scholarly journals P601 Are Inflammatory Bowel Disease patients’ expectations met by dietetic services?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S547-S547
Author(s):  
N McCarthy ◽  
M Schultz ◽  
C Wall
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Nutrition Information ◽  
Electronic Survey ◽  
Low Residue Diet ◽  
Specialist Knowledge ◽  
Inflammatory Bowel ◽  
Almost All ◽  
Qualitative Responses ◽  
Specific Diet

Abstract Background Guidelines recommend that Inflammatory Bowel Disease (IBD) patients should have access to specialised dietitian support. Literature suggests that patients are often dissatisfied with their access to reliable nutrition information and dietitian services. Our aim was to assess whether New Zealand (NZ) dietetic services were meeting the expectations of patients. Methods In early 2020 an electronic survey to explore experience of dietetic services was disseminated to approximately 2000 patients (and parents) by Crohn’s and Colitis NZ and IBD health professionals. Quantitative responses were analysed via non-parametric methods and qualitative responses were analysed via inductive analysis. Results Responses were received from 407 IBD patients. Participants were asked if it ‘is useful for patients diagnosed with IBD to have access to a dietitian for nutrition advice?’ with 86% responding ‘Yes’ and 12% ‘Maybe’. Almost all (95%) patients had nutrition topics that they would like to discuss with a dietitian but only 52% had seen a dietitian and 45% had never been referred. Patients were interested in various nutrition topics (Table 1). Most (65%) would like access to a dietitian whenever a new nutrition issue arises. The most frequent nutrition advice received was to follow a specific diet, most commonly a low fermentable carbohydrate diet followed by a low residue diet, or general nutrition advice. Two-thirds (66%) of respondents found the dietitian advice at least moderately useful while 18% reported it was not at all useful. Patients who saw a dietitian in a private clinic were more likely to find the advice useful (p=0.0001), as were those who had received written advice (p<0.0001). Common themes in response to open-ended questions included: frustration at difficulty accessing dietetic services; desire for routine dietitian referral at diagnosis and ongoing access; the need for dietitians to have specialist knowledge of IBD; a perception that some medical staff believe nutrition is not relevant in IBD management. Conclusion Many patients have never been referred to a dietitian and a proportion of patients did not find dietitian advice useful. Dietitian advice appears to be on the topics most commonly of interest to patients. Access to dietetic services needs to improve and exploration is needed to elucidate why some aspects of services are not meeting patient expectations.

scholarly journals Depression, anxiety and stress among patients with inflammatory bowel disease during the COVID-19 pandemic: Australian national survey

2021 ◽  
Vol 8 (1) ◽  
pp. e000581
Author(s):  
Madiha Cheema ◽  
Nikola Mitrev ◽  
Leanne Hall ◽  
Maria Tiongson ◽  
Golo Ahlenstiel ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Severe Depression ◽  
Chronic Illnesses ◽  
Electronic Survey ◽  
Validated Questionnaire ◽  
Younger Age ◽  
Modifiable Factors ◽  
High Prevalence ◽  
Inflammatory Bowel

BackgroundThe global COVID-19 pandemic has impacted on the mental health of individuals, particularly those with chronic illnesses. We aimed to quantify stress, anxiety and depression among individuals with Inflammatory bowel disease (IBD) in Australia during the pandemic.MethodsAn electronic survey was made available to IBD patients Australia-wide from 17 June to 12 July 2020. Respondents with an underlying diagnosis of IBD and over 18 years of age were included. A validated questionnaire (Depression, Anxiety, Stress Score-21, DASS21) was used to assess depression, anxiety and stress. Data on potential predictors of depression, anxiety and stress were collected.Results352 participated in the survey across Australia. 60.5% of respondents fulfilled DASS criteria for at least moderate depression, anxiety or stress. 45% reported a pre-existing diagnosis of depression and/or anxiety. Over 2/3 of these respondents reported worsening of their pre-existing depression/anxiety due to the current pandemic. Of those without a pre-existing diagnosis of anxiety or depression, high rates of at least moderate to severe depression (34.9%), anxiety (32.0%) and stress (29.7%) were noted. Younger age (OR 0.96, 95% CI 0.94 to 0.98, p<0.001), lack of access to an IBD nurse (OR 1.81, 95% CI 1.03 to 3.19, p=0.04) and lack of education on reducing infection risk (OR 1.99, 95% CI 1.13 to 3.50, p=0.017) were associated with significant stress, anxiety and/or depression.ConclusionHigh prevalence of undiagnosed depression, anxiety and stress was identified among respondents. Improved access to IBD nurse support and greater attention to education are modifiable factors that may reduce depression, anxiety and/or stress among patients with IBD during the pandemic.

Endoscopic Resections in Inflammatory Bowel Disease: A Multicentre European Outcomes Study

2019 ◽  
Vol 13 (11) ◽  
pp. 1394-1400
Author(s):  
A Alkandari ◽  
S Thayalasekaran ◽  
M Bhandari ◽  
A Przybysz ◽  
M Bugajski ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Endoscopic Resection ◽  
Bowel Disease ◽  
En Bloc ◽  
Increased Risk ◽  
Delayed Perforation ◽  
Inflammatory Bowel ◽  
Outcomes Study ◽  
Almost All ◽  
Current Guidelines

Abstract Background and Aims Inflammatory bowel disease is associated with an increased risk of colorectal cancer, with estimates ranging 2–18%, depending on the duration of colitis. The management of neoplasia in colitis remains controversial. Current guidelines recommend endoscopic resection if the lesion is clearly visible with distinct margins. Colectomy is recommended if complete endoscopic resection is not guaranteed. We aimed to assess the outcomes of all neoplastic endoscopic resections in inflammatory bowel disease. Methods This was a multicentre retrospective cohort study of 119 lesions of visible dysplasia in 93 patients, resected endoscopically in inflammatory bowel disease. Results A total of 6/65 [9.2%] lesions <20 mm in size were treated by ESD [endoscopic submucosal dissection] compared with 59/65 [90.8%] lesions <20 mm treated by EMR [endoscopic mucosal resection]; 16/51 [31.4%] lesions >20 mm in size were treated by EMR vs 35/51 [68.6%] by ESD. Almost all patients [97%] without fibrosis were treated by EMR, and patients with fibrosis were treated by ESD [87%], p < 0.001. In all, 49/78 [63%] lesions treated by EMR were resected en-bloc and 27/41 [65.9%] of the ESD/KAR [knife-assisted resection] cases were resected en-bloc, compared with 15/41 [36.6%] resected piecemeal. Seven recurrences occurred in the cohort. Seven complications occurred in the cohort; six were managed endoscopically and one patient with a delayed perforation underwent surgery. Conclusions Larger lesions with fibrosis are best treated by ESD, whereas smaller lesions without fibrosis are best managed by EMR. Both EMR and ESD are feasible in the management of endoscopic resections in colitis.

P792 Breastfeeding in our patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
M Charro Calvillo ◽  
M Charro-Calvillo ◽  
E Peña-Gonzalez ◽  
Y Ber-Nieto ◽  
M T Botella Esteban ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Outbreaks ◽  
World Health Organisation ◽  
Public Hospitals ◽  
World Health ◽  
Great Opportunity ◽  
Inflammatory Bowel ◽  
Almost All ◽  
To Receive

Abstract Background Breastfeeding is one of the most important environmental factors in early childhood for later development of an Inflammatory Bowel Disease. The duration of lactation is essential for it to have a protective effect. In addition to IBD patients, breastfeeding can have a beneficial effect for preventing disease relapse. For these reasons, we plan to know how lactation develops in our group of patients with Inflammatory Bowel Disease (IBD). Methods A retrospective analysis of patients followed by gastroenterology consultations, with established diagnosis of IBD and with at least one gestation, in a period from January 2011 to January 2016. The data were collected a posteriori through two simple questionnaires, one completed by the patient, collecting the type of childbirth and breastfeeding she experienced and factors that influenced it. Another form is filled out by the gastroenterologist recording the characteristics of his inflammatory bowel disease. The data is collected in a structured database in Microsoft Excel and analysed with the SPSS statistic package for Windows. Results Data from 78 patients diagnosed with IBD are analysed from eight public hospitals in our autonomous community. 61.1% of patients have ulcerative colitis and 38.9% Crohn’s disease. The deliveries were mainly vaginal (82%), compared with 18% of caesarean-sections, four of them directly motivated by digestive disease. More than half of patients (57.7%) started breastfeeding after childbirth, 10.25% breastfeeding and 32.05% mixed breastfeeding But only 34.6% reach six months of breastfeeding, reaching 39.7% if we include mixed breastfeeding. In 17 patients (21.8%) their base-based inflammatory bowel disease directly influenced the development of lactation. Pharmacological treatment is the main cause for breastfeeding, followed by disease outbreaks, hospitalisations and surgery. Only 47.4% of the patients stated that in the IBD consultation they were given some information about breastfeeding, although almost all replied that they would have liked to receive it. Conclusion The majority of patients with inflammatory bowel disease in our consultations, do not reach six months of breastfeeding currently recommended by the World Health Organisation, so we have a great opportunity for improvement in this field and as gastroenterologists, we can contribute by providing more information to our patients about breastfeeding and its relationship with IBD.

scholarly journals NUDT15 gene variants and thiopurine-induced leukopenia in patients with inflammatory bowel disease

2020 ◽  
Vol 18 (3) ◽  
pp. 275-281
Author(s):  
Katsuyoshi Matsuoka
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Antibody Therapy ◽  
Guanosine Monophosphate ◽  
Nudix Hydrolase ◽  
Risk Alleles ◽  
Antidrug Antibody ◽  
Inflammatory Bowel ◽  
The Stability ◽  
Almost All

Thiopurine has been used to maintain remission and to reduce antidrug antibody formation in monoclonal antibody therapy in patients with inflammatory bowel disease (IBD). The use of thiopurine is limited by side effects such as leukopenia. Thiopurine S-methyltransferase (<i>TPMT</i>) variants are associated with thiopurine-induced leukopenia in Westerners, but the frequency of the risk alleles is low in Asians. Recently, a variant in the nudix hydrolase 15 (<i>NUDT15</i>) gene (R139C, c.415C > T) was reported to be associated with early severe leukopenia in Asians. NUDT15 is an enzyme that converts 6-thio-(deoxy)guanosine triphosphate (6-T(d)GTP) to 6-thio-(deoxy)guanosine monophosphate (6-T(d)GMTP). The R139C variant impairs the stability of the protein and increases incorporation of 6-TGTP and 6-TdGTP into RNA and DNA, respectively, resulting in leukopenia. The frequency of C/C, C/T, and T/T are approximately 80%, 20%, and 1%, respectively in East Asians. Early leukopenia occurred in less than 3% of patients with C/C and in around 20% of those with C/T, whereas it occurred in almost all patients with T/T. Patients homozygous for this variant also develop severe hair loss. The measurement of <i>NUDT15</i> R139C can increase the safety of thiopurine dramatically and is a successful example of personalized medicine in the field of IBD.

scholarly journals Interstitial and Granulomatous Lung Disease in Inflammatory Bowel Disease Patients

2019 ◽  
Vol 14 (4) ◽  
pp. 480-489 ◽  
Author(s):  
Elena Eliadou ◽  
Joana Moleiro ◽  
Davide Giuseppe Ribaldone ◽  
Marco Astegiano ◽  
Katja Rothfuss ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Lung Disease ◽  
Bowel Disease ◽  
European Respiratory Society ◽  
Drug Induced ◽  
Systemic Steroids ◽  
Causative Drug ◽  
Granulomatous Lung Disease ◽  
Inflammatory Bowel ◽  
Almost All

Abstract Background Interstitial lung [ILD] disease and granulomatous lung disease [GLD] are rare respiratory disorders that have been associated with inflammatory bowel disease [IBD]. Clinical presentation is polymorphic and aetiology is unclear. Methods This was an ECCO-CONFER project. Cases of concomitant ILD or GLD and IBD, or drug-induced ILD/GLD, were collected. The criteria for diagnosing ILD and GLD were based on definitions from the American Thoracic Society and the European Respiratory Society and on the discretion of reporting clinician. Results We identified 31 patients with ILD. The majority had ulcerative colitis [UC] [n = 22]. Drug-related ILD was found in 64% of these patients, 25 patients [80.6%] required hospitalisation, and one required non-invasive ventilation. The causative drug was stopped in all drug-related ILD, and 87% of patients received systemic steroids. At follow-up, 16% of patients had no respiratory symptoms, 16% had partial improvement, 55% had ongoing symptoms, and there were no data in 13%. One patient was referred for lung transplantation, and one death from lung fibrosis was reported. We also identified 22 GLD patients: most had Crohn’s disease [CD] [n = 17]. Drug-related GLD was found in 36% of patients and 10 patients [45.4%] required hospitalisation. The causative drug was stopped in all drug-related GLD, and 81% of patients received systemic steroids. Remission of both conditions was achieved in almost all patients. Conclusions ILD and GLD, although rare, can cause significant morbidity. In our series, over half of cases were drug-related and therefore focused pharmacovigilance is needed to identify and manage these cases.

scholarly journals Sucrosomial Iron Supplementation for the Treatment of Iron Deficiency Anemia in Inflammatory Bowel Disease Patients Refractory to Oral Iron Treatment

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1770
Author(s):  
Guillermo Bastida ◽  
Claudia Herrera-de Guise ◽  
Alicia Algaba ◽  
Yolanda Ber Nieto ◽  
Jose Manuel Soares ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Bowel Disease ◽  
Clinical Symptoms ◽  
Good Health ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Inflammatory Bowel ◽  
Almost All

Iron deficiency anemia (IDA) is a common manifestation of Inflammatory Bowel Disease (IBD). Oral iron supplements are the treatment of choice, but are not always well tolerated. Sucrosomial® iron (SI) may represent an alternative. This prospective study assessed the tolerability and effectiveness of SI, and quality of life (QoL) of IDA-IBD patients who were intolerant to oral iron salts. The study included 52 individuals treated with 1 capsule/day for 12 weeks. Tolerability was assessed through a gastrointestinal symptom severity questionnaire. Hemoglobin (Hb) levels and clinical symptoms of IDA were analyzed. QoL was assessed using IBDQ-9 and EuroQoL questionnaires. The percentage of patients with excellent/good health increased from 42.9% to 94.3%. Mean Hb concentration significantly increased at all follow-up visits (p < 0.05). Almost all participants (96.9%) were adherent to the study medication. Patients’ QoL improved (IBDQ-9: from 60.9 to 65.5). Patients also improved in mobility (71.8% to 78.1%), usual activities (51.3% to 68.7%), pain/discomfort (41.0% to 53.1%), and extreme depression/anxiety problems (7.7% to 3.2%); they worsened in self-care (100% to 90.6%), but perceived an enhancement in their global health [EQ-VAS score: 61.9 (±26.1) to 66.9 (±20.3)]. SI was well tolerated and improved IDA symptoms, IBD activity, and patients’ QoL. In conclusion, SI should be considered in IDA–IBD patients.

scholarly journals P575 Nutrition and Inflammatory Bowel Disease – a nationwide survey of patients, gastroenterologists and dietitians

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S532-S533
Author(s):  
N McCarthy ◽  
M Schultz ◽  
C Wall
Keyword(s):  
Inflammatory Bowel Disease ◽  
High Risk ◽  
Bowel Disease ◽  
Nationwide Survey ◽  
High Risk Group ◽  
Healthcare Team ◽  
Ketogenic Diets ◽  
Protein Energy ◽  
Inflammatory Bowel ◽  
Almost All

Abstract Background Literature indicates that Inflammatory Bowel Disease (IBD) patients (pts), who are at high risk of malnutrition, often adjust their diet following diagnosis and wish to receive specialised nutrition advice from their healthcare team. Dietitians (DTs) are health professionals (HPs) with specialist nutrition expertise. Our aim was to assess nutrition advice provided by different HPs. Methods Electronic surveys were disseminated to New Zealand IBD pts, DTs and gastroenterologists (GIs) asking about experience of, and practice providing, IBD nutrition advice. DTs and GIs were asked which nutrition interventions they recommend. DTs responded separately for Crohn’s disease (CD) and Ulcerative Colitis (UC) while GIs responded about IBD pts as a group. Results Surveys were completed by 407 pts, 79 DTs and 40 GIs. Almost all (97%) GIs report their IBD pts ask about nutrition and 95% said they provide nutrition advice. DTs and GIs commonly recommended specific diets: modified fibre, high protein/energy and low fermentable carbohydrate diets, with occasional use of some other diet regimes (Table 1). Half of the pts (52%) had seen a DT for advice and 31% had received nutrition advice from other HPs, commonly their GI, general practitioner or IBD nurse. Some patients (13%) received nutrition advice from other practitioners: nutritionist, naturopath, other medical doctors, counsellor, cannabis practitioner, integrated health professional, osteopath and herbalist. Patients frequently received general nutrition advice and specific diet advice including various strict exclusion diets and herbal, probiotic and vitamin/mineral supplements from DTs and non-DT HPs (Table 1). No DTs or GIs recommended low carb, high fat, sugar free or ketogenic diets in IBD, which were recommended to pts by other HPs. Conclusion Pts with IBD often ask for nutrition advice but only half had seen a DT. The advice given by HPs (medical and non-medical) varies and it appears that this high-risk group of pts is not always offered advice with evidence of scientific benefit in pts with IBD. Pts would benefit from greater access to DTs with IBD expertise.

Sign in / Sign up

Export Citation Format

Share Document