Predicting the course of IBD

IBD is a chronic condition, meaning you will need to monitor your disease over your lifetime and the aim is to achieve and then keep it in remission. Remission is when you have a good control of symptoms and resolution of inflammation on colonoscopy or imaging.

Because everyone is different, it’s not easy to predict how the course of IBD will change over time. There are, however, outside factors that can help make controlling your disease a little easier.

Things that influence the IBD disease course:

• Smoking
  Cigarette smoking will make your IBD more aggressive and reduce the effectiveness of medications. If you have surgery for Crohn’s Disease and you continue to smoke, the disease will come back quicker than if you didn’t, reducing the time until you need more surgery.
• Diet
  A diet high in processed foods, preservatives and emulsifiers can lead to the development of IBD and worsen disease course. Excess alcohol consumption can also have a similar effect.
• Stress
  Stress can aggravate the disease, lead to relapse and also worsen the disease course.
• Medications
  Being on the right medication at the right time is the key to achieving remission as quickly as possible. Once remission is achieved, there is then longer-term medications that are used to maintain ongoing remission.
• Genetics
  At the moment there are over 300 genes that we think are involved in developing IBD. Studies have attempted to identify which of these genes predict disease course, however there has been limited success.  It is likely that a complex interaction between various genes coding the immune system may affect how the disease will behave.

What can I do to help avoid a bad disease course?

• Quit smoking
  Smoking cessation is the first thing you can do to achieve remission much faster. The faster we achieve remission  the better the disease course will be.
• Medication compliance
  Taking the medication that has been recommended by your specialist is important. If you are worried about side-effects from the medication please feel free to discuss this with your specialist. The newer classes of biologic medications are safe and very effective.
• Maintaining a healthy diet
  Arranging a dietician review is important at the time of diagnosis to help avoid dietary triggers and make sure you are not at risk of malnutrition.
• Reducing stress
  If you think that stress or mental health is an issue for you we can arrange psychologist input to look at ways of improving your mental well-being.

At IBD SA we have a dedicated team of IBD specialists, Nurses, Dieticians, and Psychologists to help answer any of your questions and address any issues you may have.

Contributed by Dr Paul Spizzo