ImproveCareNow Resources
ImproveCareNow Recognized by Healthline as Crohn’s Disease Resource
ImproveCareNow was recently included on a Healthline resource page to help direct people seeking help or information about Crohn’s disease.
PAC Body Image Toolkit
Body image is a topic that Inflammatory Bowel Disease patients don’t often talk about due to the embarrassment and fear associated with opening up about their experiences with their Crohn’s disease or ulcerative colitis.
It can be incredibly frustrating to feel like you have no control over how your body works or looks, especially given all the messages we receive from the media about how a body ‘should’ look and behave. We wanted to create the Body Image Toolkit as a way to express our experiences, provide tips, and start conversations about body image & IBD. It’s important to know that we’re not alone in our feelings, and that there are so many people who understand what we’re going through!
PAC Travel Toolkit
Traveling with IBD, whether it be inside or outside the country, isn’t always easy. However, the PAC has created a new tool to answer questions, share experiences, and hopefully help ease some of the stress of traveling with IBD! Initially, we planned to offer information for patients wanting to study abroad. After giving this idea some more thought, PAC members decided a toolkit with general information about traveling is more relatable and would help more people. Thus, the Travel Toolkit was born!
PAC IBD Storybook - Coming Soon
ImproveCareNow members are first to receive new, co-produced tools, toolkits and guides – like Finding a Mental Health Provider for Your Child and Teen with IBD, which was co-produced by the Psychosocial Professionals group and members of the ImproveCareNow Community.
We will be releasing a new tool very soon! Join now and be the first to see the Crohn’s & Colitis Storybook.
Enteral Therapy as a treatment for Crohn's disease
[Editor's note: This article was originally published in CIRCLE May-June 2013]
Enteral therapy refers to providing nutrition as a formula rather than by eating a regular diet. Enteral therapy has been shown to be effective in inducing, and perhaps maintaining, remission for pediatric patients with Crohn's disease. Enteral therapy does not have the side effects seen with drug treatment, and can improve growth, unlike corticosteroids, which have many known side effects. Although used very little in the United States, enteral therapy is commonly used abroad, including many European countries and Japan.
Over the years, several methods of administering enteral therapy have been evaluated, leading to variation in treatment. In 2012, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) formed the Enteral Nutrition Working Group to review the use of enteral nutrition therapy in pediatric Crohn's disease, which summarized previous research and offered recommendations for physicians.
Historically, enteral therapy was given through a feeding tube, and this is still done at many centers. However, drinking the formula is also an effective option. Studies have used both specialized nutrition formulas (in which the protein has been broken down to into smaller pieces) and non-prescription over-the-counter formulas (in which protein is not broken down). Both approaches appear to be equally effective, an important finding since over-the-counter formulas taste better and are less expensive.
The majority of the research has shown that enteral therapy is effective when taken as the sole source of nutrition (that means the patient can't eat any food), and this approach was recommended by the NASPGHAN Enteral Nutrition Working Group. However, recently a study published by Children's Hospital of Philadelphia showed that enteral therapy protocol is still effective when a small amount of food (less than 20% of the calories) is taken at the same time.
The way enteral therapy works is unclear. Theories include that it may help to provide the body with important nutrients and better overall nutrition, eliminate an unknown dietary substance that causes an immune response, or alter the bacteria found in the intestines.
A perceived barrier to enteral therapy is that the treatment may be demanding for physicians, families, and patients. For example it may be difficult to start, expensive, create a need for a feeding tube, or be displeasing to patients. Nationwide Children's Hospital is developing and testing a simple enteral therapy protocol which could be started very quickly and could be used at other GI centers. They plan to work with families and patients to reduce the perceived barriers via education on cost issues and payment options, and by developing a mentoring program. If successful, the protocol could significantly decrease the number of newly diagnosed patients with Crohn's disease who are initially treated with corticosteroids. Stay tuned.
Jen Smith, MS, RD, LD, LMT, Clinical Dietitian
Nationwide Children's Hospital, Columbus, Ohio