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Inflammatory Bowel Disease(IBD)
Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD): Symptoms, Causes and Treatment

Medically reviewed by Dr Tan Wah Siew

Dr Tan Wah Siew
Senior Consultant Colorectal Surgeon
MBBS (Singapore), MMed (Surgery), FAMS, FRCS

Inflammatory bowel disease (IBD) is one of the most common colorectal conditions in Singapore, affecting people of all ages, from children to adults. Living with IBD can be challenging, but recognising the early signs can make a difference. With timely diagnosis and the right care, you can manage symptoms, reduce the risk of complications and continue to enjoy a good quality of life.

What Is Inflammatory Bowel Disease (IBD)?

IBD is an umbrella term for conditions where the digestive tract becomes persistently inflamed. This ongoing inflammation can affect different sections of your intestines, leading to a wide range of symptoms that vary in intensity from person to person. Because it is a chronic condition, IBD requires careful management, but with the right support, you can maintain your well-being and continue with your daily activities.

Types of IBD Include

Ulcerative colitis

Ulcerative colitis primarily affects the colon and rectum, causing inflammation and small sores, known as ulcers, in the lining of the bowel. The inflammation usually starts in the rectum and can spread through the colon to varying degrees. Symptoms may include frequent diarrhoea, sometimes with blood, abdominal discomfort and fatigue. Because ulcerative colitis affects only the innermost lining of the bowel, treatment often focuses on controlling inflammation and maintaining remission.

Crohn’s Disease

Crohn’s disease can affect any part of the digestive tract, from the mouth to the anus, though it most commonly involves the small intestine and colon. Unlike ulcerative colitis, Crohn’s can involve all layers of the bowel wall, which can lead to complications such as narrowing of the intestines or fistula formation. Symptoms may vary widely depending on the area affected, but often include abdominal pain, weight loss, diarrhoea and fatigue.

What Are the Common Signs and Symptoms of IBD?

The symptoms of IBD can depend on which part of the digestive tract is affected and how severe the inflammation is. Common signs include:

  • Bloody diarrhoea
  • Abdominal pain
  • Weight loss
  • Fatigue
  • Anaemia

Some people may also experience inflammation in other parts of the body, such as the joints, eyes, bile ducts, lungs or skin.

What Are the Risk Factors of IBD?

The exact cause of IBD is not fully understood, but research suggests it develops from a combination of genetic, environmental and immune factors. While the triggers can vary between individuals, several elements are known to increase the risk of developing the condition:

  • Genetics


    A family history of IBD can raise your risk, although it is worth noting that many people with the condition have no affected relatives at all.

  • Diet and lifestyle


    IBD is more commonly seen in industrialised countries, suggesting that environmental influences play a role. Diets high in fat and heavily processed foods have been linked to a higher risk. In Asia, rapid lifestyle changes may partly explain the increasing number of cases being diagnosed.

  • Race/ethinicity


    IBD can affect people of all backgrounds. However, individuals of European descent, particularly those of Ashkenazi Jewish heritage, appear to have a higher risk.

  • Smoking


    Smoking is strongly associated with Crohn’s disease. It not only increases the risk of developing the condition but can also make symptoms more severe and harder to control.

  • Antibiotic use in childhood


    There is some evidence that suggests that antibiotic exposure early in life may increase the risk of IBD, possibly by altering gut bacteria during immune development.

  • Non-steroidal anti-inflammatory drugs (NSAIDs)


    NSAIDs may increase the risk of developing IBD or worsen symptoms in people who already have the condition. Interestingly, some studies suggest that a prior appendectomy may have a protective effect against ulcerative colitis, although the mechanism remains unclear.

Potential Complications Associated with IBD

If left unmanaged, IBD can lead to a range of complications, some of which can be serious:

  • Bowel perforation – Severe inflammation can sometimes create a hole in the bowel wall, requiring urgent care.
  • Infections and fistulas – Intra-abdominal infections, abscesses and abnormal connections between organs can occur, particularly in Crohn’s disease.
  • Bowel narrowing and obstruction – Chronic inflammation may cause strictures, making it difficult for food to pass through the intestines.
  • Perianal complications – Crohn’s disease may result in fistulas around the anal area.
  • Blood clots – IBD can increase the risk of clotting in veins and arteries.
  • Toxic megacolon – Rare but life-threatening, this is a dangerous dilation of the colon due to severe inflammation.

How Is IBD Diagnosed?

Confirming a diagnosis of IBD usually involves a combination of tests, as doctors aim to rule out other causes of your symptoms:

  • Blood tests
    • Blood tests such as a complete blood count (CBC), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are commonly used to look for signs of inflammation and assess overall health. While these tests cannot diagnose IBD on their own, they provide useful information that helps guide further investigations, including imaging studies.
  • Stool tests
    • Faecal calprotectin detects inflammation in the bowel and helps monitor flare-ups.
    • Stool cultures rule out infections or parasites that could be causing symptoms.
  • Endoscopic procedures
    • Colonoscopy examines the colon, rectum and terminal ileum.
    • Gastroscopy inspects the oesophagus, stomach and duodenum when upper digestive symptoms like nausea or pain are present. While it is not common for these areas to be affected by Crohn’s disease, this may be recommended if you have symptoms such as nausea, vomiting, upper abdominal pain or poor appetite.
    • Double balloon enteroscopy may be recommended to view sections of the small bowel beyond the reach of standard scopes.
  • Imaging studies
    • Computed Tomography (CT) scans assess the small bowel and identify complications such as abscesses or perforation.
    • Magnetic Resonance Imaging (MRI) scans evaluate the small bowel and detect perianal fistulas.

What Are the Treatments for IBD?

  • IBD Medications

    Medication is the first line of treatment for IBD. The goal is to reduce inflammation, induce remission, prevent flare-ups and minimise complications. Treatment often continues long-term and may include:

    • Aminosalicylates
    • Corticosteroids
    • Antibiotics
    • Immunosupressants
    • Biologics

  • Surgery for IBD

    Approximately 20% of patients with ulcerative colitis may eventually require surgery due to severe or treatment-resistant disease. This involves the removal of the colon and rectum, followed by the construction of an ileo-anal pouch to restore bowel function. While major, this surgery is curative for ulcerative colitis and medications are no longer required afterwards.

    Crohn’s disease follows a different course. Up to 90% of patients may need at least one operation during their lifetime. Surgery is performed to manage complications rather than cure the disease, and ongoing medical treatment remains necessary.

    Whenever possible, IBD surgery is performed laparoscopically. Studies show benefits such as fewer complications, shorter hospital stays, improved cosmetic results and lower risk of adhesions and hernias compared with open surgery.
Schedule a consultation with an IBD specialist to clarify your diagnosis and discuss appropriate management options.

Lifestyle Changes for IBD Management

Living with IBD requires ongoing care and lifestyle changes to keep symptoms manageable and prevent flare-ups. These include:

  • Maintaining a balanced diet and staying hydrated – Follow a gentle, nutritious diet and drink enough fluids to help reduce digestive strain and prevent dehydration during flare-ups.
  • Identifying and avoiding food triggers – Certain foods, including dairy products and spicy or fatty meals, may worsen symptoms. Keeping a food diary can help identify trigger foods and support better symptom control.
  • Attending regular medical follow-ups – Routine check-ups allow inflammation to be monitored, medications to be adjusted when needed and potential complications to be addressed early.
  • Managing stress effectively – Stress can contribute to flare-ups. Relaxation techniques, light exercise or structured routines may help keep symptoms more stable.
  • Getting adequate rest – Quality sleep supports immune function, reduces fatigue and helps the body recover.
  • Monitoring symptoms consistently – Paying attention to changes and maintaining regular routines supports long-term symptom control and overall well-being.

Consult our IBD Specialist for Personalised Treatment

Inflammatory bowel disease requires timely medical care to prevent symptom progression and reduce long-term complications. At Surgical Associates, care focuses on thorough evaluation, personalised treatment plans and nutritional guidance to support daily comfort and quality of life. Our IBD specialist, Dr Tan Wah Siew, provides assessment and ongoing management tailored to each patient’s condition. If you have IBD or suspect you may be affected, book a consultation for a detailed evaluation and to discuss treatment options suited to your needs.

Frequently Asked Questions (FAQs) About IBD

IBD is a chronic condition and cannot currently be cured. However, with appropriate medical treatment, lifestyle adjustments and, in some cases, surgery, many people achieve long periods of remission.

IBD develops due to a combination of genetic, immune and environmental factors. While the exact triggers vary between individuals, infections, certain medications, diet and stress may contribute to symptom flare-ups.

Yes, IBD can occur in children, including both Crohn’s disease and ulcerative colitis. Early diagnosis and treatment are important to manage symptoms, support normal growth and reduce the risk of complications.

Yes, IBD can usually be managed safely during pregnancy and breastfeeding. Many medications are considered safe, but treatment should always be reviewed by a specialist.

IBD is a chronic inflammatory condition that causes ongoing inflammation and tissue damage in the intestines. IBS, or irritable bowel syndrome, is a functional bowel disorder that does not cause inflammation or permanent damage.

Our Specialist for Long-Term IBD Management

Singapore Female Surgeon

Dr Tan Wah Siew

Senior Consultant Colorectal Surgeon

MBBS (Singapore), MMed (Surgery)
Fellow of the Academy of Medicine Singapore
Fellow of the Royal College of Surgeons of Edinburgh

Dr Tan Wah Siew is a senior consultant colorectal surgeon with experience managing a wide range of colorectal conditions, including inflammatory bowel disease. She has been part of the multidisciplinary IBD team at Singapore General Hospital since 2016, working closely with gastroenterologists and other specialists to guide care decisions. When surgery is required for ulcerative colitis or Crohn’s disease, Dr Tan adopts an approach tailored to the individual patient, selecting surgical techniques based on disease severity, overall health and recovery considerations.

Female General Surgeon

Mount Elizabeth Medical Centre
#08-07, 3 Mount Elizabeth, Singapore 228510
Tel: 6454 0054 | Fax: 6764 0054 | Email: ask@surgicalassociates.sg

Gleneagles Medical Centre
#05-01, 6 Napier Road, Singapore 258499
Tel: 6471 0054 | Fax: 6271 0054

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