Stomach aches and diarrhoea: How can we tell if it’s food poisoning, IBS or irritable bowel disease?

In Crohn’s disease, the mouth, oesophagus, stomach, small bowel, colon and anus can be affected. The damaged areas may appear in patches that are next to areas of healthy tissue, according to the US Centers for Disease Control and Prevention.

“Crohn’s disease may affect one location in the digestive tract or multiple places simultaneously,” said Dr Wee. “In severe cases, the inflammation may extend through the bowel wall and into other organs or the skin.”

Meanwhile, ulcerative colitis mainly affects the large intestine or colon, said Dr Sulaiman. “In some cases, ulcerative colitis can also affect the last part of the small intestine before it joins the colon. Typically, ulcerative colitis affects the left side of the colon and rectum. Its hallmark feature is continuous areas of shallow ulceration of the colon.”

Both of these conditions may also manifest with joint pain in the knee or elbow, added Dr Wee.


Nearly one in 10 Singaporeans suffers from IBS, according to HealthXchange. When it comes to IBD, the number is lower. “Currently, it is estimated that there are 1,500 individuals, who may be suffering from IBD in Singapore, of which 200 are children,” said Dr Sulaiman.

While low, IBD cases appear to be on the rise. “Singapore General Hospital saw close to 600 patients diagnosed with the disease in the year 2017, a two-fold increase from a decade ago in 2007,” said Dr Sulaiman, citing press reports. “National University Hospital saw a striking eight-fold increase in IBD patients, from below 50 in 2013 to close to 400 cases in 2018. The rise in numbers can be attributed to better awareness and better diagnostic capabilities in recent years.”

Of the two IBD conditions, “ulcerative colitis is more common than Crohn’s disease and fortunately, ulcerative colitis is easier to treat”, said Dr Wee. “Crohn’s disease has more complications and is more resistant to treatment.”

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