Numbers of Canadians With Crohn's and Colitis on the Rise, Wake-Up Call to Healthcare System - BRIGID Magazine

Friday, November 2, 2018

Numbers of Canadians With Crohn's and Colitis on the Rise, Wake-Up Call to Healthcare System

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There are only 36.71 million people in Canada, and 270,000 of them are living with inflammatory bowel disease (IBD). By the year 2030, that number is expected to rise to around 403,000.

Crohn's and Colitis Canada has just released its "2018 Impact of Inflammatory Bowel Disease in Canada" report, which stands as a wake-up call for Canada's healthcare system.

Canada has one of the highest rates of IBD in the world, and the prevalence of Crohn's and ulcerative colitis (the two main forms of IBD) in Canadian children alone has risen nearly 50 percent over the past decade.

Symptoms of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) covers a handful of disorders that involve inflammation of the intestines, though Crohn's disease can cause inflammation along any part of the gastrointestinal tract. Symptoms of both Crohn's and ulcerative colitis include diarrhea, reduced appetite and weight loss, fatigue, fever, and abdominal pain. In some instances, IBD can be life threatening. With IBD the body has trouble digesting food, absorbing nutrients from food, and eliminating waste products properly.

While IBD can be diagnosed at any age, it is typically diagnosed during adolescence or young adulthood. This is a time, authors of the 2018 report said, when individuals "are pursuing employment, building their family, and reaching key milestones."

The impact of IBD on quality of life "is multifaceted, from direct physical impairment due to symptoms like diarrhea and abdominal pain, to financial burdens associated with healthcare encounters, to psychological distress stemming from factors such as symptoms, distorted perception of body image, fear of sexual inadequacy, social isolation, fear of dependency, concern about not reaching one's full potential, and fear of stigmatization."

Underlying Factors in Crohn's and Ulcerative Colitis

Previously, diet and stressful life conditions were thought to cause IBD, but now these are considered triggers or aggravating factors. The exact underlying causes remain unknown or unclear, meaning that more research is required. Immune system dysfunction occurs in cases of IBD, where the immune system "attacks" cells throughout the digestive tract — treating bacteria and other microbes normally found in the intestines as invading substances.

Genetics likely plays a role, as IBD is commonly seen in those who have family members diagnosed with an inflammatory bowel disease.

Leading hypotheses as to the cause of IBD point to deleterious alterations of the gut microbiome. These alterations likely trigger immune responses that lead to chronic inflammation and disease progression.

Treatment and Outlook

Treatments for Crohn's and ulcerative colitis often include corticosteroids to reduce inflammation, biological therapies or immune modifiers to help maintain remission states, antibiotics to treat any infections, or surgeries to remove sections of the intestine when medications become ineffective.

Having IBD increases one's risk of developing colon cancer; skin, eye, and joint inflammation; blood clots; liver damage due to scarring of the bile ducts; and medication side effects such as osteoporosis and high blood pressure. People with Crohn's disease have a higher chance of premature death.

According to the Crohn's and Colitis Canada website, "The 2018 Impact of Inflammatory Bowel Disease in Canada report is the first wide-ranging examination of the disease and its impact on Canada since 2012. In the six years that elapsed between reports, researchers have uncovered new findings about the disease, about the people who are living with it, and how Canada can take strides to better care for those affected."

Some of the key findings of the report include:

  1. The annual cost of caring for Canadians with IBD is around $1.28 billion.
  2. Canadians with IBD in rural areas are less likely to receive specialized care, which has serious long-term consequences.
  3. IBD impacts people of all ethnicities and religions, but the rate of new diagnoses in Canada is higher among Ashkenazi Jewish and South Asian people. 
  4. Over 7,000 Canadian children have been diagnosed with IBD.

And recommendations from the report's authors include:
  1. Increase funding for research into preventing and treating IBD.
  2. Recognize IBD as a national health priority and increase resource allocation in order to optimize healthcare delivery to those with IBD.
  3. Launch nationwide public health campaign to increase awareness, in order to facilitate earlier diagnose and treatment.
  4. Introduce income security measures and employee assistance programs to provide support for those with IBD.

by Kristen Hovet

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