Recently Diagnosed with IBD? Make Sure You’re Doing These 5 Things

Tuesday, May 5, 2015

Donald Lum, MD, FACG

If you have been diagnosed with Inflammatory Bowel Disease (IBD), including Ulcerative colitis or Crohn’s disease, your gastroenterologist has likely done various tests to help diagnose your condition and determine the severity of your disease.  There are many medical and surgical options to control symptoms and to heal the inflammation in your GI tract. This may involve the use of immunomodulators such as azathioprine, mercaptopurine or methotrexate; or biologic therapy such as Remicade, Humira, Cimzia, Simponi, Stelara, Tysabri and Entyvio. In addition to choosing the right medication for treating your condition, make sure that these five health maintenance issues are addressed by your GI specialist to provide comprehensive care for your disease:

Preventing Infections

This is a key issue in keeping good health that should not be overlooked. Although updating vaccinations are important for everyone, those with IBD are often taking medications that increase infection risk. Depending on whether or not you receive immunosuppressant or biologic therapy for IBD (which determines whether or not you can receive vaccinations with live viruses), and if you qualify based on your age, you should consider getting vaccinated for any vaccine-preventable diseases:

Live Vaccines

  • Chicken Pox (Varicella)
  • Shingles (Zoster)
  • Measles/mumps/rubella (MMR)

Non-Live Vaccine

  • Diphtheria and pertussis (Tdap, every 10 years)
  • Influenza (yearly flu shot, avoid intranasal if you are immunocompromised)
  • Human Papillomavirus (HPV)
  • Hepatitis B
  • Hepatitis A
  • Meningococcal (college students and military recruits)
  • Pneumococcal pneumonia (booster every 5 years)

Bone Health

Many studies have shown a link between low vitamin D levels and IBD. Some researchers feel having IBD symptoms may cause you to stay indoors and eat less.  Other studies have shown newly diagnosed patients with IBD have low vitamin D levels, making one think low vitamin D levels may be a risk factor for developing IBD.

Your vitamin D level should be checked and supplements offered if levels are low. If you have used corticosteroids, have a maternal history of osteoporosis, are post-menopausal, or are malnourished, you are at risk for developing osteoporosis.  If you have any of these risk factors, request a bone density assessment (DEXA bone scan).  If you are using prednisone consider taking calcium in addition to vitamin D.

Cancer Prevention

If you have chronic ulcerative colitis, or Crohn’s colitis, you will need an annual or bi-annual colonoscopy 8-10 years after you are diagnosed. If you are on biologics or immune modulators make sure you are getting annual PAP smears by your primary care provider, and that you receive annual skin cancer screenings by a dermatologist.

Smoking Cessation

This is very important for those with Crohn’s disease. Using tobacco products makes treatment of Crohn’s disease very challenging. Your gastroenterologist may involve your primary care provider or a pulmonologist to assist with smoking cessation and lung cancer screening.

Nutritional Assessment

While eating certain foods is not known to cause IBD, a healthy, balanced diet will help make sure that you are getting essential vitamins and other nutrients. A visit with a dietitian should be considered and often is essential in managing your disease. Your iron levels should be checked regularly, and may need to be supplemented with oral or IV forms of iron. Vitamin B12 levels should also be checked, especially if the disease is affecting your small intestine, or if you have had a previous ileal surgery. The Oregon Clinic now offers appointments to IBD patients with a registered dietitian at all of our gastroenterology locations. Talk to your provider about getting scheduled, call your clinic’s office, or request an appointment online.

To quote Benjamin Franklin, “an ounce of prevention is worth a pound of cure.”  These precious words sums up the importance of health maintenance when it comes to comprehensive IBD care!