Photo Credit: Marco Marca

Physician’s Weekly has compiled a collection of expert insights on inflammatory bowel disease, focusing on cancer rates and the use of a more holistic approach.

Recent research in inflammatory bowel disease (IBD) has focused on cancer rates in this patient population and a more holistic view of patients with both Crohn’s disease and ulcerative colitis, the two conditions that fall under the umbrella of IBD. Below is a sampling of what your peers have had to say on these topics.

A Broader View on IBD: Pain, Gut-Brain Interactions, & More

“In a patient with Crohn’s disease presenting with a bowel obstruction, we’re already concerned about content’s inability to pass by the intestinal tract due to mechanical obstruction. The patient or healthcare team may desire opioids to alleviate pain, but those opioids can also exacerbate pain because they can worsen the gut’s inability to function. In that sense, opioids can worsen the situation they’re intended to treat.” — Gil Melmed, MD

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“Our study detected associations between fatigue symptoms and regional [gray matter volume (GMV)] in the left precentral gyrus, right fusiform gyrus, and right lingual gyrus. If a contribution of structural abnormalities in the precentral gyrus, which may also affect regional brain function, is confirmed in the pathogenesis of [Crohn’s disease]-related fatigue, noninvasive brain stimulation such as transcranial magnetic stimulation may represent a promising and novel therapeutic approach to target fatigue in [inflammatory bowel disease].” — R. Christian Wolf, MD, and colleagues

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“Our data support the recommendation that the implementation of a clinical pharmacist in the [multidisciplinary team] of a tertiary care center is an appropriate intervention to substantially improve the comprehensive management of patients with IBD under anti-TNF therapy.” — Johannes Plechschmidt, PhD, and colleagues

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Cancer Rates Among Patients With IBD

“Overall, while the higher risks for intestinal cancers among those with IBD have been persistent since the early 1990s, the risks for extra-intestinal digestive cancers, collectively, have shifted from being lower among those with IBD in the 1990s to being higher among those with IBD in the 2010s. Gastroenterologists who treat IBD will need to exercise increased vigilance in screening and preventing small bowel, liver, bile duct, and pancreatic cancers.” — Sanjay K. Murthy, MD, MSc (Epid)

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“Patients with IBD represent a distinct and important population among patients with colon cancer. There can be more challenges with treatment, including compounding toxicity with cancer-directed therapy, managing advanced medical therapy during treatment, and dealing with sequelae of more extensive surgical resection.” — Lindsay M. Hannan, MD, MSc

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