Ahead of World IBD Day this Friday May 19, and against this backdrop of delayed diagnosis, Crohn’s and Colitis Ireland has launched a new Symptom Checker (www. crohnscolitis.ie/symptomchecker). The tool forms part of its “Poo Taboo” campaign which aims to lift the lid on some of the stigma around IBD symptoms and the importance of people not being too shy to get checked out.
IBD covers a number of conditions in which the digestive tract becomes inflamed, swollen and ulcerated – the two most common conditions being Crohn’s Disease and ulcerative colitis. It is thought that at least 40,000 people are living with IBD in Ireland, with most being diagnosed between 15 and 35 years, and then later in life, between 50 and 70 years. However, Crohn’s and Colitis Ireland believes that many more people remain undiagnosed.
While ulcerative colitis affects the large intestine only, Crohn’s disease can occur anywhere along the digestive tract, and the inflammation can be much deeper, even perforating the bowel. Common symptoms include diarrhoea or loose stools, bleeding from the bottom, fever, fatigue, anaemia, weight loss, cramps and abdominal pain. With ulcerative colitis, there can also be a feeling of being unable to completely empty the bowel.
Don’t wait to get seen… Consultant gastroenterologist, Professor Barbara Ryan, continues, “I have known from my own clinical practice for some time that too many people delay getting seen to. They may put off getting checked out and having their symptoms investigated, or sometimes IBD, particularly Crohn’s disease, can be difficult to diagnose. For others, the path to diagnosis is much smoother and quicker, once they start to undergo investigation. Thankfully, once the diagnosis is made, we now have an excellent and ever-expanding array of treatments available, and people can experience a rapid improvement in symptoms.
“While the results of the recent survey undertaken on behalf of Crohn’s and Colitis Ireland are not surprising to me, they are nonetheless still very concerning. It found that while four in ten would go to see a doctor immediately if they saw blood in the toilet bowl, an equal number would delay getting seen to.
“We want people to stop ignoring the key signs of what can be a serious disease, to overcome any embarrassment that they may have, and to seek medical advice. With our newly-developed symptom checker, people can, in the comfort and privacy of their own homes, answer a series of questions. In less than a minute, they will know if they need to see a GP for further examination.”
The symptom checker asks questions such as: whether an individual has seen blood in their poo more than once; if symptoms are present such as diarrhoea, needing to have a poo urgently or waking up in the night to poo; and whether a person is experiencing unexplained weight loss, abdominal pain, fatigue and fissures that don’t heal, or abscesses that keep coming back. Based on the results, they will then receive advice as to next steps.
Our Survey Says…
The survey to determine awareness of IBD among the population was conducted by Amárach research in March of this year. It found that:
• Awareness: most people (94%) have heard of IBD, Crohn’s disease or ulcerative colitis. Specifically, 79% had heard of Crohn’s disease while 43% had heard of ulcerative colitis.
• Symptoms: most also had a knowledge of some of the symptoms with four in five (83%) able to identify cramps or abdominal pain, 79% diarrhoea or loose stools, 70% blood in stool/toilet bowl/toilet paper, and 67% a feeling of being unable to completely empty the bowel.
• Taking action: however, when it came to acting on symptoms, two in five (40%) would do nothing or adopt a “wait-andsee” approach. This includes 5% of the overall sample who would be too embarrassed to seek advice, hoping that the symptoms would go away. One in ten (9%) would consult “Dr Google” before deciding what to do, while 7% would seek advice from a family member or trusted friend before deciding next steps. Of the overall sample, less than half (41%) would immediately seek advice from a GP or healthcare professional.
The “Poo Taboo” campaign is supported by the Irish College of General Practitioners.
IBD & YOU – SEVEN THINGS YOU SHOULD KNOW…
1. What is IBD? Inflammatory Bowel Disease (IBD) is an umbrella term for inflammatory conditions of the gastrointestinal (GI) tract including ulcerative colitis and Crohn’s disease. It is a chronic and complex condition with periods when it is both active and inactive. Ulcerative colitis is limited to the large bowel and rectum, while Crohn’s disease can occur anywhere from the mouth to the anus.
2. What causes IBD? The cause of IBD is not fully understood, but may relate to a combination of genetic, gut bacteria and environmental factors.
3. What are the symptoms of IBD? Symptoms of IBD include diarrhoea, rectal bleeding, urgency to use the toilet, mouth ulcers, weight loss, fatigue, anaemia and abdominal pain and cramping. Crohn’s disease is often associated with anal problems such as fissures, tags and abscesses. IBD can also affect other parts of the body, particularly the joints, skin, eyes and liver.
4. What’s the difference between IBD and IBS? IBD and IBS are two different gastrointestinal disorders. While they can have some similar symptoms, they are not the same condition and require very different treatments. IBD refers to inflammatory disease including Crohn’s disease and ulcerative colitis. IBS is a syndrome consisting of a group of symptoms that occur together, including abdominal pain, changes in bowel movements, which may be diarrhoea or constipation, or both, and excessive gas and bloating.
5. Will I spend the rest of my life running to the bathroom? No. Once a diagnosis and treatment plan are in place, the aim of treatment is to reduce symptoms, obtain remission and improve quality of life.
6. How can diet help? Malnutrition can affect up to 85% of people with IBD and so a well-balanced and healthy diet is important. This should incorporate protein which is key to muscle growth, good fats –known as unsaturated fats – which have health-promoting properties, and carbohydrates which are an important source of energy and B-vitamins. Of course, every person with IBD is different, and so too will be their dietary plan.
7. Is there a cure? There is currently no cure for IBD, however, treatment can help stabilise the disease and provide a return to a normal quality of life. Treatment can involve medications, surgery, and adopting new diet, exercise and lifestyle routines.
Written by: Consultant gastroenterologist, Professor Barbara Ryan