Routine Health Maintenance for People With Inflammatory Bowel Disease
Routine health maintenance for people with inflammatory bowel disease (IBD) is very important.
IBD consists of Crohn’s Disease and Ulcerative Colitis, which are chronic inflammatory diseases of the digestive tract. Read more about IBD here.
IBD is thought to be an autoimmune disease. Normally, the body produces a whole bunch of cells and proteins, with various different jobs, including fighting infections and protecting the GI tract from harm. The immune systems of people with IBD react inappropriately to these cells and proteins, mistaking them as foreign invaders rather than helpers. Their bodies then mount a strong reaction to this perceived threat, which can result in damage to the digestive tract, which in turn can lead to symptoms.
Because of this, treatments for IBD often focus on suppressing the immune system. Unfortunately, this can mean that the body’s natural defense against infections is weakened. Because of this, your doctor may recommend that you obtain certain vaccines (like a flu shot or a pneumonia vaccine), or have your blood checked for immunity to certain vaccine-preventable disease (like hepatitis A and B).
You may be wondering why your doctor would recommend these if you aren’t on immunosuppressive therapies (or any medications at all) for IBD. The reason is that IBD is a relapsing and remitting disease, meaning most people have periods of no symptoms at all, called remission, alternating with “flare-ups.” Periods of remission can last anywhere from a few months to a few years, and some lucky people with IBD may never have any flare-ups at all. Unfortunately, it’s impossible to know for sure if and when someone with IBD will flare-up. And so your doctor will likely want to make sure that your body is ready and protected if and when the time comes to give you medications that suppress the immune system. The reason your doctor may not want to wait until then is because some vaccines take a while to work (and you may require more than one shot over several months), and vaccines tend to work better when you are healthy and not having a flare-up.
Your doctor may suggest age-appropriate cancer screening, and screening for colon cancer early and more aggressively if you’ve had colitis. They may also suggest skin exams if you are on certain medications that increase your risk of skin cancer.
Finally, people with IBD can be at increased risk for osteoporosis and osteopenia, so you doctor may suggest checking vitamin D levels and doing bone density testing.
For all of these reasons, if you have IBD, it’s really important to see your doctor regularly, even if you feel fine.
Here’s a checklist I use to make sure I don’t forget anything. Feel free to print this out and bring it with you to your doctor’s appointment, or show your doctor the link.