Bowel disease study finds young immigrants at risk
Vulnerable include people from South Asia, the Middle East and North Africa
Training for a half-marathon, in the best shape of his life, everything seemed great for Rasheed Clarke when he was 22.
But two years later, in 2008, Clarke was diagnosed with inflammatory bowel disease (IBD), a painful and incurable condition.
A recent study by researchers at the University of Ottawa published in the American Journal of Gastroenterology has revealed that young immigrants and the children of immigrants are more likely to develop IBD than other Canadians, something Clarke has always suspected.
Now, after surgery to replace his colon with a pelvic pouch, the 30-year-old communication co-ordinator for Independent Financial Brokers of Canada is starting to see his condition improving.
The J-shaped pouch sits at the end of his small intestine, and serves as a stand-in colon, where stool is held until he has it removed.
Born in Toronto, Clarke was the first in his family to develop the disease since his Indian parents immigrated to Canada. The study looked at everyone with IBD in Ontario, and assessed the risk in immigrants, children of immigrants and non-immigrants. Canada has one of the highest rates of IBD worldwide, and Ontario has one of the highest rates within Canada.
People who immigrated earlier in life seemed to have a higher risk of developing the disease than those who arrived later. Immigrants from countries where IBD is rare, such as places in South Asia, the Middle East and North Africa, were more likely to develop the disease than those from other parts of the world. The study indicated the risk increased by 14 per cent per younger decade. That means a nine-yearold immigrant had a 14-per-cent greater risk than a 19-year-old.
The researchers did not speculate on reasons for their findings.
According to Dr. Eric Benchimol, one of the researchers, IBD makes patients feel like the skin in their intestines is being rubbed against concrete. There is no cure, and when it flares up patients can suffer through bloody diarrhea, stomach aches, soreness and, in some cases, constant trips to the washroom.
“There’s this idea that the disease is not as bad as it is,” Clarke said. “But it really takes away from your quality of life.”
At the peak of his IBD, he would make up to 30 trips to the bathroom a day, and it wasn’t uncommon for him to suffer through bloody diarrhea.
There are two variations of IBD: Crohn’s disease and ulcerative colitis. Ulcerative colitis essentially only affects the large intestine, whereas Crohn’s can affect anywhere between the mouth to the anus, including the esophagus and stomach. Crohn’s can also cause infections inside the abdomen, called abscesses.
The main symptom is the inflammation of the bowel. When it’s in limited amounts, and if it stops when it needs to, inflammation is a good thing.
“Inflammation is the body’s natural process to heal,” Benchimol said. “It’s essential for normal immune system functioning.”
Normally, when something is infected, the immune system reacts by sending chemicals to help fight off the infection. Once the infection is gone, the inflammation stops.
But the problem with IBD is that it doesn’t stop. A change in the balance of bacteria in the intestines causes the immune system to constantly release inflammation chemicals, and eventually cause damage to the body.
Irritable bowel syndrome (IBS) is a separate condition but is often confused for IBD.
IBS is seen as a “functional” bowel disorder, meaning the bowels appear to be perfectly normal. The pain from IBS is most likely related to how the nerves in the area interpret movement, stretching and pain, and can be helped with little things, such as diet modification to help cope with the symptoms.
The more serious of the two, IBD has more long-term complications.
Although there is no cure, there are treatments that can help patients to be more comfortable.