scholarly journals DEDICATED PSYCHIATRY CLINIC FOR INFLAMMATORY BOWEL DISEASE PATIENTS HAS A POSITIVE IMPACT ON DEPRESSION SCORES

2021 ◽  
Author(s):  
Kaleb Bogale ◽  
Sanjay Yadav ◽  
August Stuart ◽  
Allen R. Kunselman ◽  
Shannon Dalessio ◽  
...  
Keyword(s):  
Mental Health ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Depression Score ◽  
Control Group ◽  
Study Cohort ◽  
Psychiatry Clinic ◽  
Tertiary Center ◽  
Inflammatory Bowel ◽  
The Impact

BACKGROUND: Psychiatric disorders, including anxiety and depression, are significantly more common in patients with inflammatory bowel disease. We established an integrated psychiatry clinic for IBD patients at our tertiary center IBD clinic to provide patients with critical, but frequently unavailable, coordinated mental health services. We undertook this study to evaluate the impact of this service on psychiatric outcomes, quality of life, and symptom experience. METHODS: We performed a longitudinal prospective study comparing patients who had been cared for at our integrated IBD-psychiatry clinic to those who had not. We abstracted demographic and clinical information as well as contemporaneous responses to validated surveys. RESULTS: Thirty-six patients cared for in the IBD-psychiatry clinic were compared to a control cohort of thirty-five IBD patients. There was a significant reduction in the HADS depression score over time in the study cohort (p=0.001), though not in the HADS anxiety score. When compared to the control group, the study cohort showed a significant reduction in the HADS depression score. No significant differences were observed in the HBI, SCCAI or SIBDQ. CONCLUSIONS: This is the first study to evaluate the impact of an integrated psychiatry clinic for IBD patients. Unlike their control counterparts, individuals treated in this clinic had a significant reduction in mean HADS depression score. Larger scale studies are necessary to verify these findings. However, this study suggests that use of an integrated psychiatry-IBD clinic model can result in improvement in mental health outcomes, even in the absence of significant changes in IBD activity.

scholarly journals Anemia in Crohn’s Disease—The Unseen Face of Inflammatory Bowel Disease

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1046
Author(s):  
Mihaela Dranga ◽  
Lucian Vasile Boiculese ◽  
Iolanda Popa ◽  
Mariana Floria ◽  
Oana Gavril ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Clinical Manifestations ◽  
World Health ◽  
Tertiary Center ◽  
Inflammatory Bowel ◽  
The Impact

Background and Objectives: Anemia is the most frequent complication of inflammatory bowel diseases. Clinically, anemia can affect important quality-of-life (QoL) components, such as exercise capacity, cognitive function, and the ability to carry out social activities. The disease activity has a significant impact on QoL, mainly due to clinical manifestations, which are more severe during the periods of disease activity. Our aim was to estimate the impact of anemia on QoL in patients with Crohn’s disease. Material and Methods. We made a prospective study on 134 patients with Crohn’s disease (CD) in a Romanian tertiary center. The CD diagnosis was established by colonoscopy and histopathological examination. In particular cases, additional examinations were required (small bowel capsule endoscopy, computed tomography enterography, and magnetic resonance enterography). Anemia was defined according to the World Health Organization’s definition, the activity of the disease was assessed by Crohn’s disease activity index (CDAI) score, and the QoL was evaluated by Inflammatory Bowel Disease Questionnaire 32 (IBDQ 32). Results: 44.8% patient had anemia, statistically related to the activity of the disease and corticoids use. We found a strong association between QoL and disease activity on all four sub-scores: patients with more severe activity had a significantly lower IBDQ (260.38 ± 116.96 vs. 163.85 ± 87.20, p = 0.001) and the presence of anemia (127.03 vs. 148.38, p = 0.001). In multiple regression analyses, both disease activity and anemia had an impact on the QoL. Conclusions: Anemia has high prevalence in the CD in northeastern region of Romania. Anemia was more common in female patients, in patients undergoing corticosteroid treatment, and in those with active disease. Both anemia and disease activity had a strong negative and independent impact on QoL.

P026 The impact of different dietary factors in the etiopathogenesis of inflammatory bowel disease: a retrospective case–control study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S144-S144
Author(s):  
C M Preda ◽  
T Manuc ◽  
A E Chifulescu ◽  
D Istratescu ◽  
E Louis ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Protective Factor ◽  
Ice Cream ◽  
Dietary Factors ◽  
Control Group ◽  
High Fat ◽  
Fried Food ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Inflammatory bowel disease development has been associated with several environmental factors, among which diet can play a key role, probably due to a westernised lifestyle. However, its involvement in the pathogenesis of IBD is difficult to be demonstrated. The aim of this study was to analyse dietary composition in a Romanian and Belgian population with IBD. Methods We conducted an observational retrospective comparative study using two European cohorts (Romanian and Belgian). The IBD group included 76 Romanian and 53 Belgian patients with an IBD diagnosis while the control group included 56 healthy persons (35 Romanians and 21 Belgians). All subjects were interviewed and asked to fill in a questionnaire regarding diet. Results The baseline characteristics of the patients included in the two cohorts were described in the table. Figures 1 and 2 illustrated the consumption of different foods in Romanian, respectively, Belgian IBD patients before the onset of the disease vs. healthy controls (variables were compared with Fisher’s exact test). In the entire IBD cohort (Romanian+Belgian), we found a significantly increased consumption of sweets (OR 3.36[95% CI 1.6,7]), processed and high-fat meat (OR 2.5[95% CI1.4, 4.7], fried food (OR 9.5[3.8, 23.6]), salt (OR 2.8[1.5, 5.3]), ice cream (OR 3.25[1.1, 9.8]), mayonnaise (OR 3.49[1.1, 10.3]), margarine (OR 5.63[1.64, 19.33]), chips/nachos/other snacks (OR 2.3[0.97, 5.73]), compared with the healthy control group. The intake of seeds, nuts (OR 0.26[0.14,0.52]) and the yoghurt consumption (OR 0.44[0.23, 0.83]) was lower in the IBD group compared with the control group. Conclusion In Romanian and Belgian IBD patients, a westernised diet with increased consumption of sweets, processed food, high-fat meat, fried food, salt, margarine, snacks, ice cream and mayonnaise seems to be a risk factor for IBD. Food intake of seeds, nuts and yogurt may be a protective factor.

scholarly journals Impact of BMGIM Music Therapy on Emotional State in Patients with Inflammatory Bowel Disease: A Randomized Controlled Trial

2021 ◽  
Vol 10 (8) ◽  
pp. 1591
Author(s):  
Vicente Alejandro March-Luján ◽  
Vicente Prado-Gascó ◽  
José María Huguet ◽  
Xavier Cortés ◽  
José María Paredes Arquiola ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Emotional State ◽  
Control Group ◽  
Acute And Chronic Stress ◽  
State Of Mind ◽  
Inflammatory Bowel ◽  
The Impact

Background. Patients with inflammatory bowel disease (IBD) have a high prevalence of emotional disturbances which worsen the symptoms of the disease. As a therapeutic alternative that is part of a comprehensive care alongside medication, the Bonny Method of Guided Imagery and Music (BMGIM) music-assisted therapy has achieved promising emotional improvements in patients with chronic diseases. The objective of the study was to determine the impact of a treatment based on a BMGIM group adaptation on patients with inflammatory bowel disease (IBD) and their emotional state, therefore analyzing state of mind, quality of life, anxiety, depression, immunocompetence as a marker of well-being, and levels of acute and chronic stress. Methods. Longitudinal, prospective, quantitative, and experimental study including 43 patients with IBD divided into an intervention group (22 patients), who received eight sessions over eight weeks, and a control group (21 patients). A saliva sample was taken from each patient before and after each session in order to determine cortisol and IgA levels. Similarly, a hair sample was taken before the first and after the last session to determine the cumulative cortisol level. All molecules were quantified using the ELISA immunoassay technique. In addition, patients completed several emotional state questionnaires: HADS, MOOD, and CCVEII. Results. An improvement was observed in the following states of mind: sadness, fear, anger, and depression. No significant effect was observed in state of mind in terms of happiness or anxiety, in the levels of cortisol in hair, and in patients’ perceived quality of life. A reduction in cortisol was observed in saliva, although this did not significantly affect the IgA titer. Conclusions. BMGIM seems to improve the emotional state of patients with IBD.

scholarly journals The Effect of a Tailored Patient Activation Intervention in Inflammatory Bowel Disease Patients

2019 ◽  
Vol 66 (3) ◽  
pp. 11-21 ◽  
Author(s):  
Chisom Kanu ◽  
Carolyn Brown ◽  
Jamie Barner ◽  
Casey Chapman ◽  
Heather Walker
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Bowel Disease ◽  
Patient Activation ◽  
Baseline Survey ◽  
Control Group ◽  
Post Intervention ◽  
Inflammatory Bowel ◽  
And Control ◽  
The Impact

Purpose A pre-test, post-test, control group design was employed to investigate the impact of a tailored patient activation intervention (PAI) among inflammatory bowel disease (IBD) patients. Methods Patients who met the inclusion criteria were selected from medical records via convenience sampling, were consented, and completed a baseline survey. Based on responses to the baseline 13-item patient activation measure (PAM-13), they were categorized into one of four patient activation stages. During office visits, intervention patients (N=23) were given a tailored PAI based on their baseline stage, which consisted of an information booklet and focused discussion with the gastroenterologist, while the control group (N=27) received usual care. Baseline and 1-month post-intervention scores were compared between the intervention (N=20) and control (N=21) groups for changes in patient activation score, medication adherence, and satisfaction with care. Results Most participants were Caucasian (88%), female (64%), college graduates (56%), and had Crohn's disease (59.2%). Overall, females had a significantly higher (p=0.04) mean activation score (mean=70.9±15.4) than males (mean=60.9±10.7) at baseline. This trend was the same post-intervention (75.6 females vs 64.4 males; p=0.03). The difference in mean activation scores pre- vs post-intervention was not statistically significant between the intervention and control groups (mean=4.9±12.3, p=0.21). However, this difference could be considered to be clinically significant based on results from previous studies. There were no significant differences in medication adherence or satisfaction scores pre- vs post-intervention for either group. Conclusion Tailored PAIs have the potential to increase activation level of patients with inflammatory bowel disease. This customized medical interaction increased patient involvement in disease management and could potentially lead to improved health outcomes.

11 ENTERAL NUTRITION THERAPY IS ASSOCIATED WITH FEWER READMISSIONS AND DEATHS AMONG MALNOURISHED INPATIENTS WITH INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S43-S44
Author(s):  
Wendi LeBrett ◽  
Jenny Sauk ◽  
Berkeley Limketkai
Keyword(s):  
Inflammatory Bowel Disease ◽  
Propensity Score ◽  
Enteral Nutrition ◽  
Bowel Disease ◽  
Nutrition Therapy ◽  
Control Group ◽  
Protein Calorie Malnutrition ◽  
Inflammatory Bowel ◽  
Matched Study ◽  
The Impact

Abstract Background Malnutrition is a common complication observed in hospitalized patients with inflammatory bowel disease (IBD). Enteral nutrition therapy can be used to support the nutritional needs of inpatients with IBD. However, evidence on the impact of inpatient enteral nutrition on clinical outcomes is equivocal. This study assesses post-hospitalization outcomes associated with enteral nutrition therapy amongst inpatients with IBD in a large nationwide database. Methods We conducted a retrospective propensity score-matched study among IBD inpatients diagnosed with protein-calorie malnutrition using the Nationwide Readmissions Database from 2010–2015. ICD9 codes associated with each admission were used to identify patients who received enteral nutrition. Using propensity score matching, patients who received inpatient enteral nutrition were matched with patients who did not receive enteral nutrition based on the following variables: age, sex, elective admission, patient income, teaching hospital, and hospital urban or rural locality. Primary endpoints included 30-day readmissions, 90-day readmissions, 30-day mortality and 90-day mortality. Results Among the 1,588 IBD patients (822 Crohn’s disease, 755 ulcerative colitis, 11 unclassified IBD) with protein-calorie malnutrition, patients who received enteral nutrition (n=794) had fewer 30-day readmissions (OR 0.73; 95% CI 0.55 – 0.96) and 90-day readmissions (OR 0.77; 95% CI 0.61 – 0.97). None of the patients (0%) in the enteral nutrition group died on a subsequent admission within 30 days of discharge, compared to 6 patients (0.8%) in the control group (p=0.027). Inpatient mortality within 90 days of discharge did not differ significantly between the two groups (0.8%, enteral nutrition vs. 1.6%, control; p=0.086). Discussion Enteral nutrition therapy among IBD inpatients with malnutrition was associated with lower odds of readmission and 30-day mortality, but not 90-day mortality. The findings of our study support the use of enteral nutrition in IBD inpatients and motivate the need for prospective studies assessing the impact of enteral nutritional support in IBD inpatients.

scholarly journals P587 Utility of intestinal ultrasound in Inflammatory Bowel Disease patients on management decisions

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S538-S539
Author(s):  
B Abraham ◽  
A Saleh ◽  
C Perry
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inflammatory Markers ◽  
The United States ◽  
Management Decisions ◽  
Drug Mechanism ◽  
Tertiary Center ◽  
Inflammatory Bowel ◽  
The Impact ◽  
Active Disease

Abstract Background Intestinal Ultrasound (IUS) has been gaining momentum in the management of patients with inflammatory bowel disease (IBD). Underutilized in the United States(U.S.), we present the impact of IUS in management decisions in a cohort of IBD patients seen at a tertiary center. Methods This retrospective study analyzed all IBD patients seen at our institution undergoing IUS as part of routine clinical evaluation. Patient demographics, disease type, clinical activity, laboratory markers, and therapy was obtained. Patients with evidence of inflammation based on IUS characteristics of bowel wall thickening, with additional parameters of mural stratification, mesenteric fat, doppler flow, lymph nodes, dilated bowel, free fluid used as adjunct measures were compared to those without IUS features of activity. Subsequent management plan based on findings were evaluated. Results Of 148 patients seen for IUS (median age 41 (range 18–81), 67% female), 108(73%) had Crohn’s disease (CD), 39(26.4%) had ulcerative colitis (UC), 1(0.7%) had IBD-undetermined (IBD-U) with 111(75%) Caucasians, 9.5% Blacks, 8.8% Asians, and 6.8% Hispanics. Median disease duration was 8 years, range (0–43) with 113(94.1%) on biologic/small molecule therapy and 7(5.8%) on mesalamines. No differences in BMI were noted in those with active disease vs. those in remission. However, we noted 29(19.3%) had fatty liver on ultrasound, which correlated highly with high BMI (31 vs. 24) in those with normal liver (p<0.05). On IUS, 110(66%) of our patients had evidence of disease activity and 56(34%) were in remission. Inflammatory markers ESR and CRP did not correlate to IUS activity. In our UC patients Mayo score correlated to IUS findings but not Harvey Bradshaw Index (HBI) for CD. For those with positive findings on IUS, 29.5% escalated therapy for their IBD, and 13.3% required change in drug mechanism. For those in remission, the majority of patients 43(84.3%) continued their therapy while 3(5.9%) successfully de-escalated therapy. Conclusion In our study, IUS was useful in providing management decisions in those with active disease especially as there was a lack of correlation to inflammatory markers and HBI scores.

scholarly journals A176 THE IMPACT OF COVID-19 ON ANXIETY, DEPRESSION, AND STRESS IN WOMEN WITH INFLAMMATORY BOWEL DISEASE: A CROSS-SECTIONAL SURVEY

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 188-189
Author(s):  
P Tandon ◽  
K O’Connor ◽  
C Maxwell ◽  
G C Nguyen ◽  
V W Huang
Keyword(s):  
Mental Health ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Health Care Professionals ◽  
Post Partum ◽  
Stress Symptoms ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Anxiety Depression ◽  
The Impact

Abstract Background Women with inflammatory bowel disease (IBD) are at an increased risk of mental-health illness and reduced fertility. Aims To determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on the mental-health and pregnancy plans of women with IBD. Methods Women with IBD (age 18–45) were asked to anonymously complete surveys on baseline demographics, IBD characteristics, and mental health comorbidities. They were also asked to comment on prior symptoms consistent with COVID-19 and whether they were tested for the virus. Finally, patients were asked to complete three mental health surveys to reflect on anxiety (Generalized Anxiety Disorder-7 (GAD7)), depression (Patient Health Questionnaire-9 (PHQ9)), and stress (Perceived Stress Scale (PSS)) symptoms prior to and during the pandemic. Total scores were reported as continuous variables and means with standard deviations (SD) were compared using paired T-tests. Results Twenty-nine patients (12 UC, 17 CD) were included. 14 patients were preconception, 12 were pregnant, and 3 were post-partum. The mean age was 31.4 (SD 3.7). Fifteen of 29 (51.7%) of patients were on anti-tumor necrosis factor therapy. Twelve (41.4%) and 6 (20.7%) patients had pre-morbid anxiety and depression prior to the pandemic. COVID-19 symptoms were reported in 8 patients (27.5%). Six patients had undergone COVID-19 testing, all of whom had a negative test. Four patients indicated that COVID-19 had negatively affected their plans for pregnancy, with reasons reported including fear of the hospital (n=1), fear of COVID-19 impact on the fetus (n=2), and uncertainty on the duration of COVID-19 (n=1). During the pandemic, fourteen of 28 (50%) patients experienced symptoms of anxiety (GAD score > 5), with a majority (70%) experiencing mild symptoms (score 5–9). During the pandemic, 60.7% (17/28) and 71.4% (20/28) reported symptoms of depression (PHQ9 > 4) and at least moderate stress (PSS > 14) respectively. Furthermore, compared to pre-pandemic, 57.1% (16/28) and 67.9% (19/28) had an increase in depression and stress symptoms during the pandemic respectively. This appeared to only apply to those with CD, but not UC (Table 1). Compared to pre-pandemic, those with stricturing CD appeared to have higher stress scores whereas those with fistulizing and perianal disease appeared to have higher depression scores during the COVID-19 pandemic (Table 1). A lower house-hold income and a reduction in exercise during the COVID-19 pandemic appeared to increase the risk of stress, depression, and anxiety symptoms. Conclusions Over half of women with IBD indicate worsening of anxiety, depression, and stress symptoms during the COVID-19 pandemic. It remains critical that health-care professionals address these mental health concerns during these otherwise difficult times. Funding Agencies None

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

Marine Drugs ◽  
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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