I think most simply,
it depends on where in
the bowel the disease is
affecting and how severe your case is.
Every practitioner will tell
you that in an ideal world,
it shouldn't affect your life at all.
It's been well studied that
actually inflammatory bowel disease does not
significantly change the overall
lifespan of the patients.
But what we really care
about is quality of life.
I think for the vast majority
of patients that we see,
the appropriate medical plan
can keep patients generally
free of symptoms over
the order of one to three years.
So I think the biggest ways
that the disease is going to affect
your life is perhaps you
may need to watch a bit what you eat.
You'll need to keep in touch with
your treatment team and
you'll need to take medications
as they've been prescribed.
But if you do those three things,
I think that most
practitioners would tell you,
we'd rather you not be thinking
about your inflammatory bowel disease.
Let us worry about that.
Most of us that are involved in the research of
this condition would suggest that
there's three major causes
that we study for this condition.
The first would be the environment.
Most of us believe that there's
some environmental insult that
leads to
the chronic inflammation in the intestine.
That environmental insult may be dietary.
It may be a particular
bug that lives in the bowel,
or may be a function of that bug,
which is also a function of the diet.
The second most important thing
is having the right genes.
The genetics of inflammatory bowel disease is
complicated and actually quite widespread.
So most people have
the right genetic makeup for this disease,
but don't actually develop the disease.
And then the third component is
these two things impact on the immune system.
And the immune system
is what is actually causing
the chronic inflammation that's present in
the intestine that we prescribe medications to treat.
The short answer is no, it will not.
There's multiple lines of
research that when patients with
inflammatory bowel disease are
controlled against patients their same age,
with their same medical problems,
without inflammatory bowel disease,
achieve roughly the same lifespan.
If one has a narrowing in
the small bowel related to Crohn's disease,
something called a stricture,
diet becomes very important
because if certain patients
eat foods that have
too much roughage or fiber,
then those types of foods
can cause an impaction or
block the narrowing in the small bowel,
leading to signs and symptoms
of something we call an obstruction:
Belly pain, vomiting, loud noises in the bowel.
Another way diet can impact
the disease is if you have
damage of the small bowel,
that can impact your ability to do
certain types of functions
in the small bowel --
like absorbing dairy products, for example.
The main risk factor for cancer would
be colorectal or cancer of the large bowel.
And that comes, we believe, from
the chronic inflammation of the colon.
That's why it's a good idea to
maintain
close contact with your treatment team.
And that's why we recommend
routine colonoscopies,
passing the scope up into the colon,
looking for those early changes
associated with cancer.
That's a very common
and valid concern amongst
parents that come for
evaluation for their inflammatory bowel disease.
Generally the risk is slightly
higher for
Crohn's disease than ulcerative colitis.
But that being said,
you're still far more likely to be
the only member of your
family with this condition,
than have a familial
what we call penetrance.
The short answer is yes.
This science was actually developed for
an infection rather than
inflammatory bowel disease.
The science has been developed over
a period of about 15 years.
And it really has come to age with
an infection called clostridium
difficile or C diff.
Stool transplants now are
actually a very common tool to treat
recurrent or refractory infection
with this C diff species.
Because of the excitement in
the infectious disease field
or the C diff field,
there are numerous trials
that are running in
inflammatory bowel disease.
So I think just showing
up is the first thing that you can do.
We always consider this as a partnership
between the patient and the provider.
There's a lot to consider when we talk about
the medications for
inflammatory bowel disease.
Some of those medications have risk factors.
So those discussions are important,
can be complex and can be time-consuming.
So showing up, being present,
participating in those conversations,
and being educated yourself.
There are a lot of resources
out there to investigate what
the risks and benefits to a variety of
different strategies might be.
Communicating well with your team
and again, just being there and showing up.