3 million people suffer from inflammatory bowel disease, which can lead to injuries and debilitation of the body. Europeans. In recent decades, the incidence of these diseases has increased dramatically, mainly among children and young people, experts alarm.
Doctors and patients talked about it at the 8th European Crohn’s and Colitis Organization (ECCO) congress in Vienna.
– Strong pains in the lower abdomen, diarrhea (up to 20 or more bowel movements during the day) lasting for weeks or months, blood in the stool, rapid weight loss, constant fatigue, increased temperature – these are symptoms that occur in patients with inflammatory bowel disease – she reminded meeting with the media prof. Severine Vermeire, President-elect of ECCO. The two most common diseases in this group are Crohn’s disease and ulcerative enteritis.
The latest research presented in Vienna by Dr. Tine Jess from the Statens Serum Institut in Copenhagen, Denmark, shows that in Europe, about 3 million people suffer from them, and the most common diagnosis is people aged 15-29. The number of people with these diseases is clearly growing in the countries of Eastern and Southern Europe, although so far most cases have been recorded in the west and north of our continent. Polish experts estimate that in our country the number of patients may be as high as 50. people (including 10 thousand with Crohn’s disease).
– At the time of diagnosis, 40 percent patients with Crohn’s disease have very serious complications – a narrowing of the gut or a fistula (i.e. junction) between the gut and the organs or skin. A similar proportion of those who did not have them at diagnosis acquire them in the next 10-15 years, Dr. Jess said.
The data presented by her show that many patients undergo frequent surgical operations involving the excision of a fragment or the entire intestine and constantly go to the hospital. The risk of death is 40% higher in people with Crohn’s disease. compared to the general population (no such differences were found in patients with ulcerative colitis), and 34% patients with these conditions are disabled.
According to prof. Walter Reinisch from the Medical University of Vienna, the increase in the incidence of inflammatory bowel diseases, especially in children and adolescents, is very worrying. The researcher noted that in the past, they were most often diagnosed between the ages of 20-30, and now this average is shifting more and more towards adolescence and childhood.
– In the last 9 years in Denmark, the incidence of inflammatory bowel disease in children has increased by 50%. and it is similar in other European countries, said Dr Jess. In Austria, the number of children hospitalized for these conditions has doubled in the last 15 years.
– Importantly, the earlier this disease develops, the more aggressive is its course. This can be seen well in the example of ulcerative colitis, where a large percentage of patients diagnosed in childhood have a partially or completely resected large intestine (colectomy) – noted Prof. Reinisch.
The researcher estimated that the increase in the incidence of inflammatory bowel disease is only the tip of the iceberg. – In the last five decades, developed countries have seen a 10-15 fold increase in the incidence of various chronic inflammatory diseases, which mainly affect children and young people, such as asthma, type 1 diabetes, rheumatoid arthritis, multiple sclerosis and of course inflammatory bowel disease – said prof. Reinisch.
In the USA, which has the most complete statistics on this subject, a total of 50 million people (16% of the population) suffer from them, which places these diseases in second place after cardiovascular diseases.
– We are all aware that our societies are aging, we are all aware that in this aging population the number of cancer diseases will increase, but politicians do not realize that children and young people are increasingly affected by chronic, progressive inflammatory diseases – emphasized the researcher.
Scientists are intensely searching for the reasons for this growth.
Prof. Reinisch explained that many genetic tests were carried out and over 160 genetic changes (called polymorphisms) were found that were associated with IBD. They are also common in people with other inflammatory diseases such as RA and psoriasis.
– However, it must be remembered that it takes about 150-200 years for new genetic changes to show up, so it is unlikely that they are responsible for the observed increase. Therefore, we suspect that environmental factors play a huge role here – said the specialist.
He reminded that the intestines are the largest surface of our body that has contact with the external environment (through contact, among others, with the food we eat). Their total area – approx. 300 sq m is larger than the tennis court and therefore it is very sensitive to the influence of environmental factors.
Research suggests that this may be due to a poorly diversified diet rich in simple sugars and low in plant fiber, increased consumption of antibiotics, excessive hygiene and other factors that disrupt the composition of our gut microflora, as well as smoking and stress.
As prof. Reinisch, many studies confirm that the composition of the gut flora in people with inflammatory bowel disease is different from that in healthy people. – But we still can’t tell which came first: the chicken or the egg? Some studies show that it is inflammation in the intestines that may contribute to a change in the composition of the microflora – he explained.
He added that his team is currently conducting research on transplanting intestinal microflora from healthy people to patients with inflammatory bowel disease. – So far, we have performed such a procedure in five patients, but only one of them has had the bacteria – he noted.