Recently, the reporter learned from the Sixth Hospital of Sun Yat-sen University that the training program representing the highest level of diagnosis and treatment of inflammatory bowel disease (IBD) in China, the Advanced IBD Physician Training Course of the Center of Excellence, was held in the hospital from March 25 to March 29, 2013. The training course attracted physicians of associate director level or above from many hospitals in Beijing, Zhejiang, Jiangxi, Sichuan, Tianjin, Guangdong and other places to participate together.
It is reported that inflammatory bowel disease is a chronic non-specific inflammatory disease of the intestine of unknown etiology, including Crohn’s disease (CD) and ulcerative colitis (UC). Patients often have symptoms such as abdominal pain, blood in the stool, diarrhea, wasting and anemia. Because of the unknown etiology, the large clinical variation in individual patient performance, and the lack of specific clinical tests, there are more misdiagnosis and misdiagnosis in practice, and the risk of clinical diagnosis and treatment is high.
The Chinese Medical Association Digestive Diseases Branch of the Inflammatory Bowel Disease Group leader, Zhongshan Sixth Hospital Inflammatory Bowel Disease Center chief expert Professor Hu Pinjin said, so far there is really no single test to confirm the diagnosis of inflammatory bowel disease, therefore, in addition to a detailed and comprehensive medical history and physical examination, patients generally need to do blood tests, upper and lower gastrointestinal tract endoscopy, small intestine Therefore, in addition to a detailed history and physical examination, patients generally need blood tests, upper and lower gastrointestinal endoscopy, small bowel imaging or small bowel microscopy, and other related tests.
Prof. Hu Pinjin introduced that blood sampling is to understand the inflammatory activity of the disease, routine gastroscopy and small bowel imaging or small intestine microscopy are mainly to understand the scope of the disease lesion, mucosal manifestations, etc. Meanwhile, a small piece of tissue can be taken off for biopsy during the gastrointestinal endoscopy to observe more clearly whether it is different from normal tissue.
Therefore, the Inflammatory Bowel Disease Center of Zhongshan Sixth Hospital has experts from various disciplines, including gastroenterology, colorectal surgery, endoscopy, radiology and imaging, pathology, clinical nutrition, etc., and has established a complete database and follow-up system, which can provide comprehensive, whole process and individualized treatment services for patients with inflammatory bowel disease.
The incidence of inflammatory bowel disease in China is high, and the course of the disease can be cancerous. Professor Hu Pinjin pointed out that IBD is common in Europe and the United States, with about 1.4 million patients in the United States, and more than 10% of them are teenagers under 18 years old. The incidence rate in China is not high, but it is not rare either.
According to our statistics, the peak age of ulcerative colitis is 20-49 years old, with little difference between men and women (male to female ratio of about 1.0-1.3:1). The clinical manifestations are persistent or recurrent diarrhea, mucopurulent stools with abdominal pain, urgency and varying degrees of systemic symptoms.
In contrast, Crohn’s disease most often occurs in young adults, and according to our statistics, the peak age of onset of the disease is 18-35 years old, with slightly more men than women (male to female ratio of about 1.5:1). The clinical manifestations are diverse and usually include gastrointestinal manifestations, systemic manifestations, extraintestinal manifestations and complications. Complications include fistulas, abdominal abscesses, intestinal strictures and obstructions, perianal lesions (perianal abscesses, perianal fistulas, anal fissures, etc.) and, less commonly, gastrointestinal hemorrhage, acute perforation and, in cases of long duration, cancer.
Treatment of inflammatory bowel disease Nutritional support and psychological care are important Good nutrition is necessary in any disease, especially for patients with inflammatory inflammatory bowel disease. Hu Pinjin emphasized that patients often have diarrhea, bloody stools, abdominal pain and other symptoms, it is important to ensure proper nutritional supply, which is an important part of the treatment plan, and most patients with the disease do not need to adjust their diet. Of course, each patient’s situation is different, for example, in the ileum when the inflammatory response is so severe that the intestinal cavity is very narrow, you need a low-fiber diet or total intestinal liquid nutrition can also be continuously injected through the gastric tube while sleeping to provide energy, but such and such must be made under the guidance of a professional physician according to the actual situation of the patient to choose.
Hu pointed out that the diagnosis of any chronic disease will affect the patient’s psychological state to a greater or lesser extent, which will require psychological care. If the patient is a school-age child, the impact will be even greater. Therefore, this disease needs the care and attention of the whole society.
Finally, Hu Pinjin said that although IBD is a serious chronic disease, it is not fatal. Most people with IBD live optimistically and healthily, although they need to take medication regularly and even sometimes need to be hospitalized, but during the remission period many people can feel well and can live a normal life without any discomfort, and even have children.