ECCO IBD Curriculum
13.4. Understands the burden of psychological morbidity in IBD and how to treat it
This course has been developed for physicians interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to increase competence and knowledge with regard to the use of complementary medicines and psychotherapy in IBD patients in order to improve patient outcomes.
After this case you will:
- Know the evidence for the use of dietary supplements, herbs, vitamins, omega-3 fatty acids, probiotics and cannabis in IBD patients
- Be able to identify which herbs or dietary supplements might be useful as complementary therapies in IBD
- Understand the relation between anxiety/depression, stress and fatigue in IBD
- Be able to identify the role of psychological therapies in IBD
- Understand the benefits and side-effects of manipulative and body-based practices
- Counsel your patient on manipulative and body-based practices
This course is designed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to increase competence and knowledge with regard to the prediction, diagnosis and management of Ulcerative Colitis (UC) patients and to harmonise diagnostics and treatment in order to improve patient outcomes.
Upon completion of this activity learners will:
- Have insights into the basic epidemiology of ulcerative colitis
- Know current treatment options for severe ulcerative colitis, including colectomy
- Be able to use ciclosporin correctly in severe ulcerative colitis
- Understand when to order thiopurine methyltransferase (TPMT) activity when starting azathioprine
Background and Aims:
Inflammatory Bowel Disease (IBD) impacts the individuals’ quality of life and affects all family members considerably. Previous reviews have focused on the impact of IBD on the patient, with limited exploration of the impact of IBD on family members. Therefore, this review aims to synthesise existing knowledge on the impact of IBD on family members, their coping strategies, the support needed, and interventions for family members to prevent and alleviate the burden of IBD.Methods
A systematic review using the mixed-method systematic review approach suggested by Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews (PRISMA) was undertaken. A systematic search of six bibliographic databases: MEDLINE, EMBASE, PsycINFO, CINAHL, British Nursing Index, and Web of Science, was performed in February 2021. The search focused on the impact of IBD on family members and coping strategies and interventions for this population. A narrative synthesis was conducted.
In total, 3,258 records were identified, from which 33 relevant papers (2,748 participants) were included in the review, with case-control, cross-sectional, and qualitative designs. Synthesis of these papers found three themes: the impact of IBD on family members; the coping strategies for family members to overcome the negative impact of IBD; and the support needed. The IBD affects the family members in term of emotional well-being, fear and concern, relationship and social life, work and financial impacts, and leisure time and travelling. The coping strategy theme shows that family members use adaptive coping patterns such as acceptance, resilience, and emotional support from others. Maladaptive coping patterns such as denial following the initial relief of diagnosis, self-distraction, and self-blame were also used. In the theme ‘support needed’, family members reported the need for improved information about IBD, social support groups, self-help groups, educational meetings, and providing easy access to a counsellor or psychologist to support family members. There have been no studies assessing outcomes of interventions to relieve family members’ burden in the IBD population.Conclusion
Our findings suggest that policymakers in healthcare services should emphasise the multidisciplinary professional care model such as a family therapist, IBD nurse, and psychologist. Researchers could incorporate a bio-psycho-social approach into their work on IBD to improve quality of life of both patients and their family members.
Psychological difficulties are common in people with IBD. In this session I will present the biopsychosocial model of health and discuss how it is involved in the development, maintenance and treatment of IBD. I will discuss how the MDT can support with psychosocial components and why it’s important and briefly discuss the evidence around psychological therapy in IBD.