Hidden Dangers of IBD: Rising Threat in Indonesia and Southeast Asia

Inflammatory Bowel Disease (IBD) stands as a striking example of how chronic illness can silently progress amid the public’s low awareness and limited clinical understanding in daily healthcare practice. Global and regional trends indicate a steady rise in IBD cases, proving it is no longer a rare phenomenon — including in Indonesia and across Southeast Asia.

IBD is not an ordinary digestive disorder. It is a multifactorial disease involving a complex interaction between genetics, the immune system, the environment, and the gut microbiota. Its two main forms, Crohn’s disease and ulcerative colitis, often present overlapping symptoms that resemble gastrointestinal infections or even intestinal tuberculosis.
In countries where infectious diseases remain prevalent, this overlap poses a particular diagnostic challenge. Many patients arrive late to healthcare facilities or receive incorrect diagnoses, delaying what could have been early and more effective treatment.

According to Prof. Dr. Marcellus Simadibrata, Ph.D., a consultant in gastroenterology and hepatology at Abdi Waluyo Hospital, IBD should be recognized as a chronic illness that cannot be managed through a one-size-fits-all approach. Once the diagnosis is established, he said, the greatest challenge lies in formulating an early treatment strategy that can minimize risks of disease progression, repeated hospitalizations, and serious complications such as bleeding, bowel obstruction, fistula, and elevated colorectal cancer risk.
Therefore, assessing disease activity and severity before choosing therapy becomes crucial. The “treat-to-target” approach he promotes marks a paradigm shift in modern medicine.
Treatment goals now extend beyond symptom relief toward achieving mucosal healing and preventing long-term tissue damage. This approach requires comprehensive evaluation — from clinical examinations, endoscopy, and histopathology to screening for latent infections like tuberculosis and hepatitis B.

The Risk Behind Therapy

In practice, these steps are not merely technical procedures. They serve as safeguards that protect patients from inappropriate treatment and the long-term consequences that can erode their quality of life.
Prof. Choon Jin Ooi, consultant gastroenterologist and President of both the Asian Education Network in Inflammatory Bowel Disease (AEN-IBD) and the Asian Pacific Association of Gastroenterology (APAGE), underlined the importance of cross-border medical collaboration in Asia. Given the region’s diverse healthcare systems and epidemiological challenges, a collective approach is vital to strengthening standards of care.
Knowledge exchange between countries, he added, is not only about catching up with the latest therapeutic developments but also about adapting them to field realities — including limited resources and the heavy burden of infectious diseases.

Data from Prof. Dr. Ari Fahrial Syam, Chairman of the Indonesian Society of Gastroenterology, reveal a concerning trend. Although IBD incidence in Southeast Asia remains lower than in Western nations, the upward trajectory is consistent, ranging between 0.54 and 3.44 per 100,000 people.
Referral hospitals in Indonesia have also reported a growing number of patients requiring long-term care. Behind these figures are individuals and families learning to adapt to chronic illness, facing uncertainty, and reshaping their daily lives around it.

IBD in Children

IBD also carries a lesser-known social dimension, especially in children. Prof. Jose D. Sollano Jr., Professor of Medicine at the University of Santo Tomas, Philippines, warned that recurrent abdominal pain, growth disorders, anemia, and delayed puberty are often dismissed as minor complaints.
Such underestimation leads to delayed suspicion of IBD, even though a family history or symptoms such as fistula-in-ano in children should serve as strong warning signs that warrant further medical evaluation.
Early detection not only helps prevent medical complications but also ensures that affected children can grow and develop healthily without being held back by a disease that could otherwise be effectively managed.

At the healthcare level, a multidisciplinary approach is essential. The involvement of various specialists — from gastroenterology, infectious disease, pulmonology, and nutrition, to digestive surgery and pathology — reflects IBD’s complexity as a systemic disorder.
This model emphasizes that patients are not mere subjects of treatment but individuals who need comprehensive support physically, psychologically, and socially.

Above all, understanding IBD highlights that advances in healthcare are born not only from technology and new drugs but also from an ongoing commitment to learning and collaboration.
When experts stress the importance of latent infection screening, biological therapy positioning, and noninvasive disease monitoring, they are effectively bridging science and patients’ everyday realities.

Public awareness plays an equally critical role. Symptoms that seem trivial — prolonged diarrhea, recurrent abdominal pain, or unexplained weight loss — should prompt people to seek medical help sooner. In parallel, the healthcare system must continue to strengthen the capacity of medical personnel to recognize and treat IBD accurately and sustainably.

IBD reminds us that chronic illnesses are not only about the body but also about resilience and shared support. This is where collaboration, continuous education, and empathy in clinical practice converge, helping patients move beyond mere survival toward a life of achievable recovery and dignity.

Indonesianpost.com | Antara