Living with Inflammatory Bowel Disease

The global incidence rate of Inflammatory Bowel Disease (IBD) has been increasing from 1990 to 2021 as per the figures provided by the Global Burden of Disease Organization with a rising trend in Asian countries that requires immediate attention. Thanks to the awareness created globally there is now early detection methods, improved management, and new treatments to alleviate the condition. At a conference (IBD Nexus) organized by Takeda, a global biopharmaceutical leader, committed to advancing patient care, and one of the stakeholders in the Inflammatory Bowel Disease (IBD) therapeutic area, many healthcare professionals and gastroenterologists from around the world conferred about the epidemiology, symptoms and new age treatments/ interventions in IBD management, in Dubai.

Dr. Badr Al-Bawardy, MD, an eminent gastroenterologist specializing in the management of IBD at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia and adjunct faculty at Yale University, who was a delegate at the IBD Nexus event, spoke to HEALTH regarding the etymology, treatment and management of the disease.

Dr. Badr Al Bawardy, MD
Gastroenterologist at King Faisal Specialist Hospital and Research Center

Dr. Al-Bawardy earned his M.D. with distinction from George Washington University. After medical school, he completed an internal medicine residency, gastroenterology fellowship and a specialized inflammatory bowel disease fellowship at the Mayo Clinic in Rochester, MN, which gave him valuable experience treating the disease alongside leaders in the field.

What is Inflammatory Bowel Disease (IBD)? Can you elaborate on it?

IBD is an umbrella term that refers to two conditions including Ulcerative Colitis (UC) and Crohn’s disease (CD) that have many similarities and few differences. Both are considered autoimmune conditions. While ulcerative colitis involves the colon only, Crohn’s disease can involve any part of the gastrointestinal tract. The earlier it can be detected, diagnosed, and appropriately managed, the higher the chances of putting the disease into remission.

What causes IBD?

The exact cause of IBD remains unknown. It is thought to be related to genetic and environmental factors that trigger the body’s immune system to self-attack parts of the gastrointestinal tract. Environmental factors that have been associated with IBD include smoking, early exposure to antibiotics and certain dietary patterns.

How does IBD get diagnosed?

Many of the IBD symptoms for both UC and CD are common such as:

Some of these symptoms may be experienced in other conditions such as food poisoning or other infections and therefore individuals tend to have a delay in diagnosis. We advise that if an individual is frequently experiencing abdominal pain, diarrhea, blood in the stool and so on, he or she should immediately seek help with their GP who can then recommend specialist and also go in for tests such as blood work, stool test, colonoscopy with biopsy, different kinds of endoscopy (capsule, upper endoscopy as recommended by his physician), CT to be able to have the diagnosis as early as possible to start treatment. Early detection and management can not only provide relief to the patient but also improve his chances for remission and provide a better quality of life.

Who is at risk?

The condition is frequently diagnosed in Caucasian population in Canada, UK, parts of Europe, US and Australia, however, now there is evidence of a rising incidence in Asian countries too.

Please tell us about the IBD Nexus Summit and how this initiative by Takeda will raise more awareness about IBD?

I think this conference – the IBD Nexus Summit, is a great initiative by Takeda in helping bring in so many physicians and gastroenterologists of the region under one roof to raise awareness about the rising incidence, new treatments, and insights into the management of this condition. The conference allowed multiple IBD experts from varying parts of the region to share collective experiences and learn from each other.

What is the role of stress and sedentary lifestyle, poor nutrition in exacerbating the condition?

IBD is a multifactorial disease which is due to a genetic predisposition and environmental factors. Although the disease can be well controlled, relapses in which the disease becomes active and causes symptoms can occur. Flares of the disease has been associated with dietary patterns including high intake of processed foods, stress or anxiety, gut infections, and certain medications. Leading an overall healthy lifestyle along with adherence to medications and close follow up with the treating gastroenterologist can limit periods in which the disease becomes active and causes symptoms.

A lot of people think once diagnosed with IBD they will have to live with it … is there any surgical intervention or immunomodulators /biologics treatment that can resolve the condition?

IBD is a chronic condition where early detection and intervention can help the disease go into remission and minimize any flares. Although the disease is chronic, there are now multiple different treatment modalities that can place the disease into complete remission (a state in which the disease is inactive and not causing symptoms). This includes medications such as those that regulate the immune system including biologics. In addition, at times, surgical excision of the inflamed portion of the colon or the small intestines is needed.

It is favorable for patients diagnosed with IBD to be in regular touch with their doctor, go in for regular monitoring and screening, such as blood work, scans including intestinal ultrasound, and as needed colonoscopy. More importantly, IBD is a complex disease and requires a team of specialists including but not limited to gastroenterologists, surgeons, dieticians, and pharmacists working closely together to provide the best care for patients with IBD.