GET THE GUTSY TRUTH ABOUT INFLAMMATORY BOWEL DISEASE EXPECT MORE FROM YOUR TREATMENT

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1 GET THE GUTSY TRUTH ABOUT INFLAMMATORY BOWEL DISEASE EXPECT MORE FROM YOUR TREATMENT Patient Education Forums - KOL Presentation

2 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

3 UNDERSTANDING INFLAMMATORY BOWEL DISEASE

4 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

5 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)

6 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

7 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 Geography

8 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)

9 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

10 WHY IS IT IMPORTANT TO EFFECTIVELY MANAGE YOUR INFLAMMATORY BOWEL DISEASE?

11 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!

12 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

13 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

14 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

15 TREATMENT OPTIONS FOR CROHN S DISEASE Always talk to your doctor to understand the risks and *Always talk to benefits your doctor of to any understand treatment the risks and benefits of any treatment

16 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.

17 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

18 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

19 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

20 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

21 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

22 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

23 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

24 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?

25 Resources (CCFC): Visit

26 QUESTIONS?

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