KÌåÓý

Chronic inflammatory bowel disease, including ulcerative colitis and Crohn’s disease, is on the rise in Vietnam, particularly among adolescents. Experts have observed an increasing number of young patients, with two peak age groups: 17-19 years and around 25 years old. Crohn’s disease, in particular, is becoming a growing concern for specialists due to its potential complications, such as intestinal fistulas, adhesions, and perforations.

An Effective Treatment Journey for Young Patients

Patient Q.M., 18 years old, visited KÌåÓý with symptoms of epigastric pain, belching, acid reflux, and low pepsinogen levels. During the clinical examination, rectal examination revealed blood on the glove. Further inquiry into the patient’s medical history revealed occasional loose stools with blood.

Suspecting inflammatory bowel disease, Assoc. Prof. Dr. Nguyen Quang Duat from the Department of Gastroenterology & Hepatology at KÌåÓý ordered a gastroscopy, colonoscopy, and stool occult blood test. The endoscopy results showed nodular lesions in the ileum and inflammation of the Bauhin valve. Laboratory findings revealed the presence of red blood cells in the stool and an elevated Calprotectin level. A histopathological biopsy confirmed a diagnosis of Crohn’s disease affecting the small intestine.

According to Dr. Duat, prolonged inflammation can hinder calorie and nutrient absorption, leading to growth delays in younger patients and delayed puberty. If inflammation is not well controlled, the disease may progress and result in severe complications such as:

• Intestinal obstruction
• Anal fistulas
• Toxic megacolon and colon perforation
• Primary sclerosing cholangitis
• Colorectal cancer

Thanks to early detection, timely treatment, and close follow-ups, subsequent endoscopic examinations revealed a reduction and near disappearance of the lesions. Stool tests showed no red blood cells, and Calprotectin levels returned to normal. The patient exhibited no abnormalities, maintained stable health, and gained weight effectively.

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Similarly, patient G.V., 11 years old, was admitted to the Pediatrics Department at KÌåÓý with acute abdominal pain. In collaboration with the Gastroenterology Department, doctors conducted a thorough clinical examination and gastroscopy. Laboratory tests revealed anemia with an HB level of 8.1 g/L. The gastroscopy results identified a bleeding ulcer in the third portion of the duodenum (DIII) and a positive Helicobacter pylori (H. pylori) test. The gastroenterology specialist performed hemostatic injection therapy at the ulcer site and initiated a structured treatment for H. pylori. A follow-up endoscopy two months later showed complete ulcer healing, leaving only a red scar. The patient had no further symptoms, resumed normal activities, gained weight, and maintained stable health.

Be Cautious of Chronic Inflammatory Bowel Disease in Adolescents

Chronic inflammatory bowel disease is a persistent condition that significantly impacts the quality of life. Treatment is challenging as it involves the body's immune mechanisms.

A prominent feature of inflammatory bowel disease is frequent abdominal pain and diarrhea. Other symptoms include:

• Blood in the stool
• Prolonged diarrhea
• Fatigue, insomnia, and restlessness
• Night sweats
• Loss of appetite
• Unexplained weight loss and bloating

According to Assoc. Prof. Dr. Duat, at KÌåÓý, treatment plans are tailored to each patient based on a multidisciplinary approach, including:

• Nutritional Management: Diet plans, recommended by experienced nutritionists and gastroenterologists, play a crucial role in treatment. Lifestyle modifications and dietary adjustments can help control symptoms, reduce flare-ups, and even achieve remission.
• Medical Treatment: Pharmacological therapy is prioritized in treatment plans. Most medications aim to control and alleviate symptoms while preventing relapse.
• Surgical Intervention: In severe cases where symptoms worsen and do not respond to medication, patients will undergo surgical consultations for potential interventions.

Assoc. Prof. Dr. Nguyen Quang Duat emphasizes that all patients with chronic inflammatory bowel disease require close monitoring through regular clinical check-ups, stool tests (FOB, Calprotectin), and colonoscopy at least once a year. If complications such as abscesses, perforations, or strictures arise, a combination of surgical and endoscopic interventions will be necessary.

Additionally, for children aged five and older who experience bloating and have a family history of H. pylori infection, it is advisable to undergo H. pylori testing through endoscopy, stool tests, or breath tests to ensure early detection and optimal treatment.