Patients with inflammatory bowel disease (IBD) often face complex health challenges, requiring coordinated efforts for effective health maintenance. Despite significant advances in IBD management, studies show that patients with IBD are less likely to receive preventive care services, such as immunizations and cancer screenings, compared to the general population.
Effective collaboration between PCPs and gastroenterologists ensures patients receive comprehensive care, reducing risks of complications.
Key Areas of Health Maintenance for IBD Patients
1. Immunizations: Patients with IBD, especially those on immunosuppressive therapies, are at increased risk of infections such as influenza, pneumonia, and herpes zoster. Annual non-live influenza vaccination is recommended for all individuals. Guidelines also recommend pneumococcal vaccination for all patients with IBD. With the introduction of the newer pneumococcal conjugate vaccine, Prevnar 20 (PCV20), a single dose is sufficient, simplifying protection against pneumococcal disease. Finally, the recombinant zoster vaccine (Shingrix) is advised for individuals aged 50 and older, as well as younger patients on immunosuppression.
2. Cancer Screening: Patients with colonic involvement of their IBD face an elevated risk of colorectal cancer. Screening with colonoscopy should begin 8-10 years after diagnosis and performed more frequently than in individuals without IBD. Patients on immunosuppressants also have increased risks for cervical dysplasia and skin cancers, necessitating regular screenings and preventive measures like vaccination for HPV in age-appropriate individuals, and the use of sun-protective clothing and sunscreen with SPF 30 or higher and UVA/UVB protection.
3. Bone Health and Nutrition: Osteoporosis, vitamin D deficiency, and malnutrition are common concerns in IBD patients. Screening for osteoporosis with DEXA should be performed for individuals with the following risk factors: corticosteroid use for more than 3 months, inactive disease but past chronic corticosteroid use of at least 1 year within the past 2 years, inactive disease but maternal history of osteoporosis, inactive disease but malnourished or very thin, inactive disease but amenorrheic, and post-menopausal persons, regardless of disease status.
4. Mental Health and Lifestyle: The chronic nature of IBD increases the prevalence of anxiety and depression. Routine mental health screenings and smoking cessation support are integral parts of care.
A Call for Collaboration
Our team at The Oregon Clinic Gastroenterology is committed to partnering with PCPs to provide comprehensive care for patients with IBD. By referring your patients with IBD to our clinic, you can ensure they receive the latest in diagnostic and therapeutic advancements while we collaborate with you on preventive health strategies specific to the individual patient. Together, we can enhance outcomes and quality of life for individuals living with IBD.
