GET THE GUTSY TRUTH ABOUT INFLAMMATORY BOWEL DISEASE EXPECT MORE

GET THE GUTSY TRUTH ABOUT
INFLAMMATORY BOWEL DISEASE
EXPECT MORE FROM YOUR TREATMENT
Patient Education Forums - KOL Presentation
Crohn’s and Colitis Foundation of Canada
What We Will Discuss Today
•
Understanding Inflammatory Bowel
Disease (IBD) – includes Crohn’s disease (CD) and
ulcerative colitis (UC)
•
Why is it important to effectively manage your
inflammatory bowel disease?
•
Treatment options for inflammatory bowel
disease
Crohn’s and Colitis Foundation of Canada
UNDERSTANDING INFLAMMATORY BOWEL
DISEASE
Crohn’s and Colitis Foundation of Canada
What is Crohn’s Disease?
• An inflammatory disorder of the entire gastro-intestinal (GI)
tract
• The GI tract is your entire digestive system from "gums to
bum"
• The inner lining of the bowel (mucosa) becomes red and
swells up, causing tiny open sores (ulcerations)
• Most commonly, Crohn's disease occurs in the last portion of
the small intestine (ileum) and in the large intestine, but it
can occur in any part of the digestive tract
Crohn’s and Colitis Foundation of Canada
What is Ulcerative Colitis?
• Ulcerative colitis (UC) causes inflammation of the large intestine, or lower
bowel, which is made up of the colon and rectum
• The inner lining of the bowel (mucosa) becomes red and swells up, causing tiny
open sores (ulcers)
• UC may be limited to the lowest part of the gastrointestinal tract, called the
rectum (proctitis), it may extend further into the left part of the colon only
(left-sided colitis), or it may affect the whole colon (pancolitis)
Crohn’s and Colitis Foundation of Canada
Inflammatory Bowel Disease in Canada
• IBD is more common in some countries than in others
• Canada has one of the highest incidence rates of inflammatory bowel
disease (CD and ulcerative colitis) in the world
• IBD can affect both men and women at any age, but most people are
diagnosed by the age of 30
Approximately 233,000 Canadians are living with IBD
Crohn’s and Colitis Foundation of Canada
Causes of Inflammatory Bowel Disease
• The causes of IBD are unknown, but research suggests that various factors
may be involved
• Research into the causes has also led to the development of increasingly
effective treatments that help to control the disease
Heredity
Immune
System
Crohn’s and Colitis Foundation of Canada
Geography
Signs and Symptoms
• Symptoms may be different from person to person, and can include…
• Rectal urgency and frequent diarrhea
• Abdominal pain and cramps
• Blood and mucus in the stool
• Inflammation
• Increased intestinal gas
• Persistent fatigue
• Weight loss
• Fever
• Fistulas and abscesses
• Failure to grow (in children)
Crohn’s and Colitis Foundation of Canada
Understanding Your Symptoms
• Understand your symptoms to effectively manage your
disease
• Note the development of your symptoms from
day-to-day and week-to-week
• Are your symptoms better or worse? More or
less frequent? Any new symptoms?
• Track disruptions to your daily life due to your
condition, like missing work, school or social
activities
• Note any changes in the way you feel to track
the impact of symptoms on confidence,
relationships and quality of life
Crohn’s and Colitis Foundation of Canada
WHY IS IT IMPORTANT TO EFFECTIVELY
MANAGE YOUR INFLAMMATORY BOWEL
DISEASE?
Crohn’s and Colitis Foundation of Canada
Why is Treating IBD Important?
• Following medical treatment and going for regular
checkups can greatly reduce the effect the disease
has on your life
• Medications can make it possible to keep the
symptoms of your disease under control, because a
cure for IBD hasn’t been found yet
• Treatments may even begin to heal the inner lining
of your bowel, often allowing for long periods of
remission and well-being
The important thing is to never drop your guard!
Crohn’s and Colitis Foundation of Canada
How Do You Know if Your Symptoms are
Under Control?
• You may not experience IBD symptoms
for many months at a time
• When you do have a flare-up, it may not
always be the same–sometimes it could
be mild, at other times very intense
• Try using a journal to keep track of
flare-ups, your symptoms and their
impact on your daily life
• Discuss your symptom log with your
doctor to accurately track the progress
of your IBD
Crohn’s and Colitis Foundation of Canada
The Impact of Crohn’s Disease on Your
Emotional Well-Being
• In addition to the physical symptoms of IBD, the disease can have a huge
impact on your emotional well-being, causing feelings of isolation or lack of
self-esteem
• Don’t keep your IBD to yourself! Talking to family and friends, seeking
professional help or meeting other patients can help you address the
emotional impact of the disease
• Avoid stress triggers. Psychological factors can strongly impact different
chemicals and immune cells that promote intestinal inflammation. Chronic
stress may lead to a worsening of bowel symptoms over the long term
Did You Know? The psychological involvement in CD is so great that until the
mid-twentieth century, CD was considered a psychosomatic illness
Crohn’s and Colitis Foundation of Canada
Adapting Your Lifestyle
 Healthy eating is important
• Although there is no “CD diet”, certain foods might aggravate symptoms, which might
differ for everyone
• Positive changes in your diet might alleviate your symptoms and improve your overall
health, emotional well-being and your relationship with food
• Before making any diet modifications, be sure to speak to your doctor or a dietitian
 Nutritional supplements are helpful for people who lose calories and nutrients from
diarrhea or decreased appetite
• Supplements can help replenish iron, calcium, other minerals and vitamins
 Exercise can help manage stress
• Regular, moderate exercise helps ease tension, improves sleep and self-esteem
Crohn’s and Colitis Foundation of Canada
TREATMENT OPTIONS FOR
CROHN’S DISEASE
Always talk to your doctor to understand the risks and
treatment
*Always talk to benefits
your doctoroftoany
understand
the
risks and benefits of any treatment
Crohn’s and Colitis Foundation of Canada
Expecting More From Your Treatment
Three main overall goals of treating CD:
1. Achieve and maintain control of symptoms, also called remission (i.e., to rid the patient of
symptoms and help keep it that way)
2. Reduce mucosal inflammation (i.e., the level of inflammation in the intestine)
3. Improve quality of life
•
Short-Term Goals: The short-term treatment goals for ulcerative colitis are to keep people
feeling well without dependency on corticosteroids
•
Long-Term Goals: It’s important to consider the long-term goals of therapy and identify the
best treatment options at an early stage. Some available treatments help to heal the inner
lining of the bowel, which may help avoid hospital visits and reduce the need for surgeries.
Crohn’s and Colitis Foundation of Canada
Expecting More From Your Treatment, Cont’d
Other Benefits of Treatment:
• Controlling Flare-Ups: Once the disease is under control (in remission), treatment
(sometimes called maintenance therapy) can reduce the risk of new flare-ups
• Doctors call it maintenance therapy for a reason! Continuing to take medication—
even when you feel well—can help keep your symptoms at bay
Remember: Whatever your treatment, it’s important to take it as
prescribed by your doctor and keep visiting him or her for checkups
so that your progress can be monitored
Crohn’s and Colitis Foundation of Canada
What is Mucosal Healing?
• Some treatments may help begin to
heal the damage caused to the inner
lining of the bowel
• Mucosal healing can offer patients
long periods of remission and wellbeing, and can limit the number of
flare-ups, complications and
potentially decrease future surgery
requirements
Mucosal Healing
=
Healing the
Lining of the
Bowel
Crohn’s and Colitis Foundation of Canada
Anti-Inflammatory Medication
• Best-known treatment option
• People living with IBD receive one
or more different types of antiinflammatory medication
designed to control or reduce
inflammation
• These medications are generally
used to treat mild-to-moderate
IBD symptoms
Crohn’s and Colitis Foundation of Canada
Corticosteroids
• Often referred to simply as ‘steroids’,
this treatment comes in various forms
• Steroids work by suppressing the
immune system and are used to treat
moderately to severely active IBD
• Steroids are effective in reducing
swelling, but are not meant for longterm treatment
Crohn’s and Colitis Foundation of Canada
Immunosuppressants
• Also known as ‘immune modifiers’,
they block the body's immune
response that causes inflammation
• Your specialist may use
immunosuppressants to treat
moderate-to-severe symptoms
• Immunosuppressants may help
decrease steroid use
Crohn’s and Colitis Foundation of Canada
Biologics
• A form of treatment that uses portions of
the body's natural immune system to treat
moderate-to-severe cases of the disease
• One mode of biologic therapy involves
blocking the action of specific proteins of
inflammation, called tumour necrosis factor
(TNF) alpha
• Biologic drugs bind to and neutralize TNF
alpha, thereby helping to turn off this
portion of the overactive immune system
and control inflammation
Crohn’s and Colitis Foundation of Canada
Surgery
• For patients with strictures or fistulas,
surgery may be appropriate
• For patients with ongoing active
disease that fails to respond to
therapy, surgery may be necessary
• There are varying types of surgery
depending on the severity of the
disease and the patient's lifestyle
Crohn’s and Colitis Foundation of Canada
Some Questions to Ask Your Doctor
•
•
•
•
•
•
•
How will IBD affect my life?
How might my IBD change over time?
What treatments are currently available?
How does my medication work and how will it help me?
Are there any foods or activities that I should avoid?
Should I consult other specialists, for example, a dietitian?
What are the signs to look out for that might suggest my
illness is getting worse?
• What credible sources do you recommend so that I can learn
about my IBD?
• Should I continue to take my medications even if my disease
is not active?
Crohn’s and Colitis Foundation of Canada
Resources
Crohn’s and Colitis Foundation of Canada (CCFC):
• Visit www.CCFC.ca
Crohn’s and Colitis Foundation of Canada
QUESTIONS?
Crohn’s and Colitis Foundation of Canada