Inflammatory bowel disease (IBD) refers to a group of conditions that cause inflammation of tissues in the digestive tract. It is estimated that there are approximately 3000 to 4000 individuals who suffer from IBD in Singapore.
Although symptoms may be mild in some individuals, if left untreated, it can progress into more severe complications.
The two types of IBD include:
Symptoms of IBD may vary depending on the location of the inflammation along the gastrointestinal tract, and someone suffering from IBD may have periods of remission with little to no symptoms, followed by flare-ups.
According to gastroenterologist Dr. Tey Tze Tong, his patients have shared instances of IBD affecting their work and social life.
“Patients worry about eating normal meals with friends and family, for fear of triggering a flare-up,” he adds. “Some may avoid some social gatherings for fear they may need to rush to the toilet midway.”
Common signs of both ulcerative colitis and Crohn’s disease include diarrhoea, tummy aches, bloody stools, weight loss, loss of appetite, and fatigue.
Despite its challenges, many with IBD have found ways to persevere and lead fulfilling lives. Behind the statistics are real people learning to live with IBD. Two of them, Anne and Sanjay, share how they’ve found strength through their struggles with the disease.
When it first happened, Anne had brushed it off as a simple case of food poisoning.
“It happened fifteen years ago, I thought it was just food poisoning after eating some raw food like sashimi. However, it ended up being quite serious and I was made to undergo an endoscopy and colonoscopy,” the 55-year-old, who works as a financial advisor, said. “There, they discovered that I actually had pretty heavy bleeding in my intestines and I was diagnosed with ulcerative colitis.”
Following her diagnosis, she experienced periods of both remission and flare-ups. This year, Anne began her treatment journey under the care of Dr. Tey, where she was prescribed mesalazine, an anti-inflammatory drug, along with a targeted advanced therapy drug to treat her condition, with significant improvement in her symptoms.
For those suffering from IBD, Dr. Tey stresses the importance of seeking medical help and sharing any concerns they may have with their healthcare provider, so as arrive at a mutually agreed treatment plan, “Patients should see their IBD gastroenterologist who can fully evaluate their IBD and recommend the best treatment plan tailored to their situation. The different medications each come with their own benefits and risks, so careful consideration is important in IBD.”
Prior to her diagnosis, Anne had not been aware of the condition and as far as she knew, no one in her family has a history of this condition. After she got past the initial shock of the diagnosis, her focus went to concerns about how the condition would affect her lifestyle.
Even after her diagnosis, Anne revealed that she had been leading an active professional life. This demanding schedule came at a cost, missed medical appointments and worsening symptoms. Such a move resulted in several recurring symptoms over the years, sometimes serious enough to land her in the hospital.
Due to her condition and periods where it would flare up, Anne has had to make several changes to her diet, such as foregoing the sashimi she used to enjoy eating, in favour of cooked food. Unfortunately, there were also times when flare-ups would force Anne to make changes to her plans, such as trips overseas with her family.
“If not for the pain, I could’ve gone to Japan with my daughter during the holidays,” Anne shared. “I was still seeing clients, thinking that it was okay and that the on-and-off pain would resolve itself. However, the pain ended up being too bad and I found myself going to the toilet around ten times a day.”
Despite the toll ulcerative colitis has taken on her body and mind, Anne remains grateful for Dr. Tey’s holistic and supportive approach, “I appreciate how he shows concern for his patients and also listens to the patient’s fears and worries about the safety of the medications they are treated with. His consultations and treatments are more multifaceted and I feel like I’ll be well taken care of.”
When times get tough, Anne finds strength in her love for her family and career. “What keeps me going? It’s family love,” Anne said succinctly. “I work because of them, to support them. But not only that, I also find fulfilment in my work, by helping people ensure they are protected, and that their hospitalisation, investment, and retirement needs are met.”
For others who may also be suffering from this condition, Anne has the following advice, “Be patient and persevere. Also be sure to follow through with your medication and doctor visits. Most importantly, as IBD is a lifelong condition, have a good doctor who understands you and your condition, and knows how to fine-tune treatments for you.”
Like Anne, Sanjay also had to navigate the uncertainty and challenges that came with an IBD diagnosis, but his journey began much earlier in life.
Sanjay’s condition started with visits to his GP after noticing blood in his stools and experiencing pain and discomfort when passing motion. Doctors initially prescribed him antibiotics for what they assumed was just a normal infection. When that failed to treat his condition, Sanjay next went to a hospital that once again treated his symptoms as if it were just a normal infection.
It was only after the symptoms kept recurring that the 24-year-old public servant realized his condition may not be a simple one. He sought medical advice from a gastroenterologist who performed a colonoscopy and MRI scan. After multiple areas of inflammation were observed in his intestines, Sanjay was finally diagnosed with Crohn’s disease.
Though the diagnosis came as a surprise, Sanjay chose to focus on finding solutions rather than dwelling on the negatives.
“I checked with my family and they were not aware that there was such a condition called IBD,” Sanjay explained. “However, when I got my diagnosis, it was not too much of a shock for me as the pain I was experiencing felt more overwhelming. Hence, when Dr. Tey told me what I had, my thought process went to figuring out how to rectify the problem, instead of feeling down over my diagnosis.”
Sanjay suffers from severe Crohn’s disease. As such, his case is one that requires more attention than most.
“For patients with severe IBD, they may experience frequent and severe flare-ups despite initial medication. Hence, they need stronger forms of medication to keep the disease under control,” he adds.
This need for stronger, more targeted treatments isn’t unique to Sanjay. Many IBD patients face similar challenges with standard medications, which, while essential, can come with side effects like increased susceptibility to infections due to immune suppression.
Fortunately, the treatment landscape for IBD is evolving. According to Dr. Tey, new therapies developed in recent years, known as “Advanced Therapies”, offer renewed hope.
“These newer medications are very beneficial to patients as they provide more options to manage and control IBD,” he explains. These drugs work by targeting specific immune system pathways to reduce inflammation and prevent long-term damage to the digestive tract.
Perhaps the biggest blow to Sanjay after getting his diagnosis was his inability to engage in strenuous activities, as going to the gym was a favourite pastime of his.
“Dr. Tey advised me not to do anything too physical, like strenuous activities. However, as my job can be quite mentally draining, I used to like going to the gym to lift some weights and blow off steam. I would also attend classes, such as martial arts. But due to this condition and my surgical wounds, I cannot do anything strenuous.”
Despite facing setbacks, Sanjay tries his best to stay positive, “I just have to deal with it. I try to think positively, like thinking to myself that there will be a solution to [my condition] and push through it.” Sanjay’s advice to others living with IBD is clear: Don’t ignore the signs.
“When I had my initial symptoms, I chose to ignore them instead of consulting a doctor. So maybe it wouldn’t have become so serious if I had acted on it earlier. So, if you have this condition, consult a specialist who knows how to treat it and do not stop your treatment midway.”
He adds, “Also surround yourself with people who can empathise with you and offer you words of comfort that can be very helpful to your mental health.”
While no two IBD journeys are the same, both Anne and Sanjay show that with the right care, support, and mindset, life with IBD can still be meaningful and empowering. IBD may be lifelong, but it doesn’t have to define your life.
If you’re experiencing persistent digestive symptoms, don’t wait and seek professional help early.
