Posted on 09 Jul 2021
It can be difficult to have all of your questions answered in a short appointment with your Gastroenterologist. Last week, we sat down with Dr Gareth Parkes as he answered commonly asked questions from the IBD community.
Here are some of your most asked questions answered!
Disclaimer: Please remember that you should consult your own GP or Clinical Team before making any changes to your lifestyle, medication or health routine.
Are there any effective medications for moderate to severe Crohn’s that don’t involve suppressing the immune system?
The short answer is: not without a robust level of randomised control trials. There are alternative medications that are anti-inflammatory, but they have not shown to have a benefit for those with moderate to severe Crohn’s. Unfortunately, most of the effects of Crohn’s seem to be translated through your immune system. The only effective way we have of blocking them is through the immune system.
I have been newly diagnosed with Crohn’s and have heard that medications do not help with fatigue, which is something I struggle with the most. Are there any upcoming drugs that will better help with fatigue?
Fatigue can be due to multiple different factors. If you are newly diagnosed, you are most likely experiencing fatigue because your disease is active. If your fatigue is from an active disease or a consequence of that disease activity (for example malnutrition, anemia, vitamin deficiency etc) then there are ways to improve your fatigue. For example, through improving your nutritional status and replacing lost minerals and vitamins, in order to switch off that inflammation.
If your fatigue is chronic and you are not experiencing inflammation, this is a side effect of the disease itself and potentially from your medication and past operations. There are currently programs being funded that are looking into the topic of fatigue and how to work to resolve it for those living with IBD in the future.
If you have IBD are you likely to have issues with arthritis and other inflammatory issues down the line?
You may be more likely than the general public to have issues such as arthritis down the line and it tends to happen in the first few years. However, if you have had IBD for 20-30 years and you haven’t had any joint problems yet, it’s unlikely you will have it in the future.
I’ve had Ulcerative Colitis for 20+ years and it is now impacting my joints. How is research progressing into the parts of IBD that aren’t related to just the colon? I struggle with the other parts of my IBD and my biologics seem to make my joints worse.
These are called extra-intestinal manifestations of IBD. There are 3 key areas that are commonly affected: joints, skin and eyes.
There are biologics that can target both the joint and the gut, however this does not work for everyone. Beyond that, if you have Ulcerative Colitis, there are some drugs that can work for both. If it is driven by your IBD, then your joints should get better. However, if you have two diagnoses, for example IBD and a joint problem, this can be trickier to treat, as even when you treat one, the other may still be active. Your Rheumatologist and Gastroenterologist need to work together to decide which biologic may be the best for you.
Do biologics cause joint pain?
Some biologics can certainly cause some joint issues. However, it is much rarer than biologics causing skin issues, which can be quite common. If this is happening to you, do see a Rheumatologist to get it checked out.
Can biologics cause skin itching and/or hives?
Yes they can. If this is the case, do contact your IBD team. This can happen a lot with medications that you inject yourself, as you can get a slight allergic reaction (almost like a bee sting) to that injection which most likely can be treated with an antihistamine or cream. However, speak with your IBD team to decide on the best course of treatment.
If you are interested in viewing the webinar where Dr Gareth Parkes answers these and more questions ( in depth) please visit the Library in the My IBD Care app and click on Ampersand Health Hub Recordings to view it in full!