What is Behcet’s disease?
Behcet’s disease, or Behcet’s syndrome, is characterised by a triad of aphthous oral ulcers, genital lesions and recurrent eye inflammation. It is a type of vasculitis, a disease that affects the blood vessels. Since blood vessels are found all over the body, symptoms of Behcet’s disease appear at many sites throughout the body. Besides the eye, mouth and genitals, the disease also involves the skin, lungs, joints, nervous system and gastrointestinal tract. This disease is named after Hulusi Behcet, a Turkish dermatologist in 1930, when he noticed the triad of symptoms and was the first physician to describe the behcet’s disease diagnosis in modern terms.
Who gets Behcet’s disease?
Behcet’s disease is more common along the Old Silk Route, extending from Japan and China to the Mediterranean. Turkey has the most cases, followed by Japan, Korea, China, Iran, Iraq and Saudi Arabia. In these countries, there are about 13 to 35 cases in 100,000 people. The disease typically affects adults around 20 to 40 years old, while the prevalence for men and women are equal. Several studies showed that Behcet’s disease has a genetic predisposition, which is gene HLA-B51. However, the gene itself is not enough to cause the disease. Other factors like infection or environmental exposure may play a role in causing Behcet’ disease.
What are the symptoms of Behcet’s disease?
The most common and first symptom of Behcet’s disease is recurrent and painful aphthous ulcers in the mouth. Compared to common oral ulcers, they are more numerous, more frequent and often larger. The ulcers are painful and may limit the ability to eat. These ulcers are usually on the tongue, the inside of the cheek and inner lips. Big ulcers may even leave a scar. These ulcers can be healed by themselves within one to three weeks, but because they are numerous and recurrent, the individual suffers from a continuous presence of painful oral ulcers.
Besides that, 75% of individuals have genital ulcers which are similar to oral ulcers. They are painful and often found on the scrotum of men or vulva in women. However, these ulcers are less frequent and rarely leave any scars.
Inflammation of the eye, or uveitis, is an ophthalmic emergency. An individual with uveitis may become permanently blind if left untreated. Uveitis is found in 25 to 75% of Behcet’s disease and is worse in males. The inflammation of the eye may be at the front of the eye (anterior uveitis) and at the back of the eye (posterior uveitis). Anterior uveitis causes pain, blurry vision, photosensitivity, tearing and red eyes. Posterior uveitis causes fewer symptoms but is more dangerous because it can damage the retina, the most important part of the eye used to detect light.
Other symptoms of Behcet’s disease include skin lesions like pus-filled bumps, rash or acne-like lesions, joint pain without any swelling, and ulcers along the gastrointestinal tract from the mouth to the anus. The most common site for ulcer is the end of the small intestine (terminal ileum) and the start of the large intestine (cecum). Ulcers in the digestive tract may present as abdominal pain, diarrhoea and bleeding, which may be mistaken as inflammatory bowel disease. Behcet’s disease also affects the lungs, causing aneurysms of arteries in the lungs that can rupture and bleed. If the brain and nervous system are affected, it may cause headache, confusion, strokes, seizure, loss of sensation, imbalance, personality changes or dementia.
Does Behcet’s disease qualify for disability?
The World Health Organisation (WHO) defines disability as a person with impaired body functions, limitations in task execution, and restricted participation in life situations.
Bechet’s disease not only causes a range of symptoms throughout the body, but there is also no cure for it. Our current treatment mainly aims to ease and control the symptoms. The symptoms of Behcet’s are debilitating; not only must they endure the severe pain from the ulcers in the mouth and genitals, but they also suffer from painful joints and eyes. They might be malnourished as a result of poor appetite as eating is painful and ulcers in the digestive tract cause abdominal pain and diarrhoea. Moreover, Behcet’s poses a risk for complications like blindness, neurological damage and even death. Thus, it is crystal clear that Behcet’s disease does qualify as a disability. It is worth mentioning that people with disabilities have the same health needs as non-disabled people while having a narrower margin of health. Interventions and support should be provided for them to control the disease, aid independence, and to overcome life difficulties.