that cause prolonged inflammation of the digestive tract. There are two main forms of IBD: Ulcerative colitis (UC) and Crohn’s disease (CD). The exact cause of IBD remains unknown. However, genetics and immune system malfunction have been associated with IBD. When your immune system tries to fight off an invading bacteria or virus, an abnormal immune response causes the immune system to attack the cells in your own digestive tract, too. Ulcerative colitis is an IBD that causes long-lasting inflammation and ulcers in the innermost lining of the large intestine (colon) and rectum. Crohn’s can affect any part of the gut – from the mouth to the anus, though the most common area affected is the end of the ileum (the last part of the small intestine), or the colon. The areas of inflammation are often patchy with sections of normal gut in between, and it often spreads deep into affected tissues. Complications in the gut may include strictures, bowel obstruction, perforations and fistulas. Who gets it?

IBD usually starts before the age of 40. It affects men and women equally. People with a family history of IBD are at least 10 times more likely to develop the condition than those with no history. Caucasians and people of Jewish descent have a higher risk. Certain medications, especially NSAIDs (non steroidal anti inflammatory drugs – often used as pain killers) may increase the risk of developing IBD or worsen disease in people who have IBD. Smoking is one of the main risk factors for developing Crohn’s disease. People who live in urban areas and industrialized countries have a higher risk of getting IBD, in which the high fat diet or refined foods, may play a role here. Nowadays, we are starting to see increasing number of new cases of IBD in Asia. The incidence and prevalence rates of IBD are reported as low in Malaysia but the incidence appears to be increasing with marked racial differences (Ida Hilmi et al. 2015). How does IBD present?

Symptoms of IBD vary depending on the location and severity of inflammation. Its symptoms will vary from person to person. They range from mild to severe and may also change over time. In general, both usually present with chronic diarrhea, tummy pain, easy tiredness and weight loss. IBD is a chronic illness. It is ongoing and life-long, although you may have periods of good health (remission), as well as times when symptoms are more active (relapses or flare-ups). How is IBD diagnosed?

To diagnose IBD, the doctor needs to gather information about your family’s medical history and your bowel habits, together with a thorough physical exam, followed by investigation especially colonoscopy. Colonoscopy is an investigation that allows the doctor to look at the inner lining of the large intestine. It helps find ulcers, colon polyps, tumors, and areas of inflammation or bleeding. Few small samples of the bowel wall are often to be taken for microscopic examination (biopsy). Sometimes, radiological studies such as barium study or CT scan is required for further assessment. Is IBD = IBS?

IBD is sometimes confused with IBS, which stands for irritable bowel syndrome. As a gastroenterologist, we always emphasize that IBD is not IBS. IBS is a set of symptoms resulting from abnormal function of the small and large bowel. IBS is characterized by crampy tummy pain, diarrhea, with/without constipation, but is not accompanied by fever, bleeding or an elevated white blood cell count. Examination by colonoscopy or barium study reveals no abnormal findings.

Is there a link between IBD and bowel cancer?

It’s important to stress that IBD is not a form of cancer. However, if one has had extensive or total colitis (inflammation of the large intestine) for many years, he or she has a greater risk than normal of developing bowel cancer. Patients with IBD are often unaware that they have bowel cancer as the initial symptoms are similar to IBD, such as passing bloody motion, diarrhoea and abdominal pain. Because of this, you will probably be advised to have a colonoscopy every few years as surveillance. How to fight IBD?

IBD can often be managed by drug treatment, but surgery can be necessary if symptoms are very bad, or there are complications. Nowadays, gastroenterologists use one of two approaches to treatment: “step-up,” which starts with milder drugs first (anti-inflammatory drugs as the first line of treatment in UC), versus “top-down,” which gives patients stronger drugs earlier in the treatment process (tumor necrosis factor (TNF)-alpha inhibitors, or “biologics” for CD). Surgery can often eliminate UC, but that usually means removing the entire colon and rectum. While in CD, up to one-half of the patients will require at least one surgery. However, surgery does not cure CD. You may find during flare-ups that certain foods affect your symptoms, such as raw vegetables, high-fibre foods, spicy foods, beans, dairy products, alcohol and caffeine. You should eat a nutritious and balanced diet to maintain your weight and strength. You may need to take a calcium supplement with added vitamin D as IBD is associated with osteoporosis, especially if you are treated with steroid.

Living with IBD can have both an emotional and practical impact on your life. Flare-ups can be disruptive to relationships and work. Learning stress management techniques may help you handle the illness better. Can patients with IBD have children? If the IBD is well controlled, most women with IBD can expect to have a normal pregnancy and a healthy baby. Also, for most women, having a baby does not make their IBD worse. If you have active IBD, especially CD, you may have a slightly lower chance of conceiving. Most of the drugs prescribed for IBD do not affect fertility, except sulphasalazine, a 5-ASA medication, which is known to reduce fertility in men. IBD may be a lifelong condition, but there are ways to keep it in check. Through medications, lifestyle changes, and stress management, many patients with IBD can still enjoy their life. IBD is largely a hidden disease, and one that causes stigma, fear and isolation – it’s thought that a lot of people with the presentation go undiagnosed and suffer in silence. The awareness among general public, or health care professional should be raised. Dr Chieng is a medical lecturer and Consultant Gastroenterologist & Hepatologist at the Medical Department of Universiti Putra Malaysia.

References Hilmi I, Jaya F, Chua A, Heng WC, Singh H, Goh KL. A first study on the incidence and prevalence of IBD in Malaysia–results from the Kinta Valley IBD Epidemiology Study. J Crohns Colitis. 2015 May;9(5):404-9.

Share

Related Posts via Taxonomies          

ERCP: What? When? How? – Dr. Chieng Jin Yu Go Away…Helicobacter Pylori – Dr. Chieng Jin Yu Can My Child Get Kidney Disease? – Dr. Nur Hidayati Parkinson’s Disease: The Entrapment in One’s Own Body – Dr. Chiam Keng Hoong Graves Disease: An Oxymoron – Dr. Chiam Keng Hoong Memilih Untuk Kelahiran Secara Pembedahan Caesarean? – Dr. Muhammad Izzat Abdul Razak Meliodosis: Pembunuh Senyap – Dr. Chiam Keng Hoong Sindrom Down: Insan Istimewa – Dr. Shaiful Ehsan A needle for stroke? – Dr Tan Wee Yong Doktor, saya nak UBAT TIDUR !!! – Dr Shaiful Ehsan

Tags: bowel chieng disease dr inflammatory jin knowing living yu

Post navigation

← Memilih Untuk Kelahiran Secara Pembedahan Caesarean? – Dr. Muhammad Izzat Abdul Razak

Leave a Reply Your email address will not be published. Required fields are marked *

Comment

Please type the characters of this captcha image in the input box Name *

Koh321

Email * Website Post Comment

Notice: It seems you have Javascript disabled in your Browser. In order to submit a comment to this post, please write this code along with your comment:

Search for:

Search

DOCTORONCALL FEATURE ARTICLES

MMG #REACHOUT CAMPAIGN

SOCIAL MEDIA

CATEGORIES

     

#ForMedicalStudents #HealthyRamadhan #MsiaEndsDengue #SmokeFreeMY Allied Health/Kesihatan Bersepadu Back to School

                                       

Breast Cancer Awareness Cancer/Barah Dental/Pergigian Dermatology/Dermatologi Early Career Psychiatric Chapter (ECP) Editorials Emergency Medicine/Perubatan Kecemasan ENT/Telinga, Hidung & Tekak Feature Articles Floods & Health General/Umum Health Education Heart Awareness Month Infectious Diseases/Penyakit Berjangkit Internal Medicine/Perubatan Dalaman Letters To Editor Lifestyle/Gaya Hidup Medical & Literature Medication/Ubat-ubatan Medicine & Law/Undang-Undang Perubatan Ministry of Health/Kementerian Kesihatan Malaysia News & Announcements Non-communicable Disease/Penyakit Tidak Berjangkit Obstetric/Obstetrik Occupational Health/Kesihatan Pekerjaan Opinions Opthalmology/Mata Opthalmology/Opthalomologi Orthopaedics/Ortopedik Paediatrics/Pediatriks Physiotherapy/Fisioterapi Psychiatry/Psikiatri Public Health/Kesihatan Awam Research/Kajian Saintifik Sonography/Sonografi Surgery WNTD2014 Women's Health/Kesihatan Wanita World Breastfeeding Week 2014 Young Columnists Program

OWNED BY

DISCLAIMER

The Malaysian Medical Gazette (PPM-007-12-13092013) formed under Malaysian Integrated Medical Professionals Association is an informational website featuring news, issues and medical facts written by specialists, doctors and healthcare professionals. It is not a substitute for medical consultation. All facts written were authenticated by the respective authors and true at the time of publication. Copyright © 2017 The Malaysian Medical Gazette. All Rights Reserved. The Magazine Basic Theme by bavotasan.com.