When the defender becomes the attacker, there is little hope. For those who suffer from Immune-Mediated Inflammatory Disorders, this is a daily reality, managed only by compassion. AW reports.
Imagine if eating out in a nice restaurant causes you stress because any food you consume might result in side effects and irritation. Imagine if you’ve known since you were 12 that your spine will progressively and dramatically curve through the years, rendering it immobile, or that the joint in your hands will swell and cause your hands to become distorted.
For some of us, the thought is scary but for those suffering from Immune- Mediated Inflammatory Disorders (IMID), it’s a reality they live with every day. IMID is a complex group of conditions that occurs mainly when the body’s immune system attacks itself for an unknown reason.
The immune system is the body’s natural defense mechanism, protecting it against any foreign intruders, such as viruses, bacteria and fungi. It is a complex system that relies on an intricate network of many different cells patrolling the body.
In autoimmune diseases, such as Rheumatoid Arthritis (RA), Multiple Sclerosis, Psoriasis and Crohn’s Disease (CD), specific cells uncontrollably attack the body’s own tissues. This condition affects five-seven per cent of the global population. While these diseases do not have a cure and cannot be prevented, it is important to know about it as early detection can alleviate unnecessary pain and suffering.
This disease is a chronic systemic inflammatory disorder that can cause joints to become inflamed. It starts off as swelling around the joints of the hands and feet, and through time, becomes inflamed and swollen to the point that it’s totally distorted. It can damage the interior of the joints and the surrounding bone by eroding bones and cartilage.
Rheumatoid Arthritis does not have any cure. Once you have it, you have it for life. It affects more than five million people worldwide, primarily form the ages of 30-50, and this figure is expected to rise. Dr. Ali M. Jawad, Interim Director of Medical and Dental Education and Foundation Training Programme at Barts and the London NHS Trust, says that from 387,000 people afflicted with RA, the statistics project a rise up to 1.2 million by 2012.
It is a worrying disease that can creep into every corner of your lives. It can affect your health, social activities and financial source. What will life be like if you cannot type or tie your shoes? What if you cannot even hold your baby?
In the UK, the condition cost the country approximately US$ 1,453,957,00 billion in losses. It was estimated that two per cent of the population used up 34 per cent of the country’s medical fund.
Another disease under IMID is Crohn’s Disease (CD), a serious, chronic inflammatory disease of the gastrointestinal tract. Dr. Walter Reinisch, head of the Austrian Inflammatory Bowel Disease study group at the Medical University in Vienna, explains that it comes from genetic predisposition as well as environmental risk factors.
This means that having relatives who either have the disease or ulcerative colitis, another form of inflammatory bowel disease, increases your risk.
However, with environmental factors into play, nicotine usage also dramatically increases the risk of acquiring the disease.
The condition is hard to diagnose because the symptoms are similar to other intestinal disorders. Yet, it is very important to be diagnosed early. Risk of early mortality is high with CD because of clinical or surgical complications involved with this disease that affects both men and women equally.
The disease affects the small intestine or the ileum, but it may also affect the gastrointestinal tract. Symptoms include diarrhoea, cramping, abdominal pain, weight loss and fever. The most and obtains scar tissue, which leads to narrowing of the passage.
CD can be diagnosed in a variety of ways- through history, physical exam, blood tests, X-rays, stool samples, colonoscopies and upper and lower gastrointestinal exams. Up to 75 percent of patients with CD will require surgery at some point in their lives.
Psoriatic Arthritis (PA) is a chronic disease that can be found in patients with psoriasis, a chronic skin disease.
According to Dr. Lyn Guenther, Professor and Chair of the Division of Dermatology at the University of Western Ontario, Canada, psoriasis is a disease that can hit anyone from birth to 108 years old. The disease affects two per cent of people worldwide, and that translates to about 125 million people. If someone in your family has psoriasis, you have one in four chances of acquiring the condition.
It can be mild, and show up as a few marks on the derriere, lower back and elbows, but it can also be severe and take the form of scales all over the body. About 30 per cent of patients who have psoriasis can develop Psoriatic Arthritis.
Psoriatic Arthritis patients show symptoms of painful, inflamed joints, pitted, discoloured nails, inflamed, scaly skin, and, in some cases, inflammatory eye conditions similar to conjunctivitis.
Because of these symptoms, patients may find it difficult to use their hands and feet, and have to adjust their lifestyle accordingly. Some patients find themselves banned from public places such as swimming pools even though the condition is not contagious. The disease can become so severe that doctors may have to vacuum after some patients who shed a lot scales.
This causes patients to become very conscious of their appearance and their clothing become tools to hide the disease. Some patients refrain from going out of the house in fear of the social stigma it brings. They lose their place in school or work, and often experience anxiety and depression.
Up to now, the cause of PA is not known, and there is no way to prevent it. However, Dr. Guenther emphasizes that early diagnosis is vital to preventing long-term damage to the joints and tissues. Treatment for the condition depends on the type of psoriasis, the location, severity, age and medical history.
Localised areas can be treated with creams, gels and ointments. Generalised areas, however, need a more intensive approach and an effective treatment with the use of biologic agents. Biologic agents cannot remove psoriasis, but it can control the disease. An apt example is the case of a young boy, says Dr. Guenther, who sent her a letter, thanking her for healing his father.
Till then unable to go out in public to play ball with him, he was finally able to brave the world outside their house.
Ankylosing Spondylitis (AS) is another type of arthritis that causes inflammation of the spine and the spinal joints. It can lead to new bone formation on the spine, causing the spine to fuse in a fixed position. Dr. Muhammad Asim Khan, Professor of Medicine at Case Western University School of Medicine in Cleveland, Ohio, is a specialist of AS.
Interestingly enough, he also has the disease and was fortunate enough to be diagnosed when he was 12-years-old. Other patients are not so lucky and are diagnosed only after seven to nine years from the onset of the disease.
During this period, a lot of damage could have already occurred in the spine and joints. The disease commonly occurs between 15 to 40 years of age.
In developed countries, studies have found that the mean age of onset is 24, and in developing countries, the mean age is 19.
The disease can first present itself as back pain. However, it is different from the normal back pain that people get from driving long hours through traffic or sitting too long in front of a computer. The back pain starts from a sedentary position. It feels better after a warm bath, some activities, and generally goes away as the day goes on. Other symptoms can include loss of appetite, fatigue, anaemia and eye inflammation. It is also worthy to note that one third of patients who have
Arthritis develop AS.
Ankylosing Spondylitis can be diagnosed through a series of tests like X-rays and blood tests, as well as medical history and symptoms. Like the other diseases, there is no cure for AS. The important thing is to know the symptoms, especially the very telling back pain, and to tell your doctor what you feel, which will lead the way to an early diagnosis.
Biologics are also effective in treating both the signs and symptoms of the disease. The progress of Dr. Khan’s disease was classic. In the last 53 years, he has had a hip joint replacement and has no mobility in his spine. He emphasises that it is very important for General Practitioners to know the symptoms– it’s a hard disease to diagnose, much like Crohn’s Disease.
One thing common to all of these is compassion and patience required by the people around. A timely diagnosis and support from loved ones can help patients tackle these debilitating diseases with honour.
Article by: Arabian Woman