By: Yacob Billiocta
Several health experts have revealed a number of facts regarding IBD cases, one of the chronic inflammatory diseases affecting the gastrointestinal tract.
Liputan6.com, Jakarta – Health experts have revealed a number of key facts regarding inflammatory bowel disease (IBD), a chronic inflammatory condition of the gastrointestinal tract. The number of cases continues to rise in line with environmental and lifestyle changes, both in Indonesia and globally.
However, public awareness of this disease remains relatively low. As a result, many patients fail to recognize the symptoms early and only receive a diagnosis once the disease has progressed to a more advanced stage.
“Delayed diagnosis and initiation of therapy can increase the risk of disease progression, recurrent hospitalizations, and serious complications such as bleeding, intestinal obstruction, fistula formation, and an increased risk of colorectal cancer. Therefore, assessing disease activity and severity is a crucial step before determining the most appropriate therapy,” said Marcellus Simadibrata, an Internal Medicine Specialist in Gastroenterology-Hepatology at RS Abdi Waluyo.
Marcellus delivered these remarks during the IBD Update 2026: Updates on Diagnosis and Management of IBD, held on January 23–24, 2026, at Park Hyatt Jakarta. The event brought together national and regional experts as a platform for knowledge exchange to strengthen Indonesian physicians’ understanding of accurate IBD diagnosis and management, as quoted from a written statement on Monday (January 26, 2026).
IBD is a complex and multifactorial disease involving interactions among genetic factors, the immune system, environmental influences, and the gut microbiota. The two main forms of IBD—Crohn’s disease and ulcerative colitis—often present symptoms that overlap with other conditions, including gastrointestinal infections and intestinal tuberculosis.
This overlap means that establishing an IBD diagnosis must be carried out with great precision through a comprehensive approach, including clinical evaluation, endoscopic examination, histopathology, and other supporting investigations, in order to prevent delayed diagnosis and mismanagement.
Management Cannot Be Simplified
Marcellus emphasized that IBD management cannot be approached in a simple or uniform manner. After diagnosis, patients must undergo a comprehensive evaluation that includes assessing disease activity, excluding underlying infections, and determining clear therapeutic targets.
“The treat-to-target approach should be part of clinical practice, aiming not only to control symptoms but also to achieve mucosal healing and prevent long-term damage,” he explained.
He also highlighted that in countries with a high prevalence of infections such as Indonesia, infection screening is an essential step in IBD management.
“Certain infections, particularly tuberculosis and specific gastrointestinal infections, may mimic or exacerbate IBD. Therefore, thorough screening before initiating or escalating therapy is critical to avoid misdiagnosis and unwanted complications,” he added.
IBD Recognized as a Chronic Disease
Regarding the complexity of IBD, Marcellus stated that RS Abdi Waluyo regards IBD as a chronic disease requiring special attention and comprehensive management.
According to him, the hospital has developed an IBD Center to provide holistic care through a multidisciplinary team of specialists and subspecialists, integrating diagnostic services, therapy, long-term monitoring, and multidisciplinary support tailored to patients’ needs.
“The RS Abdi Waluyo IBD Center is the first IBD center in Indonesia. In addition, the hospital provides Intestinal Ultrasound (IUS) services as part of a noninvasive diagnostic and monitoring approach, which plays an important role in assessing disease activity safely and repeatedly, and in supporting more accurate clinical decision-making in IBD management,” he explained.
At the event organized by RS Abdi Waluyo in collaboration with Asian Education Network in IBD and Perhimpunan Gastroenterologi Indonesia, Ari Fahrial Syam, an Internal Medicine Specialist and Consultant in Gastroenterology-Hepatology as well as Chairman of the Indonesian Gastroenterology Association, emphasized that support and collaboration among healthcare professionals are essential in addressing the challenges of IBD diagnosis and management in daily clinical practice.
“With the support of healthcare professionals and scientific forums like this, we can continue to promote excellence in care, thereby improving the quality of services and clinical outcomes for IBD patients,” he said.
Rising Cases
Ari explained that in Southeast Asia, although the incidence of IBD remains relatively lower compared to Western countries, the upward trend has been consistent year by year.
“Studies across various Asian countries show that the incidence of IBD ranges from 0.54 to 3.44 per 100,000 population, with a rising trend alongside environmental and lifestyle changes. Data from referral hospitals in Indonesia also indicate an increasing number of IBD patients requiring long-term management. This situation demands readiness within the healthcare system as well as heightened clinical vigilance in recognizing and managing IBD earlier and more accurately,” Ari stated.
He further emphasized that IBD must be comprehensively understood as a disease with complex mechanisms. It is not caused by a single factor but by impaired immune tolerance that triggers chronic inflammation and a relapsing disease course.
“Therefore, diagnostic and management approaches for IBD must be integrated, focusing not only on clinical symptoms but also on the underlying disease mechanisms,” he added.
In another scientific session, Ling Khoon Lin, Consultant Gastroenterologist and Adjunct Associate Professor at Duke-NUS Medical School, Singapore, discussed the importance of appropriate therapeutic positioning in patients with moderate to severe IBD, both ulcerative colitis and Crohn’s disease.
He emphasized that the primary goal of IBD therapy today is no longer limited to symptom relief, but to achieving more comprehensive targets in accordance with STRIDE II recommendations from the International Organization for the Study of Inflammatory Bowel Disease (IOIBD), namely clinical remission, normalization of biochemical parameters, and mucosal healing.
“The treat-to-target approach is key to preventing disease progression and long-term intestinal damage,” he explained.
Ling stressed that screening for latent infections is an essential component of modern IBD management standards, particularly before administering biologic therapies or small molecules. He highlighted the importance of evaluating latent tuberculosis, hepatitis B, and updating immunization status as preventive measures to ensure long-term treatment safety in accordance with international recommendations.
“There is no single therapy that suits all patients. Clinical decisions must consider the balance between efficacy, speed of response, safety, and patient preferences, in order to optimize clinical outcomes and quality of life for IBD patients,” Ling stated.
Symptoms in Children
Jose D. Sollano Jr., Professor of Medicine at the University of Santo Tomas, Philippines, also emphasized the importance of vigilance regarding the signs and symptoms of IBD in the pediatric population, where the disease is often not recognized early.
“Suspicion of IBD in children should be considered in cases of recurrent abdominal pain, which unfortunately is often regarded as a common complaint and left untreated for years, as well as growth disturbances commonly associated with decreased appetite and malnutrition. Additionally, the presence of anemia in children—whether due to chronic inflammatory disease, small bowel disease, or minor bleeding—should raise concern. Delayed puberty resulting from nutritional disorders, hormonal imbalance, and chronic inflammation is also a possible sign,” he explained.
A family history of IBD significantly increases the risk of the disease, he added. The occurrence of fistula-in-ano in children is also a clinical condition frequently overlooked by both pediatricians and colorectal surgeons, leading to repeated surgeries at a young age.
“Early recognition of IBD in children is crucial to prevent long-term complications and improve patients’ quality of life, so that they do not experience worsening disease in adulthood,” he concluded.
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