3 Mount Elizabeth, #14-15, Mount Elizabeth Medical Centre, Singapore 228510

Inflammatory Bowel Disease

Inflammatory Bowel Disease

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is a medical condition that refers to chronic inflammation of the digestive tract tissues. In Singapore, the incidence rate is 1.06 cases per 100,000 people, which translates to approximately 1,500 people who may be suffering from IBD.
The digestive tract plays a pivotal role in breaking down food, extracting nutrients, and excreting waste products. As such, any inflammation along the digestive tract can disrupt the normal digestive process, and cause severe, and painful symptoms. Common types of IBDs include:
  • Crohn’s disease: Crohn’s disease can cause any part of the digestive tract to become inflamed, but it mostly occurs in the tail end of the small intestine.
  • Microscopic colitis: microscopic colitis is a chronic inflammation of the intestine that can only be detected under a microscope.
  • Ulcerative colitis (UC): although ulcerative colitis implies inflammation of the large intestine, it can also lead to other non-digestive concerns.
  • Anorectal Fissure

    Individuals with a family history of Crohn’s disease, or ulcerative colitis are more at risk of developing inflammatory bowel diseases.

    What causes inflammatory bowel disease?

    Unfortunately, the exact causes of inflammatory bowel disease are unknown. However, it has been hypothesised that a weakened immune system can stimulate the development of IBD. This happens when one’s immune system attacks the bowel containing harmless viruses or good bacteria in the gut. Additionally, IBD is also notably a hereditary disease impacted by genetic factors.

    What are the symptoms of inflammatory bowel disease?

    The symptoms of IBD can range from mild to severe, and they can also come, and go. IBD flares indicate that you are currently experiencing symptoms of IBD, while the absence of symptoms indicates that you are in remission. These symptoms may include:
  • Abdominal pain.
  • Appetite loss.
  • Bloating.
  • Blood-stained stool.
  • Diarrhoea, constipation, and bowel urgency.
  • Gas.
  • Indigestion.
  • Mucus in stool.
  • Unexplained weight loss.
  • Although rare, IBD may also progressively present the following symptoms:

  • Eye inflammation.
  • Fatigue.
  • Fever.
  • Joint pain.
  • Nausea.
  • Skin disorders like rashes, and sores.
  • Vision problems.
  • Vomiting episodes.
  • Who is at risk of inflammatory bowel disease in Singapore?

    Are you at risk of IBD? Get in touch with us to have your gut screened today.
    Some of the factors that can increase your risk of getting IBD are:
  • Age: IBD is more commonly diagnosed among individuals who are younger than 30 years old, however, some people may not develop the disease until they are in their 50s or 60s.
  • Family history: people with a family history of IBD are more likely to develop the disease.
  • Smoking: as smoking harms your digestive tract, it inherently deteriorates your digestive tract, and thereby increases the chances of developing IBD.
  • Non-steroidal anti-inflammatory medications (NSAIDs): medications such as ibuprofen, naproxen sodium, and diclofenac sodium put you more at risk of getting IBD in the future.
  • These risk factors increase the pressure and strain on the anus, which can cause tears in the lining, resulting in an anal fissure.

    How is inflammatory bowel disease diagnosed in Singapore?

    The diagnostic process will usually start with a review of your medical history, and examining your symptoms to diagnose IBD. Your initial workup may consist of a complete blood count (CBC), and a stool test to determine intestinal inflammation.
    Some of the additional diagnostic tests can include:

    Colonoscopy:

    By using a colonoscope, which is a special equipment that is equipped with a built-in camera, and light at the tip, to examine the small, and large intestines for any abnormalities.

    Capsule endoscopy:

    This procedure involves swallowing a tiny camera (shaped like a pill), and taking pictures of the intestines as it travels through the digestive tract.

    Endoscopic ultrasound (EUS):

    An EUS is often used to examine the digestive tract for the presence of ulcers, or swelling.

    Gastroscopy:

    a procedure to examine the beginning of the gastrointestinal tract.

    Imaging tests:

    In some cases, our doctors may also opt to perform imaging tests such as a computerized tomography (CT) scan, or magnetic resonance imaging (MRI) to identify signs of an abscess, or inflammation.

    How is inflammatory bowel disease treated in Singapore?

    Once an IBD diagnosis has been confirmed, an array of treatment measures are deployed to keep IBD symptoms at bay. However, the treatment options will depend on the severity of your symptoms. But typically, our doctors will use one, or a combination of the following treatment options:

    Medication

    Medications are often prescribed to help control and manage IBD symptoms. These can include:
  • Aminosalicylates: an anti-inflammatory drug to help patients diagnosed with ulcerative colitis to achieve, and stay in remission.
  • Antibiotics: antibiotics are typically prescribed to alter the gut microbes or address any infections.
  • Anti-diarrheal medications: prescribed to patients with little, or mild intestinal inflammation.
  • Anti-spasmodics: may be prescribed to reduce intestinal spasms and abdominal cramps.
  • Corticosteroids: are often used as a short-term treatment to manage IBD flare-ups.
  • Immunotherapy medications: immunotherapy medications suppress the immune system, which keeps IBD patients in remission.
  • Bowel Rest

    If you are diagnosed with severe Crohn’s disease, then you may be put on bowel rest. Bowel rest is a medical strategy where the food intake is limited to ease the symptoms of Crohn’s disease. In certain cases, you are only permitted to consume pre-approved clear liquids or are fed through a feeding tube. By giving your intestines, a break from digesting food, it will allow your intestines to heal, and reduce inflammation.

    Surgery

    In the event all prior treatment plans yielded zero results, then surgical intervention such as robotic colorectal surgery may be recommended in chronic cases;
  • Crohn’s disease: surgical intervention is often necessary within the first 10 years of diagnosis, especially to manage fistulas (link to anal fistula condition page). On the other hand, surgery may also be necessary for patients who are at risk of developing intestinal blockages due to post-inflammatory healing. Prolonged Crohn’s disease may even result in multiple surgeries to treat the condition.
  • Ulcerative colitis: patients diagnosed with severe ulcerative colitis often undergo surgery to remove the colon, large intestine and rectum. This may result in the doctor creating a passageway from the small intestine to the anus, to ensure the patient still has normal bowel movements. On the other hand, some patients will require ostomy bags to collect their waste.
  • Delaying treatment for IBD can result in complications that can become life-threatening. That is why we encourage people who exhibit symptoms of IBD or are at risk of developing it to book an appointment to enable prompt intervention.

    Frequently Asked Questions

    Some of the complications that are linked to IBD include colorectal cancer, anal fistulas, anaemia, kidney stones, and malnutrition. Additionally, untreated IBD may also lead to ruptured intestines or bowel obstructions. In fact, in rare cases, IBD can lead to physiologic shock, which is a life-threatening condition characterised as sudden, and prolonged blood loss, such as bloody diarrhoea.

    One of the ways that you can prevent IBD is by making lifestyle changes such as drinking a lot of fluids, avoiding triggers such as dairy, learning how to manage stress, exercising, and quitting smoking.

    Yes, children can also be diagnosed with IBD.

    No, IBD, and IBS are not the same. While IBD is a disease that inflames and damages the intestines, IBS is a syndrome that impacts how the bowel functions.

    Yes, it is possible to be diagnosed with both IBD and IBS simultaneously.

    Location

    Colorectal Care Specialists (CRCS)

    3 Mount Elizabeth, #14-15, Mount Elizabeth Medical Centre, Singapore 228510

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