Specialists concerned about the lack of adherence to the treatment of patients with IBD

Between the ages of 20 and 40, about 70-80% of patients with inflammatory bowel disease, called IBD, are diagnosed. These include ulcerative colitis and Crohn’s disease, immune-mediated and chronic pathologies. Specialists warn of a high rate of abandonment of treatment, increasing the risk of more severe crises, increased risk of hospitalization and damage to the intestine.

Andrea Riquelme, Journalist.- On Friday, May 19, the WHO commemorates the International Day of Inflammatory Bowel Diseases (IBD), referring to Ulcerative Colitis and Crohn’s Disease, chronic and progressive autoimmune pathologies of the digestive tract that involve periods of crisis and absence of symptoms (remission). Dr. Carolina Pávez, president of the Chilean Crohn’s Disease and Ulcerative Colitis Working Group (ACTECCU), a subsidiary of the Chilean Society of Gastroenterology (SChGE), notes concern among specialists about the lack of adherence to treatment for many IBD patients.

The gastroenterologist points out that the diagnosis rate of IBD in patients fluctuates between 20 and 40 years of age. Given that these are diseases that affect the quality of life of patients due to the symptoms related to them, in terms of abdominal discomfort, diarrhea, urgency to defecate, once treatment is started, patients return to “normal” in their lives. . Unfortunately, almost a third of patients abandon drug treatment, raising the chances of new, even more severe crises.

Ulcerative colitis is typical of the colon and can compromise the rectum and other segments of the colon, occurring due to genetic predisposition, alterations in the immune system and in the intestinal microbiota. Environmental factors such as smoking, the abusive use of antibiotics, the consumption of processed foods and stress also have an impact, which cause inflammation and lesions in the intestinal mucosa. Ulcerative colitis is suspected when mucosanguineous diarrhea and crampy abdominal pain are present. Likewise, Crohn’s disease affects different parts of the digestive tract from the mouth to the anus and symptoms include abdominal pain, diarrhea, weight loss, malaise, fever and even perianal abscesses.

«Implementing a treatment to control inflammation requires the use of different medications, corticosteroids and other types of therapies. Most importantly, each treatment is individual for each patient, so it is not recommended that patients take the risk of making arbitrary changes to their therapy based on recommendations from other patients or posts on social media. What is effective in one patient, even with similar characteristics, is not necessarily replicable in another. There are induction and maintenance treatments, and all of them must be supervised by a specialist doctor because they involve adverse effects”, specified Dr. Pávez.

For the specialist, correct adherence to treatment by 50 to 70% entails a lower risk of complications, hospitalization and surgery. Therefore, the importance of maintaining the indicated treatment, especially when there are no symptoms and the crises have been controlled. Likewise, she explains that from the patient’s point of view, it is crucial to accept the disease as a condition of life, to strengthen trust in the treating multidisciplinary team, and to learn about IBD.

In the last 3 years, an increase in IBD has been observed. Although there is a genetic predisposition, other environmental factors such as the consumption of processed foods, tobacco, the abuse of antibiotics and stress; They also affect your presentation.

Although the peak of IBD diagnoses is between 15 and 29 years of age, 6 to 16% are detected in children under 6 years of age. In such cases, the objective of treatment is to prevent the progress of the disease, ensure adequate nutrition and growth, reduce hospitalization and improve the patient’s quality of life. Prolonged breastfeeding up to 6 months and 1 year has been shown to be a protective factor in this type of patient, as well as avoiding the use of antibiotics in the first year of life. In adolescents, it is recommended to avoid the consumption of alcohol and tobacco.

It has been detected that 60% of patients of childbearing age are afraid of becoming pregnant, given the chronic treatment with drugs and their adverse effects, while in men some drugs can affect sperm motility. Here preconception counseling is very important so that future parents have adequate information. Specialists point out that it is unlikely that a child with a father or mother with IBD has the disease. From 5 to 10% of children with parents with Crohn’s disease repeat the diagnosis, while 2% apply in the case of ulcerative colitis. If both parents have IBD, the risk increases to 30%.

In general terms, pregnancies tend to be carried out well as long as the patient is under medical control and in remission (adequate control of the disease) with similar results to the general population, low risk of premature births and spontaneous abortions; but for this it is necessary to keep the disease under control and avoid crises. Of those patients who became pregnant without experiencing crises, 70% remained the same during pregnancy.

On Thursday, May 19 at 4:00 p.m. (Chile), the Pan American Crohn’s and Colitis Organization (PANCCO) will hold an educational webinar about these diseases, free of charge and online. Registrations open in https://bit.ly/42yUiZJ