Crohn’s disease affects more than 700,000 people in the United States and causes extreme inflammation of the digestive tract, leading to overwhelming pain from an immune system that essentially “attacks itself.” Yet on first glance, it’s almost impossible to tell when meeting a Crohn’s patient and the disease is thus referred to as an “invisible illness.”
This fact makes raising awareness much more difficult as many patients go through their daily lives, quietly struggling with the disease. To get a further understanding of how Crohn’s disease truly affects patients, and what others can do to help, I spoke with Gastroenterologist Dr. Shannon Chang from the NYU IBD center:
How does the process of digestion look different for patients with IBD? Digestion may be different for patients with IBD who have inflammation in their small intestines. Most of our nutrients are absorbed in the small intestines, and if parts of the intestines are not functioning optimally, certain nutrients may not be well absorbed by the body. This may result in more stomach pain for some patients. Other patients with IBD have bowel blockages called strictures that make it more difficult to digest fibrous foods.
What treatments are available to mitigate this pain? Treatments have improved in the last decade. There are many different types of mechanisms of action (ways to decrease inflammation) now to help treat IBD. Not every person responds to the same type of treatment for inflammation and thus it is helpful to have different treatments for each person. In addition to the biologic therapies, we now also have a new type of treatment called small molecules. Some of the most common treatments include medications such as infliximab, adalimumab, vedolizumab, ustekinumab, ozanimod, and tofacitinib. Aside from having multiple different types of treatments now, treatments have improved as we understand better how to dose our medications to keep patients responding to treatment and also to increase the chances of helping a patient respond to treatment.
Have there been any particularly inspiring cases you’ve seen? My patients inspire me every single day. During the beginning of the COVID pandemic, I was amazed by how resilient and brave my patients were continuing their immunosuppressive medications in the setting of such uncertainty. We now know that our medications are safe and do not increase the risk of severe COVID, but we did not know that back then.
What can others do to help? Great question. Friends, family, coworkers, teachers should try to learn more about what it means for a patient to have IBD. This disease can affect not only a person's body but also can increase the risk of anxiety, depression, difficulty with school, work, and social engagements. Try not to give too much advice or to put pressure on someone with IBD to eat a specific diet or to take unproven supplements. Support science and clinical trials to improve breakthroughs in care.