Inflammatory bowel disease, which increases risk of colon cancer, is on the rise

Mr Waise Koh (left) and his doctor, Dr Shim Hang Hock, consultant at Singapore General Hospital's department of gastroenterology and hepatology. Mr Koh was 18 years old when he was diagnosed with ulcerative colitis. ST PHOTO: SONG TAO

SINGAPORE- More Singaporeans are being diagnosed with an intestinal condition that puts them at higher risk of colon cancer.

Statistics by several hospitals in Singapore show that inflammatory bowel disease (IBD) is on the rise in the last decade.

People with this chronic condition suffer from inflammation of the intestine. They may then experience symptoms such as diarrhoea, fever, abdominal pain and cramping, blood in stools, reduced appetite and unintended weight loss.

Singapore General Hospital (SGH) saw close to 600 patients diagnosed with the disease last year, a two-fold increase from 2007.

At National University Hospital (NUH), the number has jumped by eight times, from below 50 in 2013 to close to 400 cases this year.

"The reasons as to why there is this large increase is still not known," said Dr David Ong, head at NUH's division of gastroenterology and hepatology.

The disease is most common among those between 20 and 40 years old, but in rare cases can also occur in patients as young as a one-year-old child.

IBD is a collective term for two conditions: Crohn's disease, which can affect any part from the mouth to the large intestine, and ulcerative colitis, which only affects the large intestine.

"Having IBD in the long term can increase one's risk of getting colon cancer," said Dr Ong.

"It was once considered to be a western disease, but is now more prevalent in Asia, including Singapore," said Dr Shim Hang Hock, consultant at SGH's department of gastroenterology and hepatology.

Consultant at the gastroenterology and hepatology department in Changi General Hospital, Dr Malcolm Tan said: "As Singapore modernises, the food that we eat would more closely resemble that of Western countries. The number of new patients diagnosed with IBD would go up in time, as we are already seeing in Singapore."

But Dr Shim thinks a change of diet alone cannot explain the spike.

"Given the rapid rise that we are seeing, it has to be something environmental, but exactly what, it is still being researched," he said.

Many postulations, including the role of one's hygiene, antibiotic exposure at early childhood, a westernised diet and smoking, have not proven to cause the disease on its own, he added.

But Dr Shim said IBD is believed "to be due to a disturbance of the immune balance, possibly triggered by environmental factors, or bacteria in the gut, in a person who is genetically at risk".

There is no cure for the condition, said Dr Christina Ong, who heads the gastroenterology service at the department of paediatrics at KK Women's and Children's Hospital.

"However, the aim is to get the disease under control for as long as possible so that patients can lead a normal life, including going to school, participating in sports and going on family vacations," she added.

Mr Waise Koh was 18 years old when he was diagnosed with ulcerative colitis while preparing for his A-level examinations in 2013.

At first, he thought that his diarrhoea was due to food poisoning. But alarm bells rang when he passed bloody stools more than 20 times daily for a month.

Now 23, the National University Singapore (NUS) computational biology student said he visited a hospital where he was diagnosed with IBD. By then, Mr Koh had already shed more than 10kg.

Mr Koh was put on medication and now only experiences the symptoms like diarrhoea occasionally.

"Its getting better now. The last time I experienced the symptoms were in last year, November," said Mr Koh.

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