Living With Inflammatory Bowel Disease

By Sam Dickinson

From a bio-medical perspective, IBD is the name given to a group of inflammatory conditions affecting the gastrointestinal tract. There are two major types: Crohn's Disease (CD) and Ulcerative Colitis (UC). CD can affect anywhere from the mouth to the anus and UC is confined to the colon and rectum. While the etiology of IBD is unknown, with only numerous conjectures made about possible causes, a range of epidemiological information is available. IBD in the UK has a similar incidence rate to other northern European countries, with the highest incidence rates and prevalence [being] reported from northern Europe, the UK, and North America.

• Language: English
• Publisher: vincenzo nappi
• Release date: Aug 15, 2021
• ISBN: 9798201898434

Book preview

CHAPTER ONE: Introduction

What is IBD?

Within a bio-medical perspective, IBD is the name given to a group of inflammatory conditions affecting the gastrointestinal tract. There are two major types: Crohn's Disease (CD) and Ulcerative Colitis (UC). CD can affect anywhere from the mouth to the anus and UC is confined to the colon and rectum. While the etiology of IBD is unknown, with only numerous conjectures made about possible causes, a range of epidemiological information is available. IBD in the UK has a similar incidence rate to other northern European countries, with the highest incidence rates and prevalence [being] reported from northern Europe, the UK, and North America.

Further epidemiological details can be found for both UC and CD. Although the incidence of CD varies between countries, it is approximately 4– 10 per 100,000 annually, with a prevalence of 27–106 per 100,000. The incidence of UC is stable at 6–15 per 100,000 annually, with a prevalence of 80–150 per 100,000. CD is slightly more common in females (male to female ratio of 1:1.2) and occurs at a younger age (mean age of onset of 26 years) than UC (male to female ratio of 1.2:1; mean age of onset of 34 years). These figures belie considerable variability. For example, for UC, a bimodal age of onset of symptoms is evident; at ages 15-30 and again, at ages 50- 80 years.

In terms of mortality, death rates from IBD seem to be similar to those in the general population. But there are two exceptions; people with severe colitis have slightly higher mortality in the first year after diagnosis and as do people aged over sixty at the time of diagnosis. Although it is not clear whether people with CD have a slightly higher overall mortality, sufferers with extensive jejunal and ileal disease and those with gastric and duodenal disease have been shown to have higher relative mortality.

Firstly, while the causes of IBD are unknown, two common conjectures are evident in the literature.

IBD has a possible genetic predisposition. For example, the majority of sources confirm an increased risk of occurrence in people with Ashkenazi Jewish heritage.

IBD has a possible diet and lifestyle predisposition. Just under half of the sources reviewed noted an association with a „western‟ diet and lifestyle.

Further evidence on this environmental dimension is evident from studies exploring people moving to a culture and country with a „western‟ way of life, for example, Hispanic or Asian groups. Although further research is needed, „westernization‟ of originally non-western individuals seems to pivot towards emphasizing that a higher fat and sugar diet and more stressful and/or sedentary lifestyle could predispose people to develop IBD.

Secondly, an examination of this literature reveals an abundance of information on the medical pathology of disease and treatments available.

More generally, this range of sources suggests that epidemiological statistical estimates of incidence, prevalence, and age of onset have not greatly changed over the last ten years.

Thirdly, and a central rationale for the focus of this Ph.D., is the demonstration of a focus of knowledge on bio-medical perspectives of IBD. While recognising that the sources consulted focused primarily on academic writing in the context of medical education and/or on the epidemiology of IBD, it was notable that there was no mention of Traditional, Complementary and/or Alternative Medicine (TCAM) approach as a plausible option for treatment of IBD symptoms or as a pathway to health and healing.

CHAPTER TWO: Perspectives of IBD – A Comparison of Healing Practices

This chapter explores perspectives of IBD by reviewing a range of literature looking at healing practices and their characteristics involving concepts of the Self, illness, and healing. As IBD is only able to be diagnosed accurately by going through the medical process of investigation, this chapter first examines this medical approach, also known as allopathic Western Medicine or Medicine, as the mainstream healing practice for IBD in the UK. To provide a comparative perspective, the healing practice of Chinese Medicine in treating IBD is explored. This healing practice uses a different healing lens and thus a different way of perceiving illness and healing.

The aim of this chapter is not only to provide an overview of these healing practices but also to illustrate the potentially stark differences in interpretations and strategies in resolving ill-health that other healing practices may present. Healing does not occur divorced from the wider socio-economic and cultural context of individuals‟ lives, including social networks, work, and home life. Moreover, healing is interwoven with concepts of the Self, illness, healing and the „culture‟ of healing practices. This perspective locates the book in a broader interpretation of the literature enabling wider, multiple healing practices, worldview of living with IBD.

Medical Perspectives of IBD

The medical process of clinically investigating IBD assesses three parts in the management and treatment of the disease:

Symptoms and signs – usually assessed during physical examination.

Medical tests – resulting in differential diagnosis to help rule out other conditions.

Prescribing drugs or recommending surgery – to either „cure‟ or prevent disease.

This following text explores each in turn. This overview of Medicine as a healing practice for IBD draws upon an assortment of the literature of textbooks on Clinical Medicine (some for students of medical education) and general medical practice (aimed at general practitioners‟ clinical practice). To provide critical commentary and to contextualize the medical view of illness and healing for those living with IBD, the following section also draws on sources from Anthropology and Sociology.

Symptoms and Signs of IBD

Although IBD can be either