The disease progresses while patients wait for the test that could save them.
Each May, Brazil turns purple to remind its people that the body sometimes wages war against itself in silence — through persistent diarrhea, quiet weight loss, and pain too easily blamed on daily life. Inflammatory intestinal diseases like Crohn's and ulcerative colitis affect roughly one in every thousand Brazilians, striking hardest in the young and the aging, yet often going unrecognized until the damage is done. The Brazilian Society of Coloproctology's Purple May campaign is less a medical announcement than a collective plea: that early attention, and timely access to care, can mean the difference between a managed condition and a life diminished.
- Symptoms like chronic diarrhea, abdominal pain, and unexplained weight loss are frequently dismissed as minor complaints, allowing inflammatory intestinal diseases to advance undetected.
- In some Brazilian regions, patients wait over a year for a colonoscopy — the very exam that could confirm diagnosis and open the door to treatment.
- That delay closes what specialists call the 'window of opportunity,' the early phase when intervention is most effective and serious complications most preventable.
- The Purple May campaign, led by the coloproctology society, is pushing for greater public awareness and faster pathways to specialist care across the country.
- For those without immediate specialist access, primary care physicians are being positioned as a first line of action — ordering initial tests and initiating referrals before the disease progresses further.
Diarrhea that persists for more than four weeks, abdominal pain that lingers, unexplained weight loss — these are the body's quiet distress signals, and in Brazil, too many people wait too long to heed them. Inflammatory intestinal diseases, chiefly Crohn's disease and ulcerative colitis, affect roughly one in a thousand Brazilians. Both conditions involve the immune system turning against the digestive tract, and while they can appear at almost any age, they tend to peak in people in their twenties and thirties, and again around sixty to seventy. May has been designated Purple May, a national awareness campaign urging earlier diagnosis and specialist access.
The difficulty is that symptoms are easy to rationalize away. By the time a patient reaches a specialist, the disease may have already progressed. Dr. Mariane Savio of the Brazilian Society of Coloproctology has stressed that any combination of prolonged diarrhea, abdominal discomfort, weight loss, or anemia warrants proper evaluation. Diagnosis typically involves colonoscopy, with CT scans, MRI, and ultrasound filling in where the small intestine is involved. Crohn's can affect the entire digestive tract and cause complications like fistulas, while ulcerative colitis is confined to the rectum and colon.
The most pressing obstacle is access. In parts of Brazil, colonoscopy waiting lists stretch beyond a year, consuming the early window when treatment is most effective. The public health system does offer clinical protocols and medications, and in severe cases patients may require a colostomy bag. Researchers continue to examine potential triggers — chronic stress, ultra-processed diets, smoking — though the full picture remains unclear. For those who cannot reach a specialist quickly, starting with a primary care physician is strongly advised, so that testing and referral can begin without further delay.
Persistent diarrhea that stretches beyond four weeks. Abdominal pain that won't quit. Unexplained weight loss. These are the signals that something deeper may be wrong with your intestines, and they deserve a doctor's attention—yet many Brazilians miss them or wait too long to seek help.
Inflammatory intestinal diseases affect roughly one in every thousand Brazilians, according to the Brazilian Society of Coloproctology. The two most common forms are Crohn's disease and ulcerative colitis, conditions in which the body's own immune system attacks the digestive tract. They can emerge at almost any age, though they strike most frequently in people in their twenties and thirties, and again in those approaching sixty or seventy. To draw attention to these conditions and push for earlier diagnosis, May has become Purple May—a national awareness campaign led by the coloproctology society and partner organizations.
The challenge is that symptoms can be easy to dismiss. A person might attribute persistent diarrhea to something they ate, or chalk up abdominal discomfort to stress. By the time they see a doctor, the disease may have progressed further than it needed to. Dr. Mariane Savio, a physician and member of the Brazilian Society of Coloproctology, emphasized in a recent radio interview that specialist evaluation is essential. Symptoms that warrant investigation include diarrhea lasting more than a month, bothersome abdominal pain, weight loss, and anemia. The longer these signs go unexamined, the more damage can accumulate.
Once a patient reaches a specialist—ideally a coloproctologist or gastroenterologist—the diagnostic process typically involves a colonoscopy, though imaging studies like CT scans, MRI, and ultrasound also play a role, especially when disease affects the small intestine. The two main conditions behave differently in the body. Crohn's disease can strike anywhere from the mouth to the anus, potentially causing oral ulcers, inflammation throughout the small and large intestines, and complications like fistulas and fissures around the anal opening. Ulcerative colitis, by contrast, affects only the rectum and colon and primarily damages the innermost lining of the bowel wall. Many treatments work for both conditions, though some medications target only one.
Here lies a critical problem: access. In some regions of Brazil, waiting lists for colonoscopy stretch beyond a year. That delay can cost patients what doctors call the "window of opportunity"—the early phase of disease when treatment is most effective and can prevent serious complications. A patient might finally get their appointment only to find the disease has already advanced significantly.
The Brazilian public health system does provide clinical protocols and therapeutic guidelines for inflammatory intestinal diseases, including medications. In severe cases, patients may need a colostomy bag—an external medical device that collects stool and gas. Researchers are also examining risk factors that may trigger these diseases: chronic stress, diets heavy in ultra-processed foods, and smoking. Controlling these factors might reduce a person's risk, though the underlying cause remains incompletely understood.
For those without access to a specialist, Dr. Savio recommends starting with a primary care physician who can order initial tests and refer the patient onward, ensuring treatment begins as soon as possible. The goal is simple but urgent: catch the disease early, before it steals more of a person's health and quality of life.
Notable Quotes
It is very important to seek a specialist. Sometimes symptoms can be overlooked, and the disease progresses. Persistent diarrhea, especially lasting more than four weeks, deserves investigation, as do abdominal pain, weight loss, and anemia.— Dr. Mariane Savio, Brazilian Society of Coloproctology
We know there are many places with waiting lists of more than a year for colonoscopy—an exam that could give a patient a diagnosis—and sometimes they end up losing what we call the 'window of opportunity,' when treatment would be most effective in the early phase of disease.— Dr. Mariane Savio
The Hearth Conversation Another angle on the story
Why does it matter that these diseases peak in two different age groups—young adults and the elderly?
Because the disease looks different depending on when it hits. A twenty-five-year-old might have decades of life ahead with a chronic condition, while a seventy-year-old's body may respond differently to treatment. Doctors need to know who they're treating.
You mentioned a "window of opportunity." What happens if someone misses it?
The disease keeps inflaming, keeps damaging the intestinal wall. What could have been controlled with early medication might require surgery, or a colostomy bag. The damage becomes irreversible.
The waiting lists sound like the real villain here.
They are. A person can have all the right symptoms, know something is wrong, and still wait a year to get the test that confirms it. By then, the disease has already progressed. It's not a failure of medicine—it's a failure of access.
Can these diseases be prevented?
Not entirely. But stress, ultra-processed food, smoking—these seem to trigger or worsen them. You can't prevent the underlying condition, but you might delay it or reduce its severity.
What's the difference between the two main types, really?
Crohn's is like a wildfire—it can burn anywhere in your digestive system. Ulcerative colitis is more contained, but it's relentless in the areas it hits. Treatment depends on knowing which one you have.