Inflammatory Bowel Disease (IBD)

Main article: Intestines

IBD is common equally among men and women and is often diagnosed in young and active people in their 20s and 40s, as well as in children and adolescents.

In patients suffering from Crohn's disease and ulcerative colitis, there are several periods when the disease is in the inactive stage, and symptoms are absent or manifest to a minimal extent (remission), and when the disease enters the active stage and the symptoms are pronounced (such periods are called exacerbation, or relapse).

Various factors provoke an inadequate response of the immune system body, which leads to the development of chronic inflammation of the mucous membrane intestines with its subsequent damage.

For 2024, IBD is incurable, but timely prescribed therapy can improve the quality of life of patients and improve their condition.

Incidence

The incidence of inflammatory bowel disease (IBD) is on the rise worldwide. In Russia, there is also a steady increase in the incidence of IBD. According to the Ministry of Health of the Russian Federation, the increase in the incidence of ulcerative colitis (UC) from 2012 to 2015 amounted to 31.7%, Crohn's disease (BC) - 20.4%.

According to the results of separate epidemiological studies, the prevalence of IBD in Russia is 19.3-29.8 per 100,000 population for UC and 3.0-4.5 per 100,000 population for ^[1].

Symptoms

One of the dominant characteristics of IBD is their multisystem, i.e. the involvement in the immunoinflammatory process not only of the intestines, but often of non-digestive organs. Extra-intestinal manifestations of IBD are common and can dominate the clinical picture and are not always associated with intestinal disease activity.

The main manifestations of IBD:

• abdominal pain,
• diarrhea,
• fever,
• rectal bleeding,
• weight loss,
• they also often affect the musculoskeletal system,
• skin and mucous membranes,
• eyes,
• liver

and other bodies and systems.

A survey conducted in 2024 by the All-Russian Public Organization for Support of Patients with Inflammatory Bowel Diseases (IBD) and Short Bowel Syndrome (CCM) "Trust" showed that more than half of the respondents - 52% - face complications of their disease affecting other organs and systems: joints, skin, psyche, nervous system, vision. At the same time, these manifestations are often detected in combination, having a serious negative impact on the patient's ability to work and quality of life, sometimes to a greater extent than the underlying disease. This was also confirmed by the patients interviewed: 35% replied that complications bother them even more than the underlying disease.

With untimely initiation of therapy, patients with BC may develop anemia, intestinal obstruction, and the progression of UC may lead to the removal of the colon with the withdrawal of ileostoma and the inevitable constant use of calorescences. Moreover, there are high risks of colorectal cancer.

The timely initiation of therapy helps patients improve the quality of life, in which there is a place for study, professional implementation, travel, sports and everything that is familiar to healthy people.

Diagnosis and treatment

Late diagnosis of IBD leads to a decrease in the effectiveness of therapy, more frequent development of complications, the need for surgery and disability of patients. In addition to timely diagnosis, in case of inefficiency or intolerance to conventional treatment regimens, it is important to choose an adequate therapy, monitor its effectiveness and make timely adjustments.

"IBD significantly affects the quality of life of patients and their families, causing them serious economic damage, since it limits the ability to work and, accordingly, their income. Social significance lies not only in the progressive nature of the course of the disease, but also at an early age of its debut, which usually falls on 20-35 years, which is a predictor of a more severe course of the disease. This requires timely consultation with a specialist and the urgent start of adequate therapy, since the delay in treatment negatively affects its effectiveness and clinical outcomes, "said Oksana Shchukina, Doctor of Medical Sciences, in 2020.

Often, people with symptoms of IBD go a long way to a correctly established diagnosis: 75% of respondents in 2024 waited for diagnosis for more than 6 months, and 33% for more than three years. At the same time, among already diagnosed patients, only 17.9% do not experience problems with drug provision, and almost a third - 32.5% of respondents - admitted that they have difficulties accessing all drugs - both genetically engineered biological and basic therapy.

Another barrier to effective treatment is the psychological difficulties patients face. Because of society's low awareness of IBD, they are wary of speaking openly about their illness. Many of them experience fear, embarrassment, shame. This also affects the timely contact with a doctor, the diagnosis and, ultimately, the treatment and prognosis of the disease. Often, in most patients, the disease is already detected in the development of various complications. As awareness of the disease increases in the community, more patients are able to receive adequate therapy at different stages of the disease.

"64% of patients we interviewed admitted to living constantly in anxiety and facing depression. Psychological problems are very characteristic of patients with IBD, as well as other manifestations of the disease that do not affect the intestine. Therefore, a systematic approach is extremely important in IBD therapy, "said Tatyana Igorevna Shashurina, chairman of the All-Russian public organization for supporting patients with inflammatory bowel diseases (IBD) and short bowel syndrome (CCM)" Trust. "

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