Clinical Case Database / Category: Teaching and Training

Common questions from patients with inflammatory bowel disease

Publication details

Dr Frances Tanner, Dr Emma John, Dr Nurani Sivaramakrishnan
Foundation Years Journal, volume 9, issue 2, p.30 (123Doc Education, London, February 2015)

Abstract

Inflammatory Bowel disease (IBD) is a term used to describe chronic conditions that cause inflammation of the gastrointestinal tract. Crohn's disease and ulcerative colitis (UC) are the two most common causes of IBD in the United Kingdom (UK). The incidence of IBD is gradually increasing each year with a current estimated UK prevalence of 4 in 1000 people (1-2). IBD is associated with significant morbidity, with a lifetime cost similar to that encountered following a diagnosis of cancer or heart disease (3). As junior doctors, answering a patient's questions about IBD can be difficult. However, many patients report feelings of humiliation and embarrassment from their symptoms (2). Therefore, being able to discuss IBD inpatients' concerns is an important part of a junior doctor's role. This article seeks to explore some key questions we have been asked whilst working on a gastroenterology ward.

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Authors

Dr Frances Tanner (Corresponding author)

Dewsbury and District Hospital, Halifax Road,
Dewsbury, West Yorkshire, WF13 4HS
f.tanner@doctors.org.uk

Dr Emma John

Dewsbury and District Hospital, Halifax Road,
Dewsbury, West Yorkshire, WF13 4HS
emmajohn@doctors.org.uk

Dr Nurani Sivaramakrishnan

Dewsbury and District Hospital, Halifax Road,
Dewsbury, West Yorkshire, WF13 4HS
nurani.sivaramakrish@midyorks.nhs.uk

References

1. Rubin GP, Hungin AP, Kelly PJ, et al. Inflammatory Bowel Disease: Epidemiology And Management In An English General Practice Population. Aliment Pharmacol Ther 2000, 14:1553-9.
2. Mowat C, Cole A, Windsor A, et al. Guidelines For The Management Of Inflammatory Bowel Disease In Adults. Gut 2011, 60:571-607.
3. Luces C, Bodger K. Economic Burden Of Inflammatory Bowel Disease: A UK. Perspective. Expert Rev Pharmacoecon Outcomes Res 2006, 6:471-82.
4. Nguyen GC, Kaplan GG, Harris ML, et al. A National Survey Of The Prevalence And Impact Of Clostridium Difficile Infection Among Hospitalized Inflammatory Bowel Disease Patients. Am J Gastroenterol 2008, 103:1443-50.
5. Schreyer AG, Rath HC, Kikinis R, et al. Comparison of Magnetic Resonance Imaging Colonography With Conventional Colonoscopy For The Assessment of Intestinal Inflammation in Patients With Inflammatory Bowel Disease: A Feasibility Study. Gut. 2005, 54:250-56.
6. Johnson GJ, Cosnes J, Mansfield JC. Review Article: Smoking Cessation As Primary Therapy To Modify The Course Of Crohn's Disease. Aliment Pharmacol Ther 2005, 21:921-31.
7. Munkholm P, Langholz E, Davidsen M, et al. Disease Activity Courses In A Regional Cohort Of Crohn's Disease Patients. Scand J Gastroenterol 1995, 30:699-706.
8. Langholz E, Munkholm P, Davidsen M, et al. Course Of Ulcerative Colitis: Analysis Of Changes In Disease Activity Over Years. Gastroenterology 1994, 107:3-11.
9. Munkholm P, Langholz E, Davidsen M, et al. Intestinal Cancer Risk And Mortality In Patients With Crohn's Disease. Gastroenterology 1993, 105:1716-23.
10. Lennard-Jones JE, Shivananda S. Clinical Uniformity Of Inflammatory Bowel
Disease A Presentation And During The First Year Of Disease In The North And South Of Europe. EC-IBD Study Group. Eur J Gastroenterol Hepatol 1997, 9:353-9.
11. Winther KV, Jess T, Langholz E, et al. Survival And Cause-Specific Mortality In Ulcerative Colitis: Follow-Up Of A Population-Based Cohort In Copenhagen County. Gastroenterology 2003, 125:1576-82.
12. Bernell O, Lapidus A, Hellers G. Risk Factors For Surgery And Recurrence In 907 Patients With Primary Ileocaecal Crohn's Disease. Br J Surg 2000, 87:1697-701.
13. Rutgeerts P, Geboes K, Vantrappen G, et al. Predictability of the Postoperative Course of Crohn's Disease. Gastroenterology 1990, 99:956-63.
14. Ardizzone S, Maconi G, Russo A, et al. Randomised Controlled Trial Of Azathioprine And 5-Aminosalicylic Acid For Treatment Of Steroid Dependent Ulcerative Colitis. Gut 2006, 55:47-53.
15. British Society of Gastroenterology. 2014. Azathioprine/6 Mercaptopurine. [Online]. [Accessed 2 October 2014]. Available from: www.bsg.org.uk/pdf_word_docs/aza_ibd_dr.doc

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