World Inflammatory Bowel Disease Day: Raising IBD Awareness

Moustafa Kamel Chief Medical Officer Janssen
Moustafa Kamel Chief Medical Officer Janssen

JOHANNESBURG May is Inflammatory Bowel Disease (IBD) Month, which provides the ideal opportunity for us all to brush up on knowledge about this condition and understand the important work that Janssen South Africa is doing in both the areas of Crohn’s Disease (CD) and Ulcerative Colitis (UC) – the two debilitating conditions that make up IBD. IBD is not to be confused with Irritable Bowel Syndrome (IBS), which is a condition in which the brain and digestive system are not working in functional harmony.

Ulcerative Colitis has to do with
inflammation and sores (ulcers) along the lining of your large intestine (colon) and rectum, whereas Crohn’s Disease is characterised by the inflammation of the lining of your digestive tract, which often can involve the deeper layers of the digestive tract.[1]

Although CD most commonly affects the small intestine, it can also affect the large intestine and, less commonly, the upper gastrointestinal tract. Both conditions are usually characterized by diarrhea, rectal bleeding, abdominal pain, fatigue, and weight loss.1  

A third category, Indeterminate Colitis (IC), has characteristics of both CD and UC.[2] “Extra-intestinal” symptoms, or symptoms which show up outside of the intestinal system, could affect many areas of your body, including joints, mouth, eyes, skin, liver, gallbladder, kidney, and pancreas. It’s even been connected to osteoporosis.

For some people, IBD is only a mild illness. For others, it’s a medically and socially debilitating condition that affects one’s professional and social life, but also conceivably leads to life-threatening complications.

Moustafa Kamel, the Medical Affairs Director of Janssen South Africa, presents us with this scenario: “Imagine that you’re in a meeting, and you have to excuse yourself to go the restroom – maybe even four times during that same meeting. How awkward does that make you feel? And how do others perceive you? What rumours and misconceptions could arise from such behaviour?”

IBD is the result of a weakened immune system, possibly caused by the immune system responding incorrectly to environmental triggers, such as a virus or bacteria. This, in turn, can inflame the gastrointestinal tract. The intake of nonsteroidal anti-inflammatory drugs, antibiotics, and birth control pills could also increase IBD risk.[3] There also appears to be a genetic component to this affliction, meaning that a history of IBD within a family, would predispose newer generations to encounter this dysfunctional biological response.[4] IBD has been known to affect people across all ethnic groups, although, statistically, people of Jewish ancestry are in a higher risk group. Environmental factors may also be a factor. For example, IBD is rare in the southern hemisphere.2

Of course, the symptoms described above, could, on their own, be the result of various other factors, such as a diet that doesn’t agree with one. Kamel therefore cautions us to distinguish between a once-off event and persistent symptoms. If these behaviours don’t respond to conventional treatment, a formal diagnosis would be necessary, and this could involve a gastroscopy – more precisely, an endoscopy for CD and colonoscopy for UC. Other resources would include contrast radiography, Magnetic Resonance Imaging (MRI), Computed Tomography (CT), stool samples, and blood tests.4

Kamel reassures us, however, that “the last two decades have seen a revolutionary advancement in the treatment of this condition. They have enabled us, also, to be more specific, in terms of which symptoms we can target in isolation.”

He continues: “Further good news is that it doesn’t lead to other health problems, or to damage within your digestive tract. Just remember that early diagnosis will help you to get ahead of the disease as soon as possible and prevent its progression.”

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[1] Mayo Clinic. Inflammatory Bowel Disease.

[2] Johns Hopkins Medicine. Inflammatory Bowel Disease.

[3] Harvard Health Publishing. Chronic gut inflammation: Coping with inflammatory bowel disease.

[4] CDC. What is Inflammatory Bowel Disease (IBD)?