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Coordinated Care for IBD

Crohn's disease and ulcerative colitis are Inflammatory Bowel Diseases (IBD) and can be debilitating conditions that make daily life difficult, but there are ways to manage symptoms so you can live the life you deserve.


If you experience new or worsening gastrointestinal (GI) symptoms that become a disruptive part of daily life, there’s a chance you may have inflammatory bowel disease or (Crohn's disease or ulcerative colitis). These two very similar conditions can be dangerous and even life-threatening if left untreated. Let’s talk about how to identify IBD, how to manage it, and what to look out for if you are concerned about your GI symptoms.

What Is IBD?

The reason IBD and Crohn's disease are often put together in conversations about IBD is because Crohn's disease is one of the major conditions that falls under the umbrella of Inflammatory Bowel Disease.

Ulcerative Colitis is the other common condition falling under the umbrella. In short, IBD is a term referring to conditions that involve chronic and severe inflammation of the digestive tract.

Many patients with IBD will experience remission in symptoms at times and flare ups at other times. This can make getting to the initial diagnosis tricky and frustrating.

Symptoms to be on the lookout for when it comes to IBD include:

  • Diarrhea
  • Abdominal pain
  • Blood in stool
  • Anemia
  • Unintentional weight loss

At The Iowa Clinic, the process from symptom onset to official IBD diagnosis almost always involves testing and referral from a primary care provider. Amber Tierney, MD, says that the testing can range from a routine physical exam to further abdominal imaging and more.

“Without an existing diagnosis, we usually set up the patient for a colonoscopy after they are referred to us as a specialist, and take biopsies at that time. From there, it can take 1-2 days to receive the results and, at that point, we are most often able to make the official diagnosis,” Dr. Tierney says.

How Can I Manage My IBD?

Once you’ve received a diagnosis falling under the IBD umbrella, it becomes a puzzle of how to best manage your symptoms so you can get back to living your life.

In many cases, knowledge becomes power in the world of IBD. Sometimes there are specific triggers that cause a flare up, and learning what those triggers are for your body can help avoid unnecessary flare ups.

An important part of managing IBD is understanding what’s happening in your body when a flare up occurs.

“IBD, Crohn's, Ulcerative colitis, these are all lifetime autoimmune conditions. There isn’t a cure, but you can achieve deep remission, which is our goal. Essentially what happens with IBD is that your immune system isn’t quite working right. The inflammation is its attempt at attacking something that it thinks shouldn’t be there,” Dr. Tierney says.

Managing the symptoms then becomes a balance of immediate relief and working toward that long-term remission.

“For new diagnoses, we start patients on treatment and generally will follow up in 6-12 months to monitor progress. Sometimes they’re tolerating it well, sometimes it might no longer be as effective at decreasing inflammation. If it’s no longer as effective, we work with the patient to hopefully find a more effective treatment. With IBD it’s not just about clinical remission where the symptoms are managed on a day to day basis, but it’s about histologic or deep remission, where we take biopsies and see no inflammation in the biopsies,” Dr. Tierney says. “If we can get patients to that point of deep remission, they can do really well for years.”

Short-term treatments to alleviate symptoms and get severe inflammation under control include:

  • Steroids
  • Oral medication
  • Biologic therapies
     

While long-term treatment often involves a combination of therapies and, in the case of severe inflammation like you see in Crohn's disease, it can also include injections targeted at decreasing or blocking the immune response that is causing the inflammation. Long-term treatment also frequently includes lifestyle changes to diet and exercise to help manage symptoms and avoid flare ups.

How Can IBD Affect Other Areas of My Health?

Left untreated, IBD can cause serious health issues and may even be life-threatening. Especially with Crohn's disease, complications like fistulas and narrowing strictures are serious risk factors your primary care provider can discuss with you.

“Because IBD is autoimmune, it can definitely have ripple effects on a patient’s larger health picture. That’s why it’s so important to get the diagnosis and work with your care team to work toward that deep remission. That’s the goal, that’s where you can live a mostly normal life for quite some time,” Dr. Tierney says.

Managing and Treating IBD Through Coordinated Care at The Iowa Clinic

At the end of the day, IBD is a group of conditions that can deeply impact many areas of your life if you don’t receive the right care, and Dr. Tierney notes that there is no one-size-fits-all solution for IBD.

“When it comes to IBD, care is multidisciplinary. It ranges from help with health maintenance issues like vaccines, age appropriate cancer screenings, and more to working with our partners in colorectal surgery for patients that ultimately end up needing surgical intervention. The communication across those departments is so seamless at The Iowa Clinic that it’s hard to beat the efficacy and efficiency you get,” Dr. Tierney says. “Not to mention the quality of care our patients receive. We use what’s called shared decision making to keep patients informed every step of the way, so they feel fully in control of and comfortable with the path their treatment takes.”

If you are concerned about new or worsening GI symptoms you may be experiencing, schedule an appointment with your primary care provider today and discuss the possibility of IBD.

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