Canadian Bowel Disease Experts and Patients Develop Five Key Treatment Recommendations

Canadian Bowel Disease Experts and Patients Develop Five Key Treatment Recommendations

Crohn’s and Colitis Canada and the Canadian Association of Gastroenterology have developed a list of five key recommendations that they urge patients with Crohn’s and ulcerative colitis to discuss with their physicians.

The list consists of don’ts — treatments doctors and patients should avoid.

The inflammatory bowel disease (IBD) recommendations deal with tests, treatments and procedures. They stemmed in part from the Choosing Wisely Canada national healthcare campaign, whose main goal was to improve patient-doctor communication.

“It is vital that Crohn’s disease and ulcerative colitis patients feel that they can have informed discussions with their physicians about their care,” Mina Mawani, president and CEO of Crohn’s and Colitis Canada, said in a press release.

“This list provides information and guidance around five key priority areas that patients should be aware of during discussions with their doctors, and they should feel empowered to raise questions if they feel it necessary,” she said.

A group of experts and patients developed the recommendations. The experts included radiologists and members of Crohn’s and Colitis Canada, the Canadian Association of Gastroenterology, and the Canadian Inflammatory Bowel Disease Network for Research and Growth in Quality Improvement.

The committee whittled the original list of 10 recommendations down to what it felt were the five most important. They are:

  1. Don’t use steroids such as prednisone — whose brand names include Deltasone and other labels — for maintenance therapy in IBD.
  2. Don’t use opioid-based therapies for long-term management of IBD abdominal pain.
  3. Don’t continue giving intravenous corticosteroids to patients with severe ulcerative colitis who fail to respond to the treatment.
  4. Don’t start or ramp up long-term medical therapies for IBD on the basis of symptoms only.
  5. Don’t use abdominal computed tomography (CT) scans to evaluate acute IBD unless there is a suspected complication, such as a bowel obstruction, perforation, or abscess.

“Sometimes providing the best IBD care means knowing when to avoid certain tests or treatments,”said Geoffrey Nguyen, a gastroenterologist at Mount Sinai Hospital in Toronto. “And that’s why we started the Choosing Wisely IBD campaign.

“We wanted to provide a list of tests and treatments that health providers and patients should think twice about because they may be ineffective, wasteful, or even harmful. This list empowers our patients to engage in a dialogue with their providers when these tests are ordered for them.”

The complete recommendation list, additional details and supporting information can be found at the Choosing Wisely Canada website.