Knowledge Transfer
From Institute to Community
Crohn’s Disease in Asia is as severe as in the West
Over 30% Patients have Stricturing or Penetrating Disease at Diagnosis
亞洲克隆氏症嚴重程度不下西方
超過三成患者於確診時發現腸道收窄或瘺管
22 December 2015
Crohn’s disease is a subtype of inflammatory bowel disease (IBD). In the past 20 years, its incidence increased 6 times in Hong Kong, from 0.2 per 100,000 persons to nowadays approximately 1.5 per 100,000 persons. CUHK has conducted an epidemiology study in Australia and 8 countries/regions in Asia (China, Hong Kong, Macau, Indonesia, Malaysia, Sri Lanka, Singapore and Thailand), to investigate and follow up new IBD patients. In the past, there has been a perception of a milder disease in Asia than the West. However, this study shown that Crohn’s disease in Asia is as severe as in Australia. Over 30% of patients were diagnosed with stricture and fistula. CUHK found that 47% of new Crohn’s disease patients were treated with immunosuppressants in the first year, while about 10% required biologics. Comparing with initial therapy, there is over 1 fold increase. Cumulative probability of bowel resection at 1 year after diagnosis is 8%, which means it is estimated that 8% of patients require bowel resection within first year of diagnosis. Symptoms that are often overlooked by parents include severe diarrhea, rectal bleeding and underweight. Crohn’s disease is not only life-threatening, it could cause significant physical and emotional distress to patient. Therefore, early diagnosis and treatment of Crohn’s disease is important to control disease activity and maintain quality of life. Support from family and patient group is also important. Have better knowledge is helpful in managing and minimizing Crohn’s disease and symptoms and associated conditions.
「克隆氏症」(Crohn’s disease)是炎症性腸病的一種。過去20年,此疾病於亞洲病發率持續上升,在香港由1995年前每10萬人中約有0.2人病發,上升6倍至今日平均每年每10萬人中有約1.5人患病。中大內科及藥物治療學系過去曾在澳洲及亞洲8個地區包括中國、香港、澳門、印尼、馬來西亞、斯里蘭卡、新加坡及泰國等地進行炎症性腸病流行病學研究,調查並追蹤新發病個案。以往一般認為亞洲克隆氏症病情較西方輕,是次研究則發現亞洲克隆氏症嚴重程度與澳洲相約,約三成患者於確診時已發現腸道收窄或瘺管。中大是次研究發現亞洲47%新發病個案需於一年內使用免疫抑製劑,而一成新發病個案需要使用生物製劑,比例比剛確診時增加超過一倍。另外,於確診後首年內需要進行腸道切除術的累積概率為8%,即估計8%病人需於確診後一年內切腸。臨床上克隆氏症較容易被忽略的徵狀包括︰嚴重腹瀉、原因不明的出血、以至體重低於正常標準等。克隆氏症對患者除了帶來生命威脅外,亦會誘發出不同的影響。及早診治克隆氏症,對防止病情惡化、保障患者的健康及生活質素是非常關鍵的。若不幸確診,家人及病友支持十分重要。多與其他病友溝通交流,可以加深對疾病的認識,更可互相支持鼓勵,妥善處理疾病。
TVB Interview about Crohn's disease
9 October, 2015