Considering patient lifestyle, preferences in IBD treatment plans

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When a patient has a new diagnosis of ulcerative colitis or Crohn's disease, I like to think of the whole person. So, I like to think of lifestyle, effectiveness of the therapy we're choosing, safety, and then adherence. I think it's very important for the patient to understand that this is going to be generally a long-term treatment to control the inflammation. Generally, the treatments we have are not curative. I want the medicine to work for them so that they can take it and feel better and get back to the life that they once lived. So, when I'm discussing treatment options, the IBD treatment landscape has expanded significantly. And so, the patient’s lifestyle and preference play a huge role for me. So, if I have a patient that travels a lot, going to an infusion center isn't really going to work for them. If I have a patient that prefers an injection or prefers a pill form, I try to see if we have options that will work for their disease severity and fit their lifestyle.

This is an excellent question and a question that patients ask me all the time. When I'm looking for inflammatory bowel disease, we're looking for chronic inflammation in the colon or in the small intestine. When we're looking at the differences in diagnosis, we're looking at where does the disease and inflammation affect the GI tract. Ulcerative colitis is generally limited to the colon, and Crohn's disease can affect anywhere from mouth to anus, And Crohn's disease differs from UC because it is a transmural inflammation, which means it involves the entire wall of the GI tract instead of a superficial inflammation, and that can lead to complications we see in Crohn's disease like perforations, strictures, or fistulas.