The World Gastroenterology Organization proclaimed May 29, 2004 as World Digestive Health Day. Since then, every year an attempt is made to raise awareness about some of the health problems related to the Digestive System. This year it is dedicated to Inflammatory Bowel Disease, an increasingly frequent pathology in the population living in developed countries, which significantly alters the quality of life of the patients who suffer from it, with a probability of requiring surgical treatment after 10 years close to 50%. Dr. Roncero García-Escribano, of Surgery and Digestive, explains what this pathology consists of.
Prevention of IBD
Although initially we do not have tools that allow us to prevent inflammatory bowel disease (as it is a complex health problem involving more than 250 genes, environmental factors, infectious agents, which, together with the microbiome, trigger an abnormal inflammatory immune response), in some countries, such as Canada, early detection programs have been implemented through stool analysis that allows the determination of fecal calprotectin, an inflammatory protein released by inflammatory cells in the stool, In some countries, such as Canada, early detection programs have been set up for the early detection of the disease, using stool analysis that allows the determination of fecal calprotectin, an inflammatory protein released by inflammatory cells (neutrophils) present in the digestive tract.
The determination of elevated levels of fecal calprotectin in feces implies the need for an adequate study of the patient to allow early detection of inflammatory intestinal problems. In this sense, in our country, although there are no early detection programs for the disease, similar to the screening of colon cancer or breast cancer, we can advise the relatives of patients already diagnosed with Crohn’s disease or Ulcerative Colitis to contact a physician specializing in Digestive Diseases to propose a test capable of detecting the disease early.
Early diagnosis of IBD
Although we cannot answer this question with scientific precision, we do know that patients with a shorter disease evolution time respond better to treatment. In this regard, we know that the time elapsed from the onset of symptoms until the diagnosis is established is long (sometimes up to several years). Therefore, recently the International Organization for the Study of Inflammatory Bowel Disease (IOIBD) has published a series of symptoms whose presence advises assessment by a specialist:
● The presence of perianal fistulas ● Episodes of fever maintained for 3 months ● Weight loss (more than 5% in 3 months) ● Anemia ● Chronic diarrhea ● Nocturnal diarrhea ● Abdominal pain ● Perianal pain ● Rectal bleeding ● Defecatory urgency ● Family history of inflammatory bowel disease ● Active smoking ● Asthenia ● Joint pain, uveitis, skin lesions.
There are some factors that by eliminating them can change the evolutionary course of the disease and clearly improve its prognosis; this is the case of smoking in the patient with Crohn’s disease.
Have there been changes in the treatment of IBD?
Undoubtedly, since the neutralizing drugs of Tumor Necrosis Factor Alpha (a proinflammatory mediator agent of great relevance in the etiopathogenesis of the disease) were marketed in 1998, both the management and – more importantly – the quality of life of patients has unquestionably evolved.
Today, not only do we have potent intestinal anti-inflammatory drugs, but they are also easier and safer to administer. Moreover, clinical research is unstoppable.
Today, more than 100 new biological molecules are being investigated for the treatment of the disease, so we can safely say that in the next 10 years there will be a second new revolution in the management of patients with inflammatory bowel disease, which will lead to a better quality of life, better control of their disease, less need for surgery and a lower rate of complications.
In summary, on World Digestive Health Day we must remember that:
- The presence of the aforementioned digestive symptoms makes it advisable to be evaluated by a digestive specialist.
- There are non-invasive, efficient and cost-effective diagnostic methods (such as calprotectin) that help in the early diagnosis of the disease.
- Relatives of patients diagnosed with IBD should inform their physician of this fact.
- Smoking cessation is a measure within our reach that modifies the history of the disease.
- Although it is a chronic and complex disease, the current therapeutic arsenal allows us to face it with optimism. Even so, the development of new anti-inflammatory molecules in the coming years will enable us to face the future with even more confidence and greater security, undoubtedly achieving greater well-being for patients.
In any case, on World Digestive Health Day we wish our readers a happy day, that they maintain healthy lifestyle habits (doing sports, avoiding obesity, not smoking, maintaining an emotional and affective balance) in order to achieve the Latin maxim: “mens sana in corpore sano”.