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Sponsors. Crohn’s & Colitis Foundation of America. Our Mission: To cure Crohn’s disease and ulcerative colitis, and to improve the quality of life of children and adults affected by these diseases. CCFA Programs and Services. Information Resource Center (IRC)
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Crohn’s & Colitis Foundation of America Our Mission: To cure Crohn’s disease and ulcerative colitis, and to improve the quality of life of children and adults affected by these diseases
CCFA Programs and Services Information Resource Center (IRC) Accessible via 888.694.8872 and www.ccfa.org Community website: www.ccfacommunity.org Teen website: www.ucandcrohns.org Education Chapter programs Teleconferences
CCFA Programs and Services Support groups Online resources Camp Oasis Children with inflammatory bowel diseases (IBD) enjoy a safe and supportive campcommunity
“Take Steps” Held locally Join the walk for a cure Fund research Raise awareness Be heard Change lives www.cctakesteps.org CCFA Signature Events
CCFA Signature Events • “Team Challenge” • Endurance training program to run or walka half marathon at an exciting destination • Help the Foundation raise crucial funds tofind a cure • 16 weeks of professional training as partof a team • “Challenge yourself to change a life!” • www.ccteamchallenge.org
IBD Research: CCFA’s Commitment Invested approximately $150 million in research and funded more than 1,100 grants New initiative: Challenges in IBD Research Strategic research plan Understand causes and disease processes of IBD Identify faster, more effective methods of diagnosis and treatment Sponsors scientific workshops and training programs to provide guidance on how to perform good clinical studies
Understanding Inflammatory Bowel Diseases (IBD): What Every Patient Needs to Know
Today’s Objectives Define IBD, its potential causes and diagnosis Discuss management and treatment Highlight special populations Review latest research Answer questions
What Is IBD? Comprises Crohn’s disease (CD) and ulcerative colitis (UC) Overlapping symptoms and complications Crohn’s disease can affect any area of the gastrointestinal (GI) tract, including the small intestine and colon UC affects only the colon An estimated 1.4 million Americans live with IBD 30,000 new cases diagnosed each year
What Are the Potential Causes of IBD? GeneticPredisposition 20%–25% of patients havea close relative with IBD Immune System Abnormalities An inappropriate reaction by the body’s immune system EnvironmentalFactors Infections, antibiotics, nonsteroidalanti-inflammatory drugs (NSAIDs), diet, smoking
The Spectrum of IBD • CROHN’S DISEASE • Patchy inflammation • Mouth to anus involvement • Full-thickness inflammation • Variable involvement • Fistulas • Abscesses • Strictures • Extraintestinal manifestations • Increased risk ofcancer • ULCERATIVE COLITIS • Continuous inflammation • Colon only • Superficial inflammation • Variable involvement • Increased risk of cancer • Extraintestinal manifestations Indeterminate colitis10%–15%
Understanding Complications of Crohn’s Disease Intestinal obstruction Abscess Fistula Stricture Colorectal cancer Obstruction Fistula
Understanding Complications of Ulcerative Colitis Anemia from blood loss Perforation (rupture) ofthe bowel Colorectal cancer Toxic megacolon Perforation
Recognizing Symptoms ofIBD Flares • Diarrhea • Often increased from usual course of disease • Rectal bleeding • Abdominal pain or cramping • Low-grade fever • Fatigue • Extraintestinal manifestations • Joint pain/swelling • Eye inflammation • Skin lesions • Mouth ulcers
Diagnosing IBD Normal colon on colonoscopy UC on colonoscopy CD on colonoscopy
Comprehensive IBD Management Provide emotional support Controlsymptoms IBD Management Goals Treat inflammation Prevent cancer Treatcomplications Improve quality of life Replenish nutritional deficits Minimize treatment toxicity Maintain remission
Understanding Treatment Options Prescription medications Over-the-counter agents Complementary and alternative therapies Surgery
Over-the-Counter (OTC) Agents Address only specific symptoms Antidiarrheal agents Laxatives Pain relievers Important to discuss with physician before taking any OTC medications
Complementary & Alternative Therapies: Probiotics “Good” bacteria that restore balance to the enteric microbiota-bacteria in the intestines May be helpful in aiding recovery of the intestine and maintaining remission Important to discuss with physician before initiating treatment
Complementary & Alternative Therapies: Supplements • Fish oil supplements containing omega-3 fatty acids • May reduce pain and inflammation when added to standard therapy • Clinical trial results are inconsistent • No clear recommendation • Natural aloe supplement • Works within intestines to break down impacted food to cleanse the bowel • Many formulations can actually be harmful to the bowel • Alternative therapies should not replace prescription medications
Surgery in IBD Crohn’s Disease • Strictureplasty • Resection of small intestinal segment • Colectomy (partial or complete) • Proctocolectomy • Unlike UC, CD cannot be cured with surgery Ulcerative Colitis • Proctocolectomy(removal of the colon and rectum) • With ileostomy • Restorative (ileoanal or J pouch) • Disease is “cured” once the colon is removed
Understanding the Importance of Diet & Nutrition in Managing IBD Causes of nutritional deficits Decreased intake (no desire to eat) Active disease Protein and fluid loss Decreased absorption of nutrients (when small intestine is affected by CD) Fat Vitamins Small intestine
Understanding the Importance of Diet & Nutrition in Managing IBD Create a food journal Eliminate problematic foods Strive for a well-balanced, healthy diet based on Hydration Electrolyte balance Continual adequate nutrient intake
Understanding IBD inChildren & Adolescents Special considerations Ability to swallow capsules or tablets Side effects of drug therapy Risks of long-term corticosteroid use Emotional/social concerns Adherence Growth failure and need for nutritional supplementation Emotional well-being
Understanding IBD inPregnant Women Special considerations IBD should be controlled beforeconsidering pregnancy Remain on most prescribedmedications Well-balanced diet with vitamins,including folic acid Ongoing communication betweenobstetrician and gastroenterologist
IBD Research Genetics Several genes linked to both CD and UC Large genome-wide studies continue Biologic markers Measurable substances that may helpcharacterize disease Clinical trials Better understand disease Develop novel therapies
IBD Research:Agents on the Horizon Antibiotics Rifaximin (Xifaxan®) Steroids with new delivery systems, such as COLAL-PRED® Hormone Teduglutide Mesenchymal stem therapy
Living Well With IBD Be compliant with medications Understand your disease and possible complications Schedule follow-up appointments Maintain a well-balanced diet Establish a support system Empower yourself with information Follow “Helpful Tips” handout