Podcast
Questions and Answers
What is one of the main goals of pharmacologic therapy for inflammatory bowel disease (IBD)?
What is one of the main goals of pharmacologic therapy for inflammatory bowel disease (IBD)?
- To improve the taste of food
- To reduce the incidence of relapse (correct)
- To cure the disease completely
- To enhance digestive efficiency
Corticosteroids are used to treat chronic intestinal inflammation only during acute attacks.
Corticosteroids are used to treat chronic intestinal inflammation only during acute attacks.
False (B)
What type of drugs may be prescribed to slow GI motility in IBD patients?
What type of drugs may be prescribed to slow GI motility in IBD patients?
Antidiarrheal agents
Drugs used to treat IBD include _______ acid derivatives, corticosteroids, biologic therapies, and Janus-associated kinase inhibitors.
Drugs used to treat IBD include _______ acid derivatives, corticosteroids, biologic therapies, and Janus-associated kinase inhibitors.
What route of administration is NOT used to deliver drug therapy for IBD?
What route of administration is NOT used to deliver drug therapy for IBD?
Match the drug categories with their purposes:
Match the drug categories with their purposes:
Patients with IBD should stop drug therapy immediately once they become asymptomatic.
Patients with IBD should stop drug therapy immediately once they become asymptomatic.
What should patients undergoing immunosuppressive treatment for IBD avoid?
What should patients undergoing immunosuppressive treatment for IBD avoid?
What is one potential benefit of an elemental diet like Ensure for patients with Crohn disease?
What is one potential benefit of an elemental diet like Ensure for patients with Crohn disease?
Increased dietary fiber is beneficial for all patients with Crohn disease.
Increased dietary fiber is beneficial for all patients with Crohn disease.
What is the role of a nutritionist in the management of patients with Crohn disease?
What is the role of a nutritionist in the management of patients with Crohn disease?
Patients with IBD often seek _____ therapies due to the chronic nature of their condition.
Patients with IBD often seek _____ therapies due to the chronic nature of their condition.
Match the following self-care measures with their benefits:
Match the following self-care measures with their benefits:
During an acute exacerbation of Crohn disease, what is one method of nutritional support?
During an acute exacerbation of Crohn disease, what is one method of nutritional support?
Probiotics have conclusively demonstrated benefits for all patients with IBS.
Probiotics have conclusively demonstrated benefits for all patients with IBS.
What are some common issues faced by patients with IBD that may affect their quality of life?
What are some common issues faced by patients with IBD that may affect their quality of life?
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Study Notes
Inflammatory Bowel Disease Treatment Goals
- Treat acute inflammation as quickly as possible
- Reduce the likelihood of relapses
- Manage chronic intestinal inflammation
Drug Therapy Administration Routes for IBD
- Oral: Systemic action
- Subcutaneous: Systemic action
- Intravenous: Systemic action
- Oral Time-release: Local action in ileum and upper colon
- Rectal: Local action to reduce inflammation
Drug Categories for IBD
- 5-Aminosalicylic Acid Derivatives: Not discussed in detail
- Corticosteroids: Used for acute exacerbations to reduce inflammation and induce remission
- Biologic Therapies: Three categories (not specified)
- Janus-associated Kinase (JAK) Inhibitors: Not discussed in detail
Corticosteroid Therapy
- Often used for acute exacerbations
- Can be challenging to withdraw from without experiencing relapse
- Long-term low-dose therapy may be necessary
Antibiotic or Antiprotozoal Therapy
- Used in cases of intestinal abscesses or fistulas
- May be part of treatment due to link between IBD and pathogenic bacteria
Antidiarrheal Agents
- Used for chronic diarrhea associated with IBD
- Examples include loperamide (Imodium) and diphenoxylate (Lomotil)
- Safe for mild, chronic manifestations but not during acute attacks
Drug Therapy Considerations
- Continue medication even when asymptomatic
- Immunosuppressant medications increase risk of exposure to infectious diseases
- Report any disease symptoms or fevers to healthcare providers
- Inform healthcare providers about IBD treatment when receiving treatment for other medical conditions
- May need to adjust immunization schedules for pediatric patients on immunosuppressants
Dietary Management
- Individualized approach due to potential immune response stimulation
- Some patients benefit from eliminating milk and milk products
- Increased fiber can help reduce diarrhea and rectal symptoms, but contraindicated in intestinal strictures
- Collaboration with a nutritionist is recommended to ensure adequate micronutrient intake, calories, and protein
Bowel Rest During Exacerbation
- Withholding food can promote bowel rest during acute Crohn disease exacerbations
- Nutritional support through enteral or total parenteral nutrition (TPN)
- TPN associated with higher complication risk compared to enteral nutrition
- Elemental diets like Ensure can be prescribed to provide essential nutrients
- Elemental diets may not always be palatable
Complementary Health Approaches
- Probiotics: Some preliminary evidence suggests potential benefit for IBS, but not conclusive and not all probiotics have the same effects
- Alternative therapies: Lack of research limits conventional practitioner use, especially herbal supplements
- Interactions with prescribed medications are possible, so patients should discuss all potential therapies with healthcare providers
Quality of Life Improvement
- May be impacted by stress levels, depression, and fatigue
- Mindfulness training, cognitive-behavioral therapy, and stress management can help
- Self-care measures like exercise, abdominal massage, and warm baths can manage discomfort
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