Page 61 - Harnett Life Winter 2020

your provider alone; you need to be an active partner in the In addition to medical treatments and procedures, patients
goal-setting discussion. Providing clarity to your health care should practice self-care and seek help from mental health pro-
professionals regarding personal preferences and your short- fessionals when necessary. IBD patients are at greater risk for
and long-term goals like a desire to get pregnant, to travel, to anxiety and depression than the general public, according to
decrease stress and anxiety, gain self-care skills or to return to research published in “Alimentary Pharmacology & Therapeu-
school can keep the entire team on the same page. tics,” so it’s important to address these issues when they arise.
Simple strategies to tackle IBD one day at a time include plan-
Make Decisions Together by Acting as an Effective Partner ning the night before for the day ahead, allowing yourself extra
time in the morning and scheduling time in your day for rest.
Asking questions is the first step toward creating an effective To relieve stress and anxiety, consider low-impact exercises,
partnership with your health care team. You can start by seek- such as yoga, walking, biking or swimming, techniques like
ing an understanding of which diagnostic tests are important meditation and mindfulness or diaphragmatic breathing, also
for you to undergo. Decide together which steps should be tak- known as deep breathing or belly breathing. These comple-
en now and which you should aim for in the future. Be willing mentary therapies can help improve your mental health and
to learn each part of the process, including treatment options, emotional well-being.
potential risks and benefits.
Along with your own self-care, it’s important to be willing to
It may take some time before you see any progress made to- admit when you need help. For some, this may include reach-
ward achieving your goal. Certain treatments may take some ing out to a mental health professional. A therapist, such as a
time to work. Review any external factors that may impact the clinical psychologist or licensed social worker can help you
effectiveness of your treatment. Talk to your doctor about ad- work through sadness, uncertainty and anxiety – emotions
justing treatments and consider changing your targets if avail- common for many patients with IBD. Visits may be short-term
able treatments are not helping you reach your goals. or can be longer, if needed. Effective therapy allows patients
to practice the coping strategies learned between visits. Men-
Find more advice for effectively partnering with your physi- tal health therapists may also provide assignments to reinforce
cian to manage IBD at crohnscolitisfoundation.org. what is discussed during visits. Build your support system and
seek guidance from mental health professionals if you ever feel
Practice Self-Care as though the burden of your diagnosis is too heavy to carry
alone.

A More Targeted Approach to IBD Care

In the past, health care providers managing inflammatory bowel on the disease activity and severity, patient’s genetic makeup
disease (IBD) patients focused on how their patients were feel- and anticipated risk.
ing in the moment. They worked toward fixing active symptoms
and tailored treatment plans specifically to address those symp- It’s a more proactive approach than the traditional reactive treat-
toms. ment style as it emphasizes the importance of looking toward
the future to avoid complications of the disease and minimize
Today, providers are moving toward tailoring treatment to ad- risks.
dress individual patient needs and helping them achieve remis-
sion. This approach, known as “treat-to-target,” works to im- To achieve a patient’s goals, a provider regularly checks to make
prove IBD care and outcomes by encouraging patients to partner sure the patient is responding to the strategy at certain intervals.
with their health care teams to identify specific treatment goals Both diagnostic and prognostic, or predictive, tests help phy-
and monitor progress toward those goals. sicians assess progress against a target. Common tests include
endoscopic procedures, radiologic scans and diagnostic and pre-
While clinical remission (absence of symptoms) is one level of dictive biomarkers.
success in managing IBD, the treat-to-target approach is geared
toward achieving mucosal healing, when no active inflammation If tests do not demonstrate sufficient improvement, additional
is seen during a colonoscopy, and histologic remission, when evaluation or treatment adjustments may be advised to provide
there is no active inflammation seen at the tissue level. Achiev- the right drug to the right patient at the right time for treatments
ing these levels of mucosal healing or histologic remission gen- tailored to the individual.
erally results in a lower risk of flares, fewer surgeries, lower
reliance on steroids and reduced hospitalizations. Goals depend on multiple factors and variables, but the antici-
pated outcome is an improved quality of life for patients manag-
Providers adopting the treat-to-target method are likely to work ing IBD. Under the treat-to-target method, goals are a mutual
with their patients to consider the risk of developing complica- decision between the doctor and patient. Goals must be measur-
tions in the future and tailor treatment recommendations based able and include a realistic treatment plan.