The last two decades have seen globalization with an increasing adoption of a western lifestyle. The combination of an unhealthy eating, lack of physical activity, alcohol, drugs, and smoking has resulted in development of lifestyle diseases. Most people are aware of diabetes, obesity, metabolic syndrome, heart disease, stroke, and asthma. But awareness about inflammatory bowel diseases (IBD) is in its infancy.
IBD is a group of intestinal disorders that cause prolonged inflammation of the digestive tract. It can be very painful and disruptive, and in some cases, it may even be life-threatening.
A slow pandemic of IBD as a lifestyle disease is also on the rise. The two most common diseases under the IBD umbrella are ulcerative colitis (UC) and Crohn disease (CD). Crohn’s disease mostly affects the tail end of the small intestine whereas ulcerative colitis involves inflammation of the large intestine. The primary symptoms include abdominal pain, bloody diarrhoea, and weight loss with complications like intestinal obstruction needing surgery and long-term development of cancer. These are chronic lifelong conditions which significantly affects quality of life both socially and financially.
Crohn’s diseases were rare in India but there were some reports of ulcerative colitis primarily from North India. The incidence of IBD in India remained low even up to the eighties. However, there were reports of a high prevalence of IBD in the Indian migrants to the west including to the US, UK, Canada, or even other South Asian countries. The rise of IBD appears to be associated with the changing environment, more affluent lifestyles and increasing modernization and westernization which affects the gut microbiome and increases the risk of IBD in genetically susceptible individuals.
The westernised diet with more meat, dairy products, processed foods with emulsifiers, vegetable oils, tobacco, sugary foods, sugary and alcoholic beverages are implicated in the rising cases of IBD. Recent advances suggest that smoking, oral contraceptives, diet, appendectomy, breast feeding, antibiotics, vaccination, infections, and childhood hygiene were all specific environmental risk factors involved in the development of IBD. Urban psychosocial factors such as depression, stress, and sleep disturbance also play a role in onset as well as in the natural history of this disease.
Some habits can pose some big problems and can be hard to change when they feel so good. But when you are living with IBD, it is a different story. You have no choice but to change those habits to get the most out of your IBD treatment. Therefore, lifestyle changes could play an important role both in prevention and controlling symptoms of IBD.
A combination of four factors—maintaining a healthy weight, exercising regularly, following a healthy diet, and not smoking—could reduce the risk of developing IBD. Once it develops, however the main steps that can help manage this condition would be medications to treat and prevent a flare. Lifestyle changes including avoiding foods that trigger attacks, reduction of stress, getting regular exercise and adequate sleep are additional steps. If diet and lifestyle changes, and other treatments don’t relieve your IBD signs and symptoms, your doctor may recommend surgery.
Unfortunately, there is very little public awareness about IBD in India. Many are unaware that a change in lifestyle is an important factor in the emergence of IBD as causes of increased morbidity and mortality. This disease has significant social, psychological, and financial repercussions along with a grossly impaired quality of life of the patient. Seeking early advice and medical help can prevent one and his family from a lot of unnecessary stress and complications of the disease. IBD can cause some discomfort, but there are ways you can manage the disease and still live a healthy, active lifestyle.