Don’t Let IBD Get Ahead of You
Get informed and play an active role.
Did you know that Canada has one of the highest rates of Inflammatory Bowel Disease (IBD) in the world? 300,000 Canadians are living with either Crohn’s disease or ulcerative colitis—the two main forms of IBD—and studies show that that number is steadily increasing.
What’s worrying about IBD isn’t just the growing number of people diagnosed or its debilitating symptoms—from abdominal pain, diarrhea and fatigue to fever, poor nutrient absorption, and bleeding from the bowel. It’s the damage that often goes undetected, when patients are symptom-free and don’t feel the need to see the doctor. It’s why IBD is often called the invisible disease.
Photo: Dr. Remo Panaccione
“IBD is not about controlling symptoms; it’s about controlling the disease,” says Dr. Remo Panaccione, Professor of Medicine at University of Calgary, Director of the Inflammatory Bowel Disease Group, and IBD educator. “When patients think of the disease, they think of their daily symptoms. When doctors think about the disease, we think about the damage due to inflammation, which is a hallmark of Crohn’s and colitis.”
It’s a disconnect. A patient can feel completely well while their disease is doing severe damage to the intestine and lining of the bowel, called the mucosa. And without proper healing taking place in the mucosa—which doctors call mucosal healing—this damage can lead to future flare-ups, bowel obstructions and abscesses, hospitalizations and risk of surgery. In extreme cases, ongoing active inflammation in the bowel can lead to cancer.
“The mucosa is an integral part of all of our health,” says Dr. Panaccione. “It not only creates a barrier from the external environment to the rest of your body and the immune system, but a healthy mucosa also is important for digestion and absorption.”
So, what can be done to find out if mucosal healing is being achieved in patients living with IBD? The answer is both simple and a struggle: testing. Yes, there are diets and apps that might help keep symptoms in check, but they are not proven to aid in mucosal healing. Dr. Panaccione explains that patients living with IBD can have their inflammation tested in several ways. “Options include a C reactive protein blood test, which is a measure of systemic inflammation, a fecal calprotectin stool sample to test inflammation in the stool, and bowel ultrasounds, MRIs and CTs. But the gold standard is really an endoscopic evaluation, in which a camera inserted into the end of the intestine will help us see if there is any damage there.” He adds that these tests should be done regularly—between six months and every other year, depending on the test.
“Patients are focused on symptoms, because that’s what affects their immediate quality of life,” says Dr. Panaccionne. Patients don’t understand the disconnect between lack of symptoms and the regularity of these tests. It is critical that people living with IBD take an active role in their health, asking questions about what testing is required, and tracking their test results over time. “I always tell people that it’s about the long-term game—making sure we’re ahead of the disease so the disease doesn’t get ahead of us.”
Made possible with support from a research-based biopharmaceutical company.