Chronic bowel diseases on the rise across UAE

ABU DHABI // Feeling lethargic? Lost weight? Stomach pain? You could be one of the rising numbers of residents suffering from inflammatory bowel disease.

More cases of the chronic and potentially debilitating condition are being diagnosed across the country, experts say.

Patients with Crohn's disease and ulcerative colitis - the major types of the disease - are increasing globally, although the prevalence is higher in developed countries, and particularly in urban areas.

Doctors in the UAE say they are seeing more cases.

The diseases, which have a genetic component, cannot be cured but they can be managed and early diagnosis is important.

Dr Rahul Nathwani, a consultant gastroenterologist and hepatologist at Mediclinic City Hospital in Dubai, has seen a 10 to 15 per cent increase in cases since he arrived in the UAE in 2007.

He has three or four new patients with Crohn's disease or ulcerative colitis each week.

"It's definitely increasing in prevalence," said Dr Nathwani, from India. "It's more common in the West, in the UK, Europe and the US, but since we have so many immigrants from that part of the world, we are definitely seeing an increase in incidents.

"There is no known reason why. It's an autoimmune disease. There are a lot of hypotheses about what causes it."

Both conditions cause inflammation of the gastrointestinal tract, but ulcerative colitis only affects the colon, while Crohn's disease can affect the entire digestive system.

Both can be debilitating, with symptoms including abdominal pain and weight loss.

"Almost 60 per cent of patients with Crohn's disease require surgery at some point during their life," Dr Nathwani said. "A lot of these patients will require colostomy bags, which is obviously extremely debilitating and interferes with the quality of your life.

"There is an increased incidence of colon cancer over a period of time for people with inflammatory bowel disease."

Both diseases are life-long conditions that go through varying stages - they can flare up and go into remission.

"There is no permanent cure but the goal is to keep the disease in remission," Dr Nathwani said.

He believes more awareness of the symptoms is partly responsible for the increase in cases.

The main signs are similar for both illnesses and include abdominal pain, which is more common with Crohn's disease. Other symptoms include a change in bowel habits, such as diarrhoea, weight loss and extreme tiredness.

Dr Huda Kataa, a consultant gastroenterologist at the American European Medical Centre in Abu Dhabi, said there were no exact figures relating to the UAE but she had seen an increase in cases during her 15 years in the country.

"We don't know the cause of the disease but what we are expecting is that the environmental factors are playing a role in genetically susceptible individuals," she said.

One such factor could be diet. "Patients who have a fatty and refined diet are prone to have Crohn's disease," Dr Kataa said.

Other theories are that some medications could trigger the disease, or that pollution could play a part, she said.

"There are also risk factors," Dr Kataa said. "Being white will put you at more risk of having the disease, and age. Younger people are at higher risk of getting the disease."

Some patients ignore symptoms for years, she said.

Dr Atul Chawla, a specialist in gastroenterology at Abu Dhabi's Burjeel Hospital, said factors that were believed to increase the incidence rate included a diet with low vegetable content and children not being breastfed for long enough.

The conditions predominantly develop in people in their twenties and thirties but can be diagnosed as late as their sixties or seventies.

Dr Chawla urges people experiencing symptoms to seek medical advice. "We cannot cure it but we can definitely provide good relief," he said.

Sama Ahmad, 31, found out she had Crohn's disease three and a half years ago after suffering from diarrhoea, stomach pain, bleeding and weight loss.

The Syrian, who lives in Abu Dhabi, has had two operations to drain an abscess caused by the disease and to deal with other complications. She has a check-up every two months and takes medication regularly.

"It has a 20 per cent impact on my life," said Ms Ahmad, a banker. "When the pain comes, I deal with it but I get on with my life. I just live with it. Sometimes it's better and sometimes it's worse but I have improved a lot."

She urged people with symptoms not to be embarrassed and to seek medical advice. "Just listen to your doctor and follow what they are giving you," she said.

ecleland@thenational.ae