Specialist Column Lee, Ji Hyun Director, Internal Medicine Department, Song to Hospital, Seoul, Korea
Inflammatory bowel disease, which has been rare in Korea, is rapidly increasing. According to a health insurance report and assessment, the number of patients with inflammatory bowel disease treated in 2017 is approximately 40,000 ulcerative colitis and about 20,000 Crohn's disease, which is approximately 60,000.
Inflammatory bowel disease is a chronic inflammatory disease of the gastrointestinal tract commonly referred to as ulcerative colitis and Crohn's disease. Ulcerative colitis occurs mainly in the colon and inflammation occurs sporadically throughout the digestive tract from the mouth to the rectum.
Inflammatory bowel disease is believed to occur when environmental factors and immunological factors occur in the presence of an unknown or genetic predisposition. Recently, many experts have estimated that immune cells of the intestinal mucosa are over-activated in response to external factors of intestinal bacteria or viruses and attack the intestinal mucosa to worsen.
Symptoms of inflammatory bowel disease include bloody stomach, abdominal pain, chronic diarrhea, fever, weight loss, anorexia and poorly treated anal illness. The diagnosis of inflammatory bowel disease is still low and the diagnosis is delayed due to infectious enteritis, symptoms and endoscopic findings. It is good that you are not afraid because most of you can properly manage your everyday life after diagnosis and management.
For the treatment of inflammatory bowel disease, anti-inflammatory drugs, immunomodulators, biological agents, steroidal agents, and the like are used. Surgical treatment is performed if there is no effect on the treatment or if stenosis, perforation or colon cancer develops. In particular, biological agents, including anti-TNF agents that block tumor necrosis factor (TNF) overexpression, which cause inflammation in inflammatory bowel disease, are effective in reducing inflammation and healing of mucous membranes.
Inflammatory bowel disease is recommended for periodic endoscopy, blood tests, stools and radiological examination (CT, MRI and ultrasound) even in the absence of symptoms. This is because the risk of colorectal cancer or small intestine cancer in patients with inflammatory bowel disease for a long time is higher than in the general population, and symptoms and objective findings do not necessarily match each other. In some rare cases, complications such as stenosis or perforation appear suddenly without symptoms.
Accurate diagnosis and treatment of inflammatory bowel disease, which may be accompanied by chronic and heterogeneous complications, is also essential for collaboration with various clinical departments with expertise in the field of diseases such as gastroenterology, colon surgery and imaging.
Recently, more and more hospitals have been seeking multidisciplinary treatment for inflammatory bowel disease. I think it's a good step because I can understand the symptoms and the condition of patients from different points of view and I can do individualized treatment accordingly.