A rumble in the stomach is a common occurrence but what are the signs that there’s something more serious going on?
Inflammatory Bowel Disease (IBD) is often mistaken for Irritable Bowel Syndrome (IBS).
Around 40,000 people, including an unknown number of students, are living with IBD in Ireland. IBD includes Crohn’s disease and Ulcerative Colitis, which are chronic diseases typified by inflammatory flares and periods of remission. Both diseases cause ulceration of the digestive tract. Crohn’s disease can affect anywhere from the mouth to the anus and ulcerative colitis is restricted to the large intestine.
There is currently no known cause or cure for IBD. According to the Irish Society for Colitis and Crohn’s Disease (ISCC), the diseases affects the ability of the digestive system to function properly. The most common symptoms include abdominal pain, persistent diarrhoea, bleeding, vomiting, severe weight loss, chronic fatigue and malabsorption of essential nutrients.
Surgery is often required in IBD and involves the removal of some or all of the small or large intestine and/or rectum, which can lead to the use of a stoma.
The peak age of these diseases is between 15 to 35 , with a second peak incidence between the ages of 50 and 70. The diseases can be aggressive in children and there has been a 90% increase in childhood IBD cases in Ireland between 2002 and 2012.
Professor Stephen Patchett, a Consultant Gastroenterologist who works in Beaumont Hospital in Dublin and treats approximately 1000 patients said: “I stress to newly diagnosed patients that in the vast majority of cases, treatment is very successful and that a very fulfilling and active life is possible”.
Medication is available that can be used to treat the symptoms and prevent them from returning but according to bonsecours.ie “about 80 percent of Crohn’s disease patients will require surgery to relieve their symptoms, repair damage to their digestive system and treat complications of the condition”.
Crohn’s disease affects slightly more women than men and while the exact cause of the disease is unknown, most researchers think that the condition could be caused by a combination of genetics, the immune system, previous infection, and environmental factors.
Professor of Biochemistry in Trinity College in Dublin said, “When it comes to genetics in IBD, lots of genes have been implicated in inflammatory bowel disease affecting multiple inflammatory pathways. NOD2 is a bacterial sensor, implicating bacteria in disease pathogenesis and IRGM is an inhibitor of an inflammatory pathway involving the NLRP3 inflammasome.”
Family history is the strongest predictor for developing IBD. If one parent is affected, the risks of the offspring developing IBD are two – 13 times higher than in the general population. In a poll on Instagram by the ISCC, 37% of people voted that they had someone in their family with IBD.
According to Crohn’s and Colitis UK, “one suggested link is with a diet high in fats and sugars and low in fruit and vegetables. IBD rates have been lower in non-Western countries such as Japan than in Western Europe and North America. The overall picture is still not clear and some findings contradict each other”.
“There is no one particular food that all those with IBD should avoid completely, as sensitivities can vary from person to person. If you have IBD and suffer from digestive discomfort when in remission, I would recommend keeping a strict food and symptom diary to help you to identify any problematic foods,” said Dietician Aoife McDonald.
IBD specialist nurse, Angela Mullen who works in the Mater Misericordiae University Hospital in Dublin and is one of 14 IBD nurses in Ireland said, “we definitely need more IBD nurses, the patient’s with IBD need access to care and unfortunately in some practices, they don’t have that”.
It has been nearly a year and a half since Minister for Health, Simon Harris said he could see no reason why the doubling of specialist IBD nurses from 14 to 28 could not be accommodated as part of the current recruitment drive to advanced nurses practitioners. No additional IBD nurses have been hired since.
“I don’t have access to an IBD nurse and it amazes me that so many others are without one too. How can 40,000 people in Ireland living with IBD only have 14 nurses around the country? There are times when I am forced to go to A&E because I can’t pick up a phone to call an IBD nurse,” said Crohn’s disease patient John Murphy.
“There have been seven meetings cancelled with the ISCC by the Minister for Health Simon Harris, who suffers from IBD himself. The Government needs to do more,” said Ulcerative Colitis sufferer Lyndsey Cusack.
The ISCC continues to fight for IBD sufferers in Ireland and has a support telephone line and living well with IBD self-management programme, which people can find information about on the ISCC website www.iscc.ie.