The number of Israelis currently diagnosed with Inflammatory Bowel Disease (IBD), a serious chronic gastroenterological condition, is about 70,000, but by the end of the decade, it is estimated to rise to 100,000. The standard is one doctor per 400 patients, but in reality, each gastroenterologist takes care of 1,000 people.
The Knesset Health Committee, which became aware of the situation on Monday, urged the Health Ministry to establish a working team in cooperation with the medical specialists and associations that deal in the field and submit to the committee a systematic plan to address the existing gaps.
Common symptoms of IBD (which includes Crohn’s disease and ulcerative colitis) include diarrhea (sometimes with blood); abdominal pain; weight loss; urgency to have a bowel movement and fecal incontinence; rectal bleeding; weight loss; and fever. The exact cause is not known, but genetics and a weakened immune system responding incorrectly to environmental triggers like bacteria or a virus are believed to be involved.
There are some IBDs that are more common among Jews, especially those of Ashkenazi origin, and in high socioeconomic classes, as well as in industrialized areas when compared to rural areas.
Shas MK Yoni Mashriki, head of the Knesset committee on proper treatment, said there was a serious need to establish integrated clinics in order to provide proper treatment. “I intend to work with the health minister and director-general to find a solution for the problem,” he said.
From data collected by the Knesset’s Research and Information Center from the four public health funds, it appears that in 2022, there were 68,299 Israelis diagnosed with Crohn’s or colitis, and some of them suffer from both. The diagnoses make up 0.71% of the population – about 707 diagnoses per 100,000 people
. According to Clalit Health Services, the incidence of these diseases in Israel is on the rise, and, similar to countries with a similar morbidity rate, by the year 2030, it is expected to affect one percent of the population. By the end of this decade, Israel’s population will number between 9.6 and 10.6 million people, and a morbidity of one percent means between 960,000 and 106,000 patients.
Dr. Nathaniel Cohen, a doctor from Tel Aviv Sourasky Medical Center, spoke about the lack of training among staff members to treat these diseases as well as the difficulty of patients in the periphery accessing medical devices for timely treatment, resulting in complications and the need for surgery.
According to attorney Eyal Tzur, chairman of the Crohn’s and Colitis Support Association, a patient who is not treated suffers greatly, and mental stress both worsens the disease and increases the risk of contracting it. Every integrated clinic should have a dedicated nurse and a dietitian, he said, and there are far too few specialists to treat patients.
Dr. Ofer Ben-Bassat, director of the unit for these diseases at Barzilai Medical Center in Ashkelon, spoke about many phone and online inquiries from patients and their families who couldn’t get a clinic appointment. His clinic was closed due to a lack of protection from rockets, and the evacuated patients were far from other cities that offered this service.
Shira Chen, a Crohn’s patient from Kiryat Shmona, described years of continuous, severe suffering, adding that she had to wait for an appointment and surgery for half a year.
Yehezkel Ashkenazi, who belongs to an IBD patients’ organization, said there isn’t a single center in Israel that has the perfect response, including psychological support or surgery with expertise in gastroenterology, skin, and eyes. Patients do not receive a comprehensive quality response, and for women who want to become pregnant, it’s almost impossible to receive the full medical support needed to go through the process safely.
According to the Israeli Gastroenterology Association, nurses who can coordinate care by various specialists in IBD are not recognized by the Health Ministry, unlike coordinators in other fields. Where there are such coordinators, one nurse sometimes treats 3,000-4,000 patients.