World IBD Day : Awareness a must
Dr. NC Nath :
‘IBD has no age’ is the slogan for World IBD Day 2023. The day will be celebrated worldwide on May 19. The day is observed every year to make people aware to avoid this disease. IBD is still unknown to many of us. Inflammatory bowel disease (IBD) is a non-infectious chronic inflammatory bowel disease. The disease usually presents during puberty with diarrhea and abdominal pain.
If the large intestine is affected, the disease is called ulcerative colitis. Crohn’s disease can spread throughout the intestines. The severity and complications of the disease depend on the extent of the affected area of the intestine, which is about eight meters long. Ulcerative colitis is limited to the lining of the intestine and causes bloody diarrhea. But Crohn’s disease narrows the intestinal lumen by perforating the entire intestinal wall. As a result, the movement of digested food and stool is obstructed. Because of its prevalence in high-income countries, IBD can be called the disease of kings and the king of diseases. However, it has now invaded Southeast Asia, the Middle East and Africa as well. Changing diet and urbanization may be acting as triggers for the disease. As children grow up playing in mud in their natural environment, they interact with common microbes, to which their bodies no longer have an immune response. Foods containing preservatives, fast food and the uncontrolled use of unnecessary antibiotics in the production of animal proteins disturb the natural environment of the child’s intestines from an early age. Low-fat foods and red meat contribute to the growth of harmful bacteria in the gut. Excessive use of antibiotics and gastric acid suppressants contributes to the overgrowth of harmful bacteria in the gut. Crohn’s disease and ulcerative colitis are increasing and will continue to increase in increasingly industrialized countries today compared to the recent past.
Just as a bullet will not fire from a pistol, the disease may be caused by an uncontrolled and abnormal immune response to triggering factors, even if the cause is genetic. Immune genetic-related bowel disease causes long-term suffering in the patient, but due to variations in the immune response, the disease may occasionally subside spontaneously. However, repeated inflammation can lead to colon cancer. The burden of inflammatory bowel disease IBD is increasing worldwide, with significant changes in disease levels, prevalence, and trends across countries and regions. Recognizing the importance of developing effective strategies for the prevention and treatment of IBD, the Journal Lancet published the results of a study in 2020 that reported the prevalence, mortality and material burden of IBD in 195 countries and regions. Studies show that the prevalence of IBD has increased significantly in many regions from 1990 to 2017, which may create a substantial social and economic burden on governments and health systems in the years to come. An Iran-based study published in the Journal of BMC Gastroenterology fears an increase in the incidence of IBD in the near future. The results of the study predicted a 2.5-fold increase in IBD in Iran in 2035 compared to 2020. The prevalence of IBD is expected to increase 2.3-fold in North Africa, the Middle East, and four-fold in India-Southeast Asia. Diagnosing this disease is not difficult, but requires endoscope, colonoscope, enteroscope and trained manpower, which our country has the capacity to do. Disease inflammation is caused by an abnormal and uncontrolled immune response, so the disease will be controlled if the immune response is not allowed to occur and the bad cytokines produced by the immune response can be neutralized. In addition, there are some very expensive medicines called biologics, which are also available in Bangladesh. Long-term use of some relatively inexpensive drugs can reduce the severity of the disease by suppressing the immune response.
It is necessary to avoid artificiality as much as possible in eating, walking. Naturally occurring fibrous vegetables, fruits and sour yogurt should be in sufficient quantity in everyone’s diet. If not controlled immediately, increasing IBD (Crohn’s Disease and Ulcerative Colitis) may spread in epidemic form in our country in near future and will increase the pressure on health services. Therefore, it is necessary to adopt a quick plan of the NCD department.
(The writer is Associate Professor and Head, Department of Gastroenterology, Mugda Medical College Hospital).
