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Inflammatory bowel disease (IBD)

These are conditions that result in the inflammation of the digestive tract, such as Crohn’s disease, indeterminate colitis, and ulcerative colitis. Although these conditions are rarely curable and tend to recur, they can be controlled with medication and lifestyle modifications.

Patients with IBD have varying symptoms, although the most obvious signs are diarrhoea, weight loss, blood in the stool, abdominal pain, and mouth ulcers. Some people may simply present with fistula in the anus and other parts of the digestive tract (eg. Crohn’s disease).

Causes of IBD

It is difficult to point to a particular cause of IBD in a patient. It is believed to be genetic and environmental. There is often a family history of the disease.

There is, however, a strong link with the diet and lifestyle (eg. smoking) in most patients. IBD is associated with specific bacteria in the gut, which in turn is influenced by one’s diet. Some people develop IBD because of their body’s overreaction to the immune system.

Diagnosis of IBD

IBD often presents with a constellation of symptoms and signs, that are common to other conditions of the digestive tract. Since treatment is often lifelong, an accurate diagnosis must be made prior to commencing the necessary treatment.

Some of the tests conducted include:

Blood tests: Full blood count, C-reactive protein, iron levels, erythrocyte sedimentation rate (ESR), renal panel, and liver panel.

Stool tests: Stool culture, stool calprotectin, Clostridium difficile PCR, and microscopy.

Imaging: Abdominal x-ray, chest x-ray, small bowel enteroclysis, small bowel capsule endoscopy, abdominal/pelvic CT scans, and CT/MRI enterogram.

Endoscopy to get tissues for a biopsy. The processes used include colonoscopy, Oesophagogastroduodenoscopy (OGD), and small bowel enteroscopy.

Treatment Options for IBD

IBD flares from time to time. Patients with IBD require medication to control the disease and bring it into remission. This will help to prevent complications, minimize discomfort and help optimize their quality of life. Some of the treatment options include;

  • Use of steroids which can be given intravenously, topically or orally
  • Immune suppressants
  • Antibiotics
  • Special diets
  • Surgery for complications (eg. fistula, abscess, blockage)

The treatment will be highly dependent on the severity of the IBD and the response to any given medication.

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