The international problem of ulcerative colitis and the impact of science on the inflammatory bowel

The incidence of IBD continues to rise, both in low and in high-incidence areas. The increased incidence of IBD among migrants from low-incidence to high-incidence areas within the same generation suggests a strong environmental influence.

The international problem of ulcerative colitis and the impact of science on the inflammatory bowel

Advanced Search Abstract Background and aims: Crohn's Disease CD and ulcerative colitis UC are inflammatory bowel diseases IBDwhich may result in nutrition problems that impact on patient health, nutritional status and quality of life.

The international problem of ulcerative colitis and the impact of science on the inflammatory bowel

Subjective reports of how IBD patients experience these problems as part of their disease process, including comparisons between patient groups, or the need for tailored nutrition advice as perceived by these patients, have not been widely studied.

This survey aimed to identify and explore nutritional problems that are important to CD and UC patients and to investigate their views on the IBD health services provided to help them with these.

Eighty-seven IBD patients were invited to take part in a nutrition survey using face-to-face questionnaire interviews. The survey asked about food and nutrition problems that patients have experienced, identifying which were most significant and the extent to which they had been addressed by the clinical service.

Of these, 45 Patients with CD and UC reported similar frequencies of most nutritional problems. Less than half of patients had seen a dietitian for tailored nutritional advice to address these problems. Nutritional problems experienced and reported by IBD patients are numerous and varied.

They are considered important by patients with CD and UC, both of whom would generally value specific dietary counselling, highlighting a need for further research in this area and adequate and equal provision of services for both groups.

Inflammatory bowel diseaseCrohn's DiseaseUlcerative colitisFoodNutritionPatient experience 1 Introduction Inflammatory bowel disease IBD can have a major impact on patients' lives, including disruption of daily activities, social interactions, intimacy, psychological function and physical health.

Nutritional problems, measured using objective clinical indices, are common and vary depending on disease location, pattern and activity, surgical resection, stoma and associated complications.

The role of diet is central to an individual's psychological, social and cultural wellbeing and is linked to health-related quality of life. These include diet as a treatment, 13 — 15 cause or a key factor for prevention 13 ; dietary issues associated with surgery, post-surgery relapse or presence of a stoma 16 ; and general concern over the role of diet and ambiguity about symptom control through non-pharmaceutical means.

Previous research is limited by sample size and has not fully explored the experiences of CD patients compared to those with UC, and whether health services meet their expectations. The aim of this study was to investigate the prevalence of food and nutrition problems as perceived by patients with IBD and the factors associated with these.

In addition, the study aimed to investigate the extent to which these problems are addressed by health services. Patients were approached, and those willing to participate were recruited to individual face-to-face interviews conducted by two researchers AP and AM.

Every effort was made to recruit all eligible patients to minimise selection bias. There were no exclusion criteria to maximise population representativeness. The interviews were conducted prior to or immediately following each patient's medical consultation.

The patient was assured of confidentiality and anonymity and all patients provided informed consent to participate. The St Thomas' Research and Ethics Committee deemed that this questionnaire survey did not require ethical approval, as it constituted a patient needs assessment and service evaluation.

Relevant questions from existing questionnaires were pooled and new questions developed, incorporating a range of quantitative and qualitative styles.

Topics relevant to the research aims and objectives were brainstormed and the selected questions were ordered and phrased appropriately.

A lengthy process of refinement continued until all team members considered the questionnaire to have face validity. The questionnaire was then pre-tested using role-play of fictional patients to ensure standardisation between interviewers, and then piloted with a small sample of IBD patients prior to final modifications.

The final questionnaire was structured into three sections investigating: Patients were asked to describe their experiences of IBD-related food and nutrition problems, which they may have had at any point during their disease.

Patients were asked how recently they had experienced these problems and to report them in their own words through open questioning, to allow a richer narrative exploring the breadth of food and nutrition problems, as perceived by the patient. Following this, closed questions were used to ask about specific food and nutrition problems that the research team had identified in the literature search i.

Closed questions were also used to identify patients who had previously received nutritional advice as part of their IBD care and scaled questions captured patient satisfaction ratings with these health services. Patient reported responses were not verified against objective sources, such as medical records.

Quantitative data was entered directly and qualitative data was interpreted, coded and then entered into SPSS. To minimise data entry bias, a process of complete double data entry was undertaken, which was checked for accuracy and consistency.

UC using unpaired t-tests. However, there was no difference in importance ratings depending upon surgical history previous surgery vs. The clinical and demographic factors associated with the prevalence of food and nutrition problems as perceived by patients were investigated.

People with CD and UC reported with similar frequency experiencing different types of food and nutrition problems related to their disease when asked specifically about each problem in turn Table 2.

Where problems of excessive weight gain were cited CD: There were no differences in the food and nutrition problems experienced between genders.Inflammatory bowel disease (IBD) shows exposure to bisphenol-A (BPA) found in plastic and metal containers of food can worsen its symptoms and may lead to death.

Inflammatory bowel diseases (IBD) include ulcerative colitis (UC) and Crohn's disease (CD), 1 two chronic, relapsing, and remitting conditions that have no permanent drug cure and can result in significant long-term morbidity.

UC affects only the colon and is primarily confined to the mucosal and to a lesser degree, the submucosal compartments. Inflammatory bowel disease (IBD) can have a major impact on patients' lives, including disruption of daily activities, social interactions, intimacy, psychological function and physical health.

1, 2 Food and nutrition are important aspects of peoples' lives, and these may be disturbed in patients with IBD. Apr 01,  · Crohn's disease and ulcerative colitis are chronic disabling inflammatory bowel diseases (IBDs).

Although the causes of IBD are unknown, defects in innate and adaptive immune pathways have been identified and biological therapies that target key molecules have been designed.

Jan 07,  · Distinction between Crohn’s disease of the colon-rectum and ulcerative colitis or inflammatory bowel disease (IBD) type unclassified can be of pivotal importance for a tailored clinical management, as each entity often involves specific therapeutic strategies and prognosis.

Abstract. At the “5th International Meeting on Inflammatory Bowel Diseases selected topics of inflammatory bowel disease (IBD), including the environment, genetics, the gut flora, the cell response and immunomodulation were discussed in order to better .

The Role of Physical Exercise in Inflammatory Bowel Disease