Brave Salma learns to master living with Crohn's Disease and enjoy life to the full

But behind the happy face is a history of suffering that she refuses to give in to.

Salma started suffering from symptoms which were later diagnosed as Crohn's Disease, a condition causing inflammation of the gastrointestinal tract, at the age of 11. Her GP gave her antibiotics to clear up what he thought was an abscess.

When it failed to get better and Salma's condition worsened, her parents took her to Bradford Royal Infirmary, where she was eventually referred to paediatrics.

Salma, from Heaton in Bradford, says: "Over the summer holidays the pain just got worse and I had a high fever, vomiting and diarrhoea."

Salma eventually underwent an operation at the BRI to remove the abscess which meant a three week hospital stay.

When she eventually returned home, Salma was home tutored between September 2004 and January 2005 because she was too sick to attend school.

"I was always tired, lethargic and in pain," she adds. "The abscess made life difficult because it was so sore and it was hard to sit or sleep or take part in any activities, even walking was a struggle."

It was two years later that tests revealed the underlying cause was Crohn's Disease.

"I burst out crying but at the same time it was also a relief to finally be able to put a name to what was going on," Salma recalls.

"I could now look ahead and know what the options were although initially I hadn't a clue what Crohn's Disease meant. I thought 'what is it? Is it curable? Will I die?'"

Salma was referred to consultant general surgeon, John Griffith, and consultant gastroenterologist, Linda Juby, who suggested she have a temporary colostomy.

A colostomy is where surgeons operate on the stomach and a section of the colon is diverted and attached to an opening in the abdominal wall. A pouch is also attached to collect the body's waste products.

The procedure would enable Salma's bowel to rest while the wound from her removed abscess healed.

At a time when most teenagers are body conscious, Salma had to contend with something which would test her confidence to the limit.

"The bag was the only way round me getting better so there was no option really," she adds. "But this was probably the hardest and most challenging time.

"I was in the middle of my GCSEs and I was a teenager. The bag can be quite loud and makes gurgling noises and as examination halls are very quiet, it made me more nervous and conscious of it. I felt everyone could hear it, it was just awful.

"My school were very good though and they gave me my own room to sit in so I didn't have to worry about the noise when I was taking my GCSEs."

Salma talks openly about her initial fears of coping with the colostomy. "You immediately think of a colostomy bag and you think of the elderly. To have one so young, it felt like a bit of a stigma but having been a hospital student volunteer on one of the BRI's main elderly wards, I now feel I have something in common with the patients. I did tend to wear more smoked tops with the bag as I was very conscious that I didn't want people to know I had one, but it worked wonders and immediately took away the pain of the abscess."

Salma went on to gain 12 GCSEs, including six grade As, and is now thinking about a career in medicine. On July 9 last year, Salma's colostomy was reversed and for the first time in two years she says she is enjoying the life of a carefree teenager.

"The last year has been so good you tend to forget all the pain and the hassle of the past five years," she says.

"This is the first year since 2004 that I have felt ok and been able to lead what can only be described as a normal teenage life and it's been pretty awesome.

"When you are poorly, being sick becomes a normality and you adapt but it affects everything you do. You can't go out for long because you get tired and your colostomy bag needs changing.

"I didn't go on any holidays because the thought of a different country's weather, hygiene and foreign healthcare system scared me and I felt safer staying at home... but a whole new world has opened up to me now."

Salma knows there isn't a cure for Crohn's, but she has treatment and is learning to live with it. She says the new transition clinic for young IBD sufferers in Bradford will be invaluable."Suffering from something like Crohn's disease makes you grow up quicker," she adds. "It's made me realise more that life is not a bed of roses. But the new clinic sounds really beneficial to young people in Bradford because it will help the transition to adult healthcare run more smoothly and give young people, at a vulnerable age, time to get used to the change."

Through her experience she hopes to help fellow sufferers and is involved in the Bradford Royal Infirmary's plans to set up a teenage support group for those young people with IBD.

"I want to create more awareness about Crohn's and get it out in the open so young people can talk about it. It's not an embarrassing topic, it's more common than you think, but because people don't really talk about it it's not very well known and if we can improve awareness, we will create greater understanding and remove the stigma."

BRI consultant gastroenterologist, Dr Cathryn Preston, said: "The move from paediatric to adult clinics can be very daunting for teenagers during what can be a very important and vulnerable time in their lives.

"Young people need to know they will be supported through this transition smoothly and successfully as it is an important factor if they are to achieve their maximum potential in terms of education, health, development and well-being."

WHAT IT ALL MEANS

Ulcerative Colitis (UC) and Crohn's Disease affect about one person in every 250 in the UK.

They are both chronic (ongoing) conditions, which are not infectious.

The most common age for diagnosis is between 10 and 40 (although diagnosis can occur at any age).

Men and women suffer equally.

The main symptoms of Crohn's Disease will usually include pain, urgent diarrhoea, severe tiredness and loss of weight. Crohn's Disease is quite often associated with other inflammatory conditions affecting the joints, skin and eyes.

Ulcerative Colitis affects the colon (large intestine) or rectum and can cause a variety of distressing and sometimes embarrassing symptoms. Inflammation and ulcers develop on the inside lining of the colon resulting in pain, urgent and bloody diarrhoea, continual tiredness, weight loss and loss of appetite.

The severity of symptoms fluctuate unpredictably over time. Patients are likely to experience flare-ups in between intervals of remission or reduced symptoms.

The cause or causes have not yet been identified in either illness. Both genetic factors and environmental triggers are likely to be involved.

For more information, contact the National Association for Colitis and Crohn's Disease on 0845 130 2233 or nacc.org.uk.