Shipping administrator Tasneem Baji took her son Irfaan to see the doctor in early January last year, when he was hit by fever, serious tummy pain, diarrhoea and vomiting.
The doctor said it was stomach flu, but when the symptoms went on for almost a month, Mrs Baji, 46, thought something was wrong. Irfaan, then 12, was later taken to see a specialist and found to have inflammatory bowel disease (IBD), a chronic condition that affects part of the digestive tract.
The disease has become increasingly common in children, though it is still generally rare in Singapore.
At least two hospitals here have reported more cases affecting children, they told The Straits Times in the lead-up to World IBD Day today.
At KK Women's and Children's Hospital (KKH), nearly 40 children were diagnosed with the disease last year, about five times the number recorded a decade ago.
At the National University Hospital, six children were diagnosed with IBD last year, up from only two a decade ago. Patients may also be getting younger.
"Two years ago, the youngest patient I knew was three or four. Last year, I heard that the youngest patient was just one year old," said Ms Nidhi Swarup, president of the Crohn's and Colitis Society of Singapore, the main support group for patients here.
IBD affects an estimated 2,000 people in Singapore, about 150 of whom are children, she said.
The disease can be classified into two types. One is Crohn's, where patients experience inflammation anywhere in their digestive tract. Another is ulcerative colitis, where inflammation happens along their colon.
Irfaan has Crohn's, the more common form of IBD among kids.
Doctors find it hard to explain the spike in cases among children as they, too, are unsure of what causes the disease.
"While we cannot be certain about what causes IBD, it is probably a combination of factors, including genetic predisposition and an abnormal reaction of the digestive system to bacteria in the intestine," said Dr Christina Ong, head of the gastroenterology service in the paediatrics department at KKH. Stress and diet may also be factors, she said.
It is not only the physical strain of this chronic illness that wears caregivers out, but also the financial strain.
Mrs Baji estimates that the family has spent more than $10,000 on medical bills from last year till now. Monthly blood tests and medication alone cost about $300.
Graphic designer Felicia Goh, 44, whose daughter Rachel, 15, has Crohn's, said: "I hope we can draw on Medisave to pay for outpatient visits for this chronic illness."
There is help, though. Last month, medicine used to treat more severe cases, called biologics and can cost up to $25,000 a year, was added to the list of drugs subsidised by the Government for less well-off patients.
"Now, at least I can get the medicine that I need. I can also save for my son's education," said transport logistics operator Muhammad Shariffudin, 47, who can get a subsidy of about 75 per cent for the biologics treatment.
Now, Irfaan is doing well, although occasional stomach aches distract him from his studies.
On Mother's Day recently, he whipped up garlic butter toast and scrambled eggs as a treat.
"This illness has brought my family closer. Above all, I would really like to say 'thank you' to my parents," he said.
Support group provides help on disease
The life of a former leader at a charity group, Ms Nidhi Swarup, was turned upside down when she found herself having body aches, heart palpitations, skin problems and frequent diarrhoea in 2009.
She visited 10 specialists the same year but doctors could not put a finger on the problem despite many tests.
The mother of three was once at a family dinner when she burst out into tears fearing that she might have a terminal illness.
It was not till she had a severe bout of diarrhoea that she visited a gastroenterology specialist and found out she had inflammatory bowel disease (IBD).
"Symptoms of IBD can be flu-like or stomach flu-like, but larger forces could be at play," said Ms Swarup, 47.
Like many sufferers, Ms Swarup was initially afraid and alone. But fortunately, the former executive director of the Foundation of Rotary Clubs (Singapore) could leverage on her contacts, many of whom were doctors.
"They would give me medical literature or put me in contact with people who could help. I feel like I am in a privileged position to help," said Ms Swarup, a business management and finance post-graduate.
In 2012, she started the Crohn's and Colitis Society of Singapore as a support group. With the help of donations, the society provides Modulen milk, a common nutritional supplement for IBD patients, at a discount. The 51-patient group meets monthly to share a meal, exchange dietary tips or take part in activities such as art therapy.
Ms Swarup, who volunteers at the society full-time, hopes to set up a national registry for the disease. Currently, she has to work with specialists to get estimates on the number of patients, with no official statistics.
"Little is known about IBD in the Singapore context. We need a systematic way of collating numbers to facilitate more research," she said.
This article was published on May 19 in The Straits Times.
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