P641 Impact of lockdown period due to COVID-19 pandemic in patients with Inflammatory Bowel Disease

Abstract Background The lockdown period due to the coronavirus disease 2019 (COVID-19) in Spain was established from 16th March to 21th June 2020. Therefore, the authorities controlled personal movements and private and public non-essential activities were cancelled. It has probably had an important emotional impact on chronic patients and hence in those who are suffering from Inflammatory Bowel Disease (IBD) due to their high risk of emotional disorders. The aim of this study is to know how COVID 19 influenced to the patients suffering from IBD during the quarantine period, focusing heavily on the psychological distress through the Perceived Stress Scale-10 (PSS-10), and also the impact of the pandemic on therapeutic adherence using Visual Analogue Scale (VAS). Methods This is an unicentric and analytical observational study carried out in IBD unit of a large public teaching Hospital (University Hospital “Lozano Blesa”) during August 2020. Patients were contacted and interviewed by phone by two trained researchers not involved in the patient′s medical care. Inclusion criteria were age ≥ 18 years old and confirmed diagnosis of Crohn′s Disease (CD), Ulcerative Colitis (UC) or Indeterminate Colitis. A descriptive analysis was carried out and, subsequently, the factors associated with the loss of therapeutic adherence and higher-moderate levels of stress were analyzed through Logistic regression multivariate analyses. Results Of the 426 patients included, 217 (50.9%) were women, 249 (58.4%) had UC and 177 (41.6%) had EC. During the Spanish lockdown period, most of patients did not have symptoms related to their IBD (302; 72.1%). Among those who had symptoms, the most frequent was diarrhea and abdominal pain (11.5%). Most of subjects were not diagnosed of SARS-CoV2 infection (93%), whereas 2.1% suffered confirmed infection and 4.9% had compatible symptoms without test confirmation. Regarding economic situation of patients, most of them did not have economic difficulties (87.6%). Moreover, 74.4% of participants referred a very good physician-patient relationship and 21.8% a good relationship. People who participated in the study had a median PSS-10 score of 12 (10–16). A higher level of stress was reported between those who were not married, women, and those who experimented an increase of IBD related symptoms. Adherence to treatment was not associated with stress level based on PSS-10 questionnaire. Conclusion Although the lockdown period due to COVID-19 pandemic has probably had an important emotional impact on Spanish population, IBD patients had in general lower PSS-10 scores. It could be due to a good patient-physician relationship, which contributed to maintaining a good adherence to medications in those patients.

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N19 Understanding the emotional impact of inflammatory bowel disease: looking after nurses looking after patients

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.1002 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S666-S666

Author(s):

L Younge ◽

L Medcalf ◽

A Hall ◽

C Shaw

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Psychological Impact ◽

Well Being ◽

Emotional Impact ◽

Learning Needs ◽

Emotional States ◽

Inflammatory Bowel ◽

The Uk ◽

The Impact

Abstract Background The emotional impact of inflammatory bowel disease (IBD) is well documented. Patients describe distress, anxiety, depression and relationship difficulties, (including with healthcare staff). Nurses working with IBD patients report being emotionally affected, with fears of ‘burnout’, feeling unable to respond helpfully to patients and feelings of guilt, frustration, sadness and anger. Understanding and managing the emotional impact of the work for IBD nurses is an area underrepresented in either research or nursing literature. Methods A collaborative project with IBD nurses and nursing and psychotherapy colleagues from the Tavistock and Portman NHS Foundation Trust developed a one-day event for IBD nurses in the UK. Attendees were self-selecting and the event was supported by Pharma. The conference had three aims: To provide an opportunity to recognise and understand the emotional impact on nurses working with IBD patients, to provide a networking opportunity, and to use information gathered before, during and after the conference to develop a clearer understanding of nurses’ experiences and needs. A pre-conference questionnaire was sent to attendees, observations were made during the conference (noting themes and dilemmas) and an evaluation form was provided. Results 89% agreed/strongly agreed the event provided understanding of how IBD can have an emotional and psychological impact on patients. 89% agreed/strongly agreed the event provided understanding of the emotional impact on nurses working with IBD patients. Eighty-nine per cent agreed/strongly agreed the event provided understanding of ways in which the emotional impact can influence provision of care and decision making in patients with IBD. Ninety-three per cent agreed/strongly agreed the event provided them with ideas for establishing and managing reflective learning opportunities. Seventy-five per cent agreed/strongly agreed the event enabled them to identify different ways of responding to patients they work with. Conclusion Feedback from attendees identified a need and an expressed wish by IBD nurses to understand and explore how they are affected by their work, in relation to maintaining therapeutic and safe relationships with patients and maintaining their own well-being and job satisfaction. Learning needs relating to training in supervision, developing skills in responding to patients’ emotional states, tools for looking after one’s self and opportunities for group discussions and learning were identified. There is an opportunity to develop further learning and training events in relation to these identified needs. Further exploration of accessibility, funding and evaluation would be beneficial in identifying the impact, if any, of further training.

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P764 Phenotypic analysis of patients with inflammatory bowel disease: 23 year data of a centre in a South American country

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.892 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S607-S607

Author(s):

C C Páez Cancelado ◽

R García Duperly ◽

J Park ◽

R López Panqueva ◽

E E Londoño Schimmer ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Latin America ◽

Bowel Disease ◽

University Hospital ◽

Indeterminate Colitis ◽

Second Line ◽

Phenotypic Analysis ◽

Surgical Interventions ◽

Age Of Diagnosis ◽

Inflammatory Bowel

Abstract Background Inflammatory Bowel Disease (IBD) includes Ulcerative Colitis (UC) and Crohn Disease (CD). In the last decade, there have been introduced therapeutic changes that have revolutionised the pharmacologic and surgical management of patients with IBD. The incidence of UC and CD has been increasing in Latin America but the exact prevalence is unknown. Our objective is to describe the demographic characteristics, clinical and therapeutic aspects of the IBD in patients that have presented in the University Hospital Fundación Santa Fe de Bogotá (UH-FSFB), Colombia. Methods Retrospective Descriptive Cohort Study. Clinical histories, pathology reports, and endoscopic results from data base HI-ISIS of the UH-FSFB and medical data between January 1996 and February 2019 were recollected, stored in Excel and analysed using IBM SPSS Statistics Visor. Patients with diagnosis of IBD were included. Patients with incomplete clinical histories were excluded. Results From 398 patients included in this study, 72.1% had UC, 25.6% CD and 2.3% Indeterminate Colitis. The average age of diagnosis was 43.54 years (range: 12–91). In both patients with UC and CD there were smaller proportions of men than women (0.9:1 for UC and 0.7:1 for CD). Of the patients with UC, 46.3% had been hospitalised. 37.2% presented with proctitis, 23.8% left colitis and 39% with pancolitis. 13.5% had an asymptomatic clinical disease, 22.4% mild, 15.3% moderate, and 48.8% severe. 12.9% received biological therapy (BT). 24.3% of patients received a second line BT. Fifteen per cent required surgical interventions (SI), of which there were no mortalities. 27% who were receiving BT required SI. Of the patients with CD, 82.4% required hospitalisation. 43.1% had an ileal, 9.8% colonic, 39.2% ileal- colonic, 0% isolated upper digestive and 21.6% perianal compromise. 34.3% had non-stenosing behaviour, 49% stenosing and 16.7% penetrating. 44.1% of patients with CD received BT of which 40% required a second line BT. 55.9% required SI, of which 1 mortality was reported. 71.1% who were receiving BT required a SI. Conclusion Our study contributes to the epidemiology and integral management required by patients with IBD in our environment. More studies are recommended that replicate our methodology in the population with IBD in both Colombia and Latin America.

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The impact of inflammatory bowel disease on hard teeth tissues – preliminary results from POLIBD study

10.26226/morressier.59a6b34bd462b80290b5599d ◽

2017 ◽

Author(s):

Rafa Filip

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Preliminary Results ◽

Inflammatory Bowel ◽

The Impact

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Faculty Opinions recommendation of Value of wireless capsule endoscopy in patients with indeterminate colitis (inflammatory bowel disease type unclassified).

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1060732.512650 ◽

2007 ◽

Author(s):

Karel Geboes

Keyword(s):

Inflammatory Bowel Disease ◽

Capsule Endoscopy ◽

Bowel Disease ◽

Wireless Capsule Endoscopy ◽

Disease Type ◽

Indeterminate Colitis ◽

Inflammatory Bowel ◽

Wireless Capsule

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Exploitation of Marine-Derived Robust Biological Molecules to Manage Inflammatory Bowel Disease

Marine Drugs ◽

10.3390/md19040196 ◽

2021 ◽

Vol 19 (4) ◽

pp. 196

Author(s):

Muhammad Bilal ◽

Leonardo Vieira Nunes ◽

Marco Thúlio Saviatto Duarte ◽

Luiz Fernando Romanholo Ferreira ◽

Renato Nery Soriano ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bioactive Compounds ◽

Bowel Disease ◽

Clinical Translation ◽

Biologically Active ◽

Naturally Occurring ◽

Inflammatory Bowel ◽

Functional Features ◽

Biological Entities ◽

The Impact

Naturally occurring biological entities with extractable and tunable structural and functional characteristics, along with therapeutic attributes, are of supreme interest for strengthening the twenty-first-century biomedical settings. Irrespective of ongoing technological and clinical advancement, traditional medicinal practices to address and manage inflammatory bowel disease (IBD) are inefficient and the effect of the administered therapeutic cues is limited. The reasonable immune response or invasion should also be circumvented for successful clinical translation of engineered cues as highly efficient and robust bioactive entities. In this context, research is underway worldwide, and researchers have redirected or regained their interests in valorizing the naturally occurring biological entities/resources, for example, algal biome so-called “treasure of untouched or underexploited sources”. Algal biome from the marine environment is an immense source of excellence that has also been demonstrated as a source of bioactive compounds with unique chemical, structural, and functional features. Moreover, the molecular modeling and synthesis of new drugs based on marine-derived therapeutic and biological cues can show greater efficacy and specificity for the therapeutics. Herein, an effort has been made to cover the existing literature gap on the exploitation of naturally occurring biological entities/resources to address and efficiently manage IBD. Following a brief background study, a focus was given to design characteristics, performance evaluation of engineered cues, and point-of-care IBD therapeutics of diverse bioactive compounds from the algal biome. Noteworthy potentialities of marine-derived biologically active compounds have also been spotlighted to underlying the impact role of bio-active elements with the related pathways. The current review is also focused on the applied standpoint and clinical translation of marine-derived bioactive compounds. Furthermore, a detailed overview of clinical applications and future perspectives are also given in this review.

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Impact of COVID-19 on the diagnosis, assessment and management of children with inflammatory bowel disease in the UK: implications for practice

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000786 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000786

Author(s):

Abbie Maclean ◽

James J Ashton ◽

Vikki Garrick ◽

R Mark Beattie ◽

Richard Hansen

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Delayed Diagnosis ◽

High Standard ◽

Current Evidence ◽

Faecal Calprotectin ◽

Paediatric Patients ◽

Inflammatory Bowel ◽

Working Practices ◽

The Impact

The assessment and management of patients with known, or suspected, paediatric inflammatory bowel disease (PIBD) has been hugely impacted by the COVID-19 pandemic. Although current evidence of the impact of COVID-19 infection in children with PIBD has provided a degree of reassurance, there continues to be the potential for significant secondary harm caused by the changes to normal working practices and reorganisation of services.Disruption to the normal running of diagnostic and assessment procedures, such as endoscopy, has resulted in the potential for secondary harm to patients including delayed diagnosis and delay in treatment. Difficult management decisions have been made in order to minimise COVID-19 risk for this patient group while avoiding harm. Initiating and continuing immunosuppressive and biological therapies in the absence of normal surveillance and diagnostic procedures have posed many challenges.Despite this, changes to working practices, including virtual clinic appointments, home faecal calprotectin testing kits and continued intensive support from clinical nurse specialists and other members of the multidisciplinary team, have resulted in patients still receiving a high standard of care, with those who require face-to-face intervention being highlighted.These changes have the potential to revolutionise the way in which patients receive routine care in the future, with the inclusion of telemedicine increasingly attractive for stable patients. There is also the need to use lessons learnt from this pandemic to plan for a possible second wave, or future pandemics as well as implementing some permanent changes to normal working practices.In this review, we describe the diagnosis, management and direct impact of COVID-19 in paediatric patients with IBD. We summarise the guidance and describe the implemented changes, evolving evidence and the implications of this virus on paediatric patients with IBD and working practices.

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PATIENTS’ JOURNEY THROUGH INFLAMMATORY BOWEL DISEASE (IBD): A QUALITATIVE STUDY

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa347.127 ◽

2021 ◽

Vol 27 (Supplement_1) ◽

pp. S53-S54

Author(s):

Tina Aswani Omprakash ◽

Norelle Reilly ◽

Jan Bhagwakar ◽

Jeanette Carrell ◽

Kristina Woodburn ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Qualitative Study ◽

Patient Experience ◽

Bowel Disease ◽

Quality Care ◽

Diagnostic Testing ◽

Healthcare Providers ◽

Indeterminate Colitis ◽

Patient Journey ◽

Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) is a debilitating intestinal condition, manifesting as Crohn’s disease (CD), ulcerative colitis (UC) or indeterminate colitis (IC). The patient experience is impacted by a lack of awareness from other stakeholders despite growing global disease prevalence. To gain deeper insight of the patient experience, promote quality care, and enhance quality of life, we performed a qualitative study of the patient journey starting from pre-diagnosis through treatment. Methods U.S. patients with IBD were recruited via UC/CD support groups and organizations, social media platforms, blog followers, and personal networks. Participants were screened via an emailed survey and asked to self-identify as medically diagnosed on the basis of reported diagnostic testing. Interviews were conducted by qualitative researchers by phone or web conferencing. Open-ended questions were developed to support and gather information about our learning objectives—primarily, our desire to understand the unique experiences of UC/CD patients in their journey from symptom onset through diagnosis, treatment and maintenance (e.g. “Upon diagnosis, what were your immediate thoughts about the condition?”). This qualitative data were analyzed using Human-Centered Design methodology, including patient typologies (personas), forced temporal zoom (journey maps), forced semantic zoom (stakeholder system mapping), and affinity mapping for pattern recognition of unmet needs. Results A total of 32 patients were interviewed: N=17 CD patients, N=13 UC patients and N=2 IC patients. The interviewed population reflected regional, demographic, and disease-related diversity (Table 1). Five unique, mutually exclusive journeys were identified to understand and classify patient experiences: (1) Journey of Independence, (2) Journey of Acceptance, (3) Journey of Recognition, (4) Journey of Passion and (5) Journey of Determination (Figure 1). Patients with IBD expressed a need for increased awareness, education, and training for providers to shorten the path to diagnosis. Mental health support was found to be a critical gap in care, particularly for major treatment decisions (e.g., surgery). The inclusion of emotional support into the treatment paradigm was perceived as essential to long-term wellness. Patient attitudes and self-advocacy varied on their individual journeys; understanding these journeys may accelerate time to diagnosis and treatment. Conclusion Better understanding of patient journeys can help healthcare providers improve their approach to patient care and coordination.

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