A179 GUT-DIRECTED SELF-HYPNOSIS FOR INFLAMMATORY BOWEL DISEASE PROTOCOL: COMPLIMENTARY PSYCHOTHERAPY FOR REMISSION AUGMENTATION, IBS-LIKE SYMPTOMS, AND SURGERY RECOVERY.

Abstract Background Gut-directed hypnosis (GDH) is a complimentary therapy for Inflammatory Bowel Disease (IBD), that can be learnt by patients to practice self-hypnosis. GDH in IBD has augmented remission and improved inflammation. GDH has a history of successful use for Irritable Bowel Syndrome (IBS). In IBD it may also improve IBS-like symptoms in remission and recovery from surgery. GDH is suitable for youth and adult IBD patients. In hypnosis, a relaxed state is inducted then suggestions to subconscious mind processes are made. In IBD, the mechanism of action of GDH is unknown but may influence the disease stress response. Aims Aims are the development of a GDH self-hypnosis protocol for IBD, with appropriate target symptoms. Patients first learn to practice with a clinician, then as complimentary psychotherapy for remission augmentation, IBS-like symptoms, and surgery recovery. Methods GDH is practiced first with a clinician, and then by patients as self-hypnosis (table 1). Patients receive psycho-education on GDH for IBD. Next, appropriate treatment goals are made, based on target symptoms. Relaxation techniques induce patient to a deeply relaxed state. Therapeutic suggestions specific to patient goals are given: verbal suggestions, visualizations, and post-hypnotic suggestions. Suggestions can focus on having a healthy digestive system, inflammation and symptoms reduction, and achievement and sustainment of remission. Patients emerge from hypnosis, are debriefed, and encouraged to practice ongoing self-hypnosis. Results In IBD, GDH self-hypnosis can be learnt from clinicians and practiced by patients as a complimentary therapy. Patients’ achievement and sustainment of remission, with clinical markers of inflammation can be monitored. Patients can monitor subjective improvement of IBS-like symptoms and post surgery, recovery progress can be monitored. Conclusions GDH has a history of use for IBS. In IBD, it has been shown to modulate remission, and may improve IBS-like symptoms, and in surgery recovery. The mechanism of action of GDH in IBD may influence the disease stress response. Clinicians trained in GDH are limited currently. Patients may learn GDH self-hypnosis as a complimentary psychotherapy. Funding Agencies None

Download Full-text

GUT-DIRECTED SELF-HYPNOSIS FOR INFLAMMATORY BOWEL DISEASE PROTOCOL: COMPLIMENTARY PSYCHOTHERAPY FOR REMISSION AUGMENTATION, IBS-LIKE SYMPTOMS, AND SURGERY RECOVERY

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa347.126 ◽

2021 ◽

Vol 27 (Supplement_1) ◽

pp. S53-S53

Author(s):

Joshua Paulton ◽

Amanjot Gill ◽

Joelle Prevost

Keyword(s):

Inflammatory Bowel Disease ◽

Stress Response ◽

Mechanism Of Action ◽

Bowel Disease ◽

Relaxation Techniques ◽

Markers Of Inflammation ◽

Post Surgery ◽

Patient Goals ◽

History Of ◽

Inflammatory Bowel

Download Full-text

SAT0462 ASSESSMENT OF BONE MINERAL DENSITY IN INFLAMMATORY BOWEL DISEASE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6007 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1188.1-1188

Author(s):

C. Daldoul ◽

N. El Amri ◽

K. Baccouche ◽

H. Zeglaoui ◽

E. Bouajina

Keyword(s):

Bone Mineral Density ◽

Inflammatory Bowel Disease ◽

Bone Mineral ◽

Bowel Disease ◽

Mineral Density ◽

Femoral Site ◽

Significant Difference ◽

History Of ◽

Inflammatory Bowel ◽

The Mean

Background:Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is considered as a risk factor of low bone mineral density (BMD). In fact, the prevalence of osteoporosis ranges from 17% to 41% in IBD patients. The possible contributing factors may include malabsorption, glucocorticoid treatment and coexisting comorbiditiesObjectives:The purpose of our work was to determine the frequency and the determinants of osteoporosis in patients with IBD and to assess whether there is a difference in BMD status between UC and CD.Methods:This is a retrospective study, over a period of 5 years (from January 2014 to December 2018) and including patients followed for IBD who had a measurement of BMD by DEXA. Clinical, anthropometric and densitometric data (BMD at the femoral and vertebral site) were recorded. The WHO criteria for the definition of osteoporosis and osteopenia were applied.Results:One hundred and five patients were collected; among them 45 were men and 60 were women. The average age was 45.89 years old. The average body mass index (BMI) was 25.81 kg/m2 [16.44-44.15]. CD and UC were diagnosed in respectively 57.1% and 42.9%. A personal history of fragility fracture was noted in 4.8%. Hypothyroidism was associated in one case. Early menopause was recorded in 7.6%. 46.8% patients were treated with corticosteroids. The mean BMD at the vertebral site was 1.023 g/cm3 [0.569-1.489 g/cm3]. Mean BMD at the femoral site was 0.920g/cm3 [0.553-1.286g / cm3]. The mean T-score at the femoral site and the vertebral site were -1.04 SD and -1.27 SD, respectively. Osteoporosis was found in 25.7% and osteopenia in 37.1%. Osteoporosis among CD and UC patients was found in respectively 63% and 37%. The age of the osteoporotic patients was significantly higher compared to those who were not osteoporotic (52.23 vs 43.67 years, p = 0.01). We found a significantly higher percentage of osteoporosis among men compared to women (35.6% vs 18.3%, p=0.046). The BMI was significantly lower in the osteoporotic patients (23.87 vs 26.48 kg/m2, p=0.035) and we found a significant correlation between BMI and BMD at the femoral site (p=0.01). No increase in the frequency of osteoporosis was noted in patients treated with corticosteroids (27.9% vs 21.6%, p=0.479). Comparing the UC and CD patients, no difference was found in baseline characteristics, use of steroids or history of fracture. No statistically significant difference was found between UC and CD patients for osteoporosis(p=0.478), BMD at the femoral site (p=0.529) and at the vertebral site (p=0.568).Conclusion:Osteoporosis was found in 25.7% of IBD patients without any difference between CD and UC. This decline does not seem to be related to the treatment with corticosteroids but rather to the disease itself. Hence the interest of an early screening of this silent disease.Disclosure of Interests:None declared

Download Full-text

A102 ADVERSE PREGNANCY-RELATED OUTCOMES IN WOMEN WITH INFLAMMATORY BOWEL DISEASE

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.100 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 77-79

Author(s):

Y Hanna ◽

P Tandon ◽

V W Huang

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Bowel Disease ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Categorical Variables ◽

History Of ◽

Inflammatory Bowel ◽

Adverse Pregnancy ◽

Aspirin Prophylaxis

Abstract Background Women with active inflammatory bowel disease (IBD) are at increased risk of adverse pregnancy outcomes such as preeclampsia. Though aspirin prophylaxis is prescribed in the general population (prior to 16 weeks’ gestation) for those at high-risk of preeclampsia, its use in patients with IBD has not been established. Aims To determine the frequency of and risk factors for adverse pregnancy outcomes in women with IBD, and to evaluate the risk for preeclampsia and the use of aspirin for primary prevention. Methods All pregnant women with IBD (Crohns disease (CD), ulcerative colitis (UC) and IBD-unclassified (IBDU)) seen at Mount Sinai Hospital from 2016–2020 were retrospectively identified. Demographics, reproductive history, and IBD characteristics including therapy and activity during pregnancy were recorded. Adverse pregnancy outcomes were also identified. Active disease during pregnancy was defined as a fecal calprotectin > 250 ug/g and/or using clinical disease activity scores. Categorical variables were compared using the Chi-square (x2) test and continuous variables using the Mann-Whitney test. A two-sided p-value less than 0.05 was considered statistically significant. Results 127 patients (66 with CD, 60 with UC, 1 with IBDU) were included with a median age of 32 years at conception. The majority were Caucasian (70.9%), married (82.7%), completed post-secondary education (69.3%), had no prior or current smoking (78.7%) or alcohol use history (67.7%), and had no other comorbidities (81.9%). 50.4% of women had a prior pregnancy. 3 had a history of preeclampsia and 15/127 were prescribed aspirin prophylaxis. 73.2% of women were in clinical remission at conception. Compared to women with CD, women with UC were more likely to have infants with low birth weight (LBW) (p=0.031), small for gestational age (SGA) (p=0.002) and had higher rates of active IBD during pregnancy (p=0.005). 13 women with IBD developed preeclampsia (6 with UC and 7 with CD). IBD type (p=0.844) and disease activity (p=0.308) were not associated with preeclampsia. Married women (p=0.001) while those who had a preconception consultation (50/127) (p=0.009) had lower rates of preeclampsia while those with a prior history of preeclampsia had higher rates (p=0.002). Among women who developed preeclampsia, pregnancy outcomes were comparable to those who did not. Women on aspirin prophylaxis (5/13) had a higher rate of preeclampsia (p=0.012), although they were also more likely to have a history of preeclampsia (p=0.002). Aspirin use was not associated with subsequent disease activity in pregnancy (p=0.830). Conclusions Women receiving aspirin prophylaxis had higher rates of preeclampsia, likely owing to a higher baseline risk. Preeclampsia prevention with aspirin prophylaxis does not appear to result in disease flares but larger studies are needed to confirm this finding. Funding Agencies None

Download Full-text

Prevalence of Self-Reported Spondyloarthritis Features in a Cohort of Patients with Inflammatory Bowel Disease

Canadian Journal of Gastroenterology ◽

10.1155/2013/139702 ◽

2013 ◽

Vol 27 (4) ◽

pp. 199-205 ◽

Cited By ~ 34

Author(s):

Carmen Stolwijk ◽

Marieke Pierik ◽

Robert Landewé ◽

Ad Masclee ◽

Astrid van Tubergen

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Musculoskeletal Symptoms ◽

Inflammatory Back Pain ◽

Early Referral ◽

History Of ◽

Seronegative Spondyloarthritis ◽

Inflammatory Bowel ◽

Inflammatory Drugs ◽

Or History

BACKGROUND: Musculoskeletal symptoms belonging to the spectrum of ‘seronegative spondyloarthritis’ (SpA) are the most common extraintestinal manifestations in patients with inflammatory bowel disease (IBD) and may lead to important disease burden. Patients with suspected SpA should be referred to a rheumatologist for further evaluation.OBJECTIVE: To investigate the self-reported prevalence of musculoskeletal SpA features in a cohort of patients with IBD and to compare this with actual referrals to a rheumatologist.METHODS: Consecutive patients with IBD visiting the outpatient clinic were interviewed by a trained research nurse about possible SpA features using a standardized questionnaire regarding the presence or history of inflammatory back pain, peripheral arthritis, enthesitis, dactylitis, psoriasis, uveitis and response to nonsteroidal anti-inflammatory drugs. All patient files were verified for previous visits to a rheumatologist and any rheumatic diagnosis.RESULTS: At least one musculoskeletal SpA feature was reported by 129 of 350 (36.9%) patients. No significant differences between patients with Crohn disease and ulcerative colitis were found. Review of medical records showed that 66 (51.2%) patients had ever visited a rheumatologist. Axial SpA was diagnosed in 18 (27.3%) patients, peripheral SpA in 20 (30.3%) patients and another rheumatic disorder in 14 (21.2%) patients.CONCLUSION: Musculoskeletal SpA features are frequently present in patients with IBD. However, a substantial group of patients is not evaluated by a rheumatologist. Gastroenterologists play a key role in early referral of this often debilitating disease.

Download Full-text

Mo1375 Prevalence of Family History of Inflammatory Bowel Disease Among Ulcerative Colitis Patients

Gastroenterology ◽

10.1016/s0016-5085(13)62406-3 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-649-S-650

Author(s):

Ryan E. Childers ◽

Swathi Eluri ◽

Christine Vazquez ◽

Theodore M. Bayless ◽

Susan Hutfless

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Family History ◽

Bowel Disease ◽

History Of ◽

Inflammatory Bowel

Download Full-text

(Poly)phenols in Inflammatory Bowel Disease and Irritable Bowel Syndrome: A Review

Molecules ◽

10.3390/molecules26071843 ◽

2021 ◽

Vol 26 (7) ◽

pp. 1843

Author(s):

Marilyn Hagan ◽

Bu' Hussain Hayee ◽

Ana Rodriguez-Mateos

Keyword(s):

Inflammatory Bowel Disease ◽

Irritable Bowel Syndrome ◽

Bowel Disease ◽

Evidence Base ◽

Therapeutic Benefit ◽

Markers Of Inflammation ◽

Related Quality ◽

Health Related ◽

Inflammatory Bowel ◽

Irritable Bowel

(Poly)phenols (PPs) may have a therapeutic benefit in gastrointestinal (GI) disorders, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). The aim of this review is to summarise the evidence-base in this regard. Observational evidence does not give a clear indication that PP intake has a preventative role for IBD or IBS, while interventional studies suggest these compounds may confer symptomatic and health-related quality of life improvements in known patients. There are inconsistent results for effects on markers of inflammation, but there are promising reports of endoscopic improvement. Work on the effects of PPs on intestinal permeability and oxidative stress is limited and therefore conclusions cannot be formed. Future work on the use of PPs in IBD and IBS will strengthen the understanding of clinical and mechanistic effects.

Download Full-text

Phenotypic Features and Longterm Outcomes of Pediatric Inflammatory Bowel Disease Patients with Arthritis and Arthralgia

The Journal of Rheumatology ◽

10.3899/jrheum.170168 ◽

2017 ◽

Vol 44 (11) ◽

pp. 1636-1643 ◽

Cited By ~ 2

Author(s):

Osnat Nir ◽

Firas Rinawi ◽

Gil Amarilyo ◽

Liora Harel ◽

Raanan Shamir ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Medical Records ◽

Biologic Therapy ◽

Joint Involvement ◽

Pediatric Inflammatory Bowel Disease ◽

History Of ◽

Inflammatory Bowel ◽

Phenotypic Features ◽

Pediatric Ibd

Objective.The natural history of pediatric inflammatory bowel disease (IBD) patients with joint involvement has not been clearly described. Thus, we aimed to investigate phenotypic features and clinical outcomes of this distinct association.Methods.The medical records of patients with pediatric IBD diagnosed from 2000 to 2016 were reviewed retrospectively. Main outcome measures included time to first flare, hospitalization, surgery, and biologic therapy.Results.Of 301 patients with Crohn disease (median age 14.2 yrs), 37 (12.3%) had arthritis while 44 (14.6%) had arthralgia at diagnosis. Arthritis and arthralgia were more common in women (p = 0.028). Patients with arthritis and arthralgia demonstrated lower rates of perianal disease (2.7% and 4.5% vs 16.9%, p = 0.013), whereas patients with arthritis were more likely to be treated with biologic therapy (HR 2.05, 95% CI 1.27–3.33, p = 0.009). Of 129 patients with ulcerative colitis (UC; median age 13.7 yrs), 3 (2.3%) had arthritis and 16 (12.4%) had arthralgia at diagnosis. Patients with arthralgia were treated more often with corticosteroids (p = 0.03) or immunomodulator therapies (p = 0.003) compared with those without joint involvement. The likelihood to undergo colectomy was significantly higher in patients with arthralgia (HR 2.9, 95% CI 1.1–7.4, p = 0.04). During followup (median 9.0 yrs), 13 patients developed arthritis (3.3%). Arthralgia at diagnosis was a significant predictor for the development of arthritis during followup (HR 9.0, 95% CI 2.86–28.5, p < 0.001).Conclusion.Pediatric IBD patients with arthritis have distinct phenotypic features. Arthralgia at diagnosis is a predictor for colectomy in UC and a risk factor for the development of arthritis during followup.

Download Full-text

Socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2021-25(1)-12 ◽

2021 ◽

Vol 25 (1) ◽

pp. 65-69

Author(s):

I. V. Oleksiienko

Keyword(s):

Ulcerative Colitis ◽

Health Care ◽

Inflammatory Bowel Disease ◽

Pregnant Women ◽

Bowel Disease ◽

Clinical Analysis ◽

Chronic Inflammatory Bowel Disease ◽

Care Providers ◽

History Of ◽

Inflammatory Bowel

Annotation. At the turn of the 21st century, chronic inflammatory bowel disease (CIBD) has become a global disease with accelerating morbidity in industrialized countries with a prevalence exceeding 0.3%. These data underscore the need for research into the prevention of inflammatory bowel disease and innovations in health care systems to manage this complex and costly disease. The information from a personal anamnesis of 40 women patients with ulcerative colitis (clinical group (main). In the second group (control), 30 practically healthy pregnant women with a physiological course of gestation were included, which did not have in their history of inflammatory intestinal diseases. Statistical processing of research results was performed using the software package Statistica 6.0. The arithmetic mean (M) and the standard deviation error (± m) (p<0.05) were determined, as well as the odds ratio (OR), confidence interval (CI) at p=95%. It was found that for women with ulcerative colitis is characterized by the presence of a history of obstetric pathology, such as: spontaneous miscarriage of OR 3.33, 95% CI [1.06-10.53], p=0.04 and blood secretions of OR 3.0, 95% CI [1.00-8.98], p=0.0496; among extragenital pathology in the anamnesis: children's infectious diseases of OR 4.85, 95% CI [1.25-18.85], p=0.02, chronic bronchitis of OR 7.54, 95% CI [1,56-36, 41], p=0.01, varicose veins OR 4.33, 95% CI [1.11-16.95], p=0.035, chronic gastritis OR 6.0, 95% CI [1,23-29, 31], p=0.03, anemia of OR 15.0, 95% CI [4.53-49.68], p<0.0001, allergy history of OR 6.65, 95% CI [1.73-25.60], p=0.006; among gynecological complications – premenstrual syndrome OR 6.0, 95% CI [1.55-23.15], p=0.009, algomenorrhea OR 8.14, 95% CI [2.12-31.24], p=0.002 , salpingo-oophoritis, OR 7.54, 95% CI [1.56-36.41], p=0.01. Because CIBD during pregnancy is associated with an increased risk of adverse effects on the mother and fetus, information on socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis will be useful to health care providers in making decisions about CIBD during pregnancy.

Download Full-text