It looked like the run-of-the-mill stomach flu or even a bad case of indigestion. Only the ailment turned out to be for, far worse than anything the or you could imagine
When Derek suffered “a spot of diarrhea” coupled with colicky pain following a trip to his hometown in 2002, he naturally blamed the usual culprit a stomach bug: “I thought it was the result of all the 47-year-old, who runs a computer institute. His family doctor suspected amoiebic dysentery and prescribed some medication, which failed to work their magic: “I was running to the restroom every two hours.” Ominously, Derek noticed flecks of blood in his stools. Could it be piles?? He worried. Three weeks later, debilitated by persistent diarrhoea and stomach pain, Derek sought a gastroenterologist who subjected him to the dreaded colonoscopy in which a sleek tube is threaded up the rectum to scope out his intestine. The diagnosis came as a surprise Ulcerative Colitis.
Burning Bellies
Ulcerative colitis is an inflammation of the inner lining of the large intestine or colon. Its standout symptoms: Acute abdominal pain, diarrhea, bloody stools, reduced appetite, weight loss, fever. “Since early symptoms resemble run-of-the-mill stomach flu or even acidity they’re usually taken lightly,” says Dr Frank, consultant gastroenterologist at a respected hospital.
That’s how it was for 26-year-old Kim who came down with high fever, cramping stomach pain and body aches, along with bloody diarrhea. A series of tests of tests found no sign of bacterial or viral infection. Inflammation on the left side of her colon indicated ulcerative colitis.
Trouble in the Bowels The frustrating thing about ulcerative colitis, a. k. a inflammatory bowel disease (IBD), is that its causes and triggers are still unknown.
A whole host of culprits have been blamed including genes, environmental factors, allergies, and a previous infection that may cause the body’s immune system to react abnormally to bacteria in the digestive tract.
Says Dr. Frank: “Some studies show that residing in a heavily industrialized area or eating a diet rich in fat content may trigger IBD, though this is yet to be validated. “Certain foods may also aggravate existing IBD (see “Food For Thought”).
The Indian Journal of Gastroenterology cites IBD prevalence in this country to be around half a million, with men outnumbering women as victims
IBD doesn’t always announce itself in the from of blood spotted diarrhea.
For Eric, it was a constipation and low appetite in the initial days in 2006. only later came the runs for this electronics store owner.
“The constipation and appetite loss didn’t worry me, but blood specked stools had me dashing to the doctor, especially since medication did put a plug on the diarrhea,” recalls Eric.
Another disturbing aspect of IBD is that is has a nasty habit of bouncing back after going into remission for a period.
After a symptom-free 2-year hiatus that had lulled Derek into complacence, the computer techie woke up on morning to the gripes n 2005. “It caught me unawares. I thought I’d beaten back IBD.” Derek says ulcerative colitis nearly wrecked his life. “I’d forgotten how traumatic the pain can be. Work was impossible, because I was running for the restroom 8 to 9 times a day, and the ache in my gut was so acute, there was no comfort in either sitting or lying down.”
“Severity of symptoms depends on how much of the large intestine is inflamed and which area it is located,” explains Dr. Frank. “Though the condition manifests itself in the large intestine, it’s not always that the whole on the colon is affected. Some individuals may develop IBD only in the rectum, others in the sigmoid or descending colon. A few, like Derek, may get it in all three parts collectively.”
Taming the Colon: Ulcerative colitis rarely requires surgery. Most people respond well to anti-inflammatory drugs and or immune suppressants.
“Once inflammation subsides symptoms withdraw almost immediately and patients may also see a long period of remission,” assures Dr. Frank. Medication may need to be taken indefinitely in some cases.
Derek also started maintaining a log of all that he east “to see whether any particular food was worsening my symptoms.”
By the process of elimination he has discovered that “buttermilk caused diarrhea whereas I did fine with curd, bananas weren’t a problem, but papaya and watermelon gave me the runs.” Leafy vegetables, tomatoes and spicy food also aggravated his condition. The more fibrous a food, the worse the diarrhea. “Two years of recording my intake has helped me identify exactly when symptoms are likely to pop up,” says Derek.
The start of the year ’08 saw Derek’s IBD receding, but he remains cautiously optimistic,” as one can never be sure when it may surface again.”
Kim saw little trouble for close to 4 years “despite practically surviving on junk food in the States.” In 2005, on returning home following her graduation “I was feeling under the weather. There was this gnawing sensation in my stomach and a persistent sense of nausea.” Recalls the upcoming London-based fashion designer.” Thought it was indigestion.” Only it turned to be the return of the dreaded IBD.
Again in May 2007 caught up in the hectic preparations for the Fashion Show with her designer brother Chris in London ,she saw a replay of her turn-of-the millennium agony. “Fortunately I was still able to get out of the house and work, unlike before. However towards the end of the Fashion Show I realized my condition was getting worse.” Blood in the stools, and acute stomach pain confined Kim confidence to her home. “I think the heat in the heat in the city got the better of me,” she rues. “Or perhaps it was the stress.
Living with IBD
Frustrating as ulcerative colitis is, it is still limited to the large intestine and therefore not as debilitating as Crohn’s disease a more severe version which affects the whole digestive tract. As Tina Smith, learned, having Crohn’s may mean taking enormous, life altering decisions. It has not been easy for this lawyer residing in the suburbs of London. Tina was detected with Crohn’s disease more than a decade ago, but to date, “every time I get a tingling sensation in the abdomen and find myself perspiring, I know I’m headed for trouble.
Unlike Derek and SKim, the discovery of Tina’s condition was a long drawn out process. In early 1997 what the lawyer experienced was severe joint pain. “It was unbearable. Just moving my hands and legs seemed to require enormous effort,” recalls Tina. Her doctor was convinced that it was as a flare up of rheumatoid arthritis, although the body aches were accompanied by diarrhea and fever (not common symptoms of RA). Tina was admitted to the hospital for diarrhea that refused to stop even with medication. Pain killer injections failed to deliver her relief from the excruciating joint pains as well, so she was referred to rheumatologist at the hospital. “Finally the doctor suspected that the cause of my jont aches may lie elsewhere,” says Tina.
An endoscopy showed inflammation in parts of the large intestine. She learnt that one of the symptom of Crohn’s disease is rheumatism, caused by depletion of certain nutrients like calcium. Medication helped, but only to a limited extent.
Shetty gave up a full-time law career to work with her lawyer brother, because “you’re constantly living in fear as to when the symptoms may spring up. Every time there is a relapse, my Blood Pressure goes down drastically and diarrhea is so persistent that it is uncontrollable,” says Shetty. She has been on steroids for nearly a decade now to control the condition.
A huge drawback in the treatment of IBD is that the anti-inflammatory medications and immune suppressants prescribed may bring on side effects like infection a rise in Blood Pressure, brittle bones, etc. But drug therapy “is still considered to be the safest treatment as surgery involves in 25 percent of cases where attacks do not respond to medication,” says Dr. Frank.
At times, warns Dr. Frank, onset of the illness can lead to mood swings, as it is with most chronic ailments.
