Discover and read the best of Twitter Threads about #IBD

Most recents (24)

Why does smoking have a protective effect in Ulcerative Colitis (UC) and a deleterious effect in Crohn Disease (CD)?

Generally speaking: Which CD4+ T-cells are the drivers for UC and CD?
#tweetorial #MedEd #MedTwitter #IBD
UC & CD have some shared cytokine changes relative to a healthy state, yet, each has its own unique cytokine milieu. There is much more to learn about UC and CD before fully understanding the implications of this, but it will generally help to start with what we know:
UC & CD both exhibit elevated levels of: IL-12, IL-18, IL-21, and IL-27 as compared to control (1)
Read 14 tweets
Recently members of the #IBD community have been slandered for not trying “everything” to cure their disease. Reminder: there is no cure for IBD, but we are working on it.

What was the purported “cure” you ask? A #carnivore diet. Let’s examine ... 1/
A carnivore diet, aka zero carb diet, is devoid of all foods except animal meat, fish, eggs, +/- lactose-free dairy. 2/
Despite the lack of supporting studies, proponents claim it to be a panacea, saying it cures diabetes, depression, helps weight loss and libido... the list goes on. This is all supported by testimony and conviction (highly biased), & not based on objective scientific evidence. 3/
Read 15 tweets
1/ Today is World #IBD Day. Here is my #CrohnsDisease story: When considering my post for today I've been reflecting on why awareness days are important and with that I began to think about the history of IBD: how patients were treated in the past, what
2/ treatment options were available... So much has changed and it is all because of people sharing their stories, the hard work and dedication of our GIs and other clinicians, and the money and support that came from advocacy which led to where we are today. It wasn't that
3/ long ago that patients were being blamed for their IBD. It was thought that they had a "mother fixation," marital problems, and so on. A disease of the psyche. Patients were taken away from their families and isolated and went through unimaginable things. Lobotomies were
Read 16 tweets
This Saturday, May 2nd, will be a little sad for me. I (and about 13,000 of my GI friends) would have been in Chicago for @DDWMeeting. That won't happen. So I decided (with a few friends) to have a get-together. A #TotallyUnofficial "Poster Rounds".
In a webinar format over 1 hour, at 3PM EDT, noon PDT, 8 PM UK time, 9 PM CET, with informal presentations and discussion of 4 posters. We will have two posters that would have been presented at the meeting, and two "late breakers"/works in progress.
Our new IMIBD section vice chair, Fernando Velayos @Realcecum and I will host. @charlie_lees will lead off with a presentation of his new study of #IBD telemedicine across countries, a topic we have all had to become familiar with very rapidly in the Time of #COVID19
Read 8 tweets
My first piece on #multiomics #IBD as part of my thesis is out as a preprint!

I'll summarize it on this thread…
First, we check how the many parameters of RGCCA #rstats influence and work in their original dataset. We check that different designs select different variables, we discard the superblock design.

2/x ImageImageImage
Then we look our own dataset of #IBD samples undergoing a treatment and some controls. We use a method to find good models of the data. The method is available as #rstats package, with its own #pkgdown website
3/x Image
Read 9 tweets
I've created a thread that summarizes the statements from the #IOIBD global expert panel about management of #IBD during #COVID19. This is because the meeting summary of _appropriateness_ statements is being a bit misunderstood.…
Read on ⬇️⬇️
First, a disclaimer! The statements by this expert panel are not meant to replace conversations between a patient and their healthcare providers, nor are they set in stone. As we learn more, there will be modifications provided.
▶️IOIBD is holding weekly calls about #COVID19.
A RAND panel is a formal assessment of specific given statements when decision making is complex and data are limited.
The #IOIBD panel included 66 #IBD experts from 26 countries who voted on the "appropriateness" of specific statements using a 9 point scale. Example ⬇️
Read 21 tweets
@IbdClub presents collections of #COVID19 related #IBD articles. #ibdclub. Tag @IbdClub so we can compile these articles and update here.
1. Inflammatory Bowel Disease Care in the COVID-19 Pandemic Era: The Humanitas, Milan, Experience.
Viewpoint on how operationally to manage IBD patients and ensure quality of care in the current pandemic era.#ibdclub…
2-Management of IBD during the COVID-19 outbreak: resetting clinical priorities. Changes & clinical issues IBD specialists could face during SARSCoV2 pan, highlighting potential rearrangements of care &resetting of clinical priorities @NatRevGastroHep…
Read 46 tweets
Exponential increase in cases in US and in the 🌍 since our last IBD live.
Recent @CDCgov prelim US data as of 03/16: 45% of hospitalizations, 53% of ICU admissions and 80% deaths among patients >65yo 2/
As prev. discussed, studies show SARS-CoV-2 can be found in the stool of patients with #COVID19. This more recent study shows stool tests stay + for a mean or 11 days after resp samples have become neg. 1 stayed + up to 47 days after symptom onset! 3/
Read 13 tweets
1/ Excellent update on #COVID19 by @SaraElOualiMD @ibdlive

🔺Despite the rumors-There is NO current treatment for COVID9 - trials on going

🔺#SocialDistancing needed to prevent /delay transmission & #FlattenTheCurve = Not be sick & go to the hospital when it’s beyond capacity
2/ #COVID19 @SaraElOualiMD @ibdlive
Beyond URI #COVID19 can
🔺Cause GI symptoms 50% pts
• ⬆️ w dis severity
•Can preceed fever/URI
🔺Persist in stool up to 47days
•Implications to #GI endoscopy
•?Implication using public BR
🔺Cause Loss of taste/smell
🔺Cause conjunctivitis
3/ #COVID19 @SaraElOualiMD @ibdlive @MRegueiroMD

Older pts are at higher risk of complications & death

BUT young ppl (20-44) are severely affected too:

🔺20% of hospitalized
🔺12% of those in ICU
🔺Up to 20% of death

#SocialDistancing is for everyone! #WereInThisTogether
Read 4 tweets
Due to the high volume of #COVID19 #IBD patients @nyulangone , we developed a management protocol that incorporates #COVID19 severity, risk factors, and #IBD activity. We recognize this is a challenging time and we look forward to further guidance and input into our protocol.
We look forward to input and we are aware #Hydroxychloroquine is becoming increasingly difficult to find in #NYC pharmacies #IBD
Read 5 tweets
🗣Not having a colon doesn’t change immune suppression.

❌These ideas do not correlate until another ingredient is added. Stop spreading this myth!
#ostomy #jpouch #colectomy
More info from @SchwartzbergMD expressing ❌connection (unless underlying conditions/meds) between *just* colectomy and immune suppression. 👇🏽
Here’s more information about susceptibility & #ostomy/#Jpouch from @HolubarStefan. Ostomates (or jpouchers) don’t have a lower immune system *just* because they have an ostomy, BUT it’s imperative to keep strict hygiene. #IPAA
Read 14 tweets
Update 15 March #COVID19 and #IBD. Due to the active communication of colleagues around the globe, we are now aware of several worldwide cases of #COVID19 in patients who have IBD, including one child.
Reports that the #IBD adults are in Italy, Austria and US (NJ), the child is in Madrid, Spain.
The child has #Crohns receives Humira + 6MP. She presented with fever and cough, was not hospitalized, and is doing well.
I do not have more details on the adults yet. #COVID19
It was expected that we would see #COVID19 affect our patients with #IBD, as it is affecting the general population too, and it is great that we have systems in place to capture and to learn from these cases in real time. The international collaboration is extraordinary.
Read 5 tweets
Today, our IBDLIVE program focused on #COVID19, with >25sites & >200 participants from across the 🇺🇸Great discussion on how it impacts our patients w/ #IBD. @MRegueiroMD @ConorDelaneyMD @IBD_FloMD @BenClickMD @tqaziMD @ScottRSteeleMD @drtracyhull @HolubarStefan @AmyLightnerMD
Here is a #tweetorial with selected slides from the presentation
Although the main mode of transmission seems to be through droplets, #SARSCoV2 can be found in stool and in gastrointestinal glandular epithelial cells, raising the possibility of fecal-oral transmission 2/
Here are outcomes among inpatients with #COVID19 based on available data. Mortality rates are higher in older patients and in patients with comorbidities
Read 10 tweets
Brief update on #COVID19 for inflammatory bowel disease (#IBD) patients as of 9 March 2020.
See the updated #IOIBD COVID19 recommendations on the website.
The #IOIBD site now includes this statement: "It is prudent that IBD patients on immunosuppressants and/or biologics limit unnecessary travel and large gatherings." (and spells out these therapies) However, please know that we still recommend staying on treatment. Read on. 🔽
In a global email exchange among #IBD experts over the last few days, the consistent recommendation is to stay on therapy for IBD, recognizing that IBD relapse or needing steroids is higher risk for the patient. There are similar recommendations from rheumatology experts.
Read 6 tweets
A Tweetorial on #coronavirus (and #IBD):
Coronaviruses are a family of viruses that can cause illness from the common cold to more severe diseases. The novel strain of #coronavirus named #SARSCoV2 was first detected in Wuhan, China and causes coronavirus disease #COVID19. 1/
How is #coronavirus transmitted?
Via respiratory droplets produced when an infected person sneezes or coughs and can infect people in close contact (within 6 feet). Touching contaminated surfaces before touching your eyes/nose/mouth might also lead to infection. 2/
How does #COVID19 compare with seasonal #influenza?
Both are infectious respiratory illnesses that present with symptoms such as fever, cough, and shortness of breath. Both can lead to serious illness especially in older people and those with prior medical conditions. 3/
Read 9 tweets
Questions today about the risk of coronavirus nCoV-19 in #IBD patients on immunosuppressive therapies. We don't know a lot, as this is quite new. The most up-to-date information can be found at the CDC website…
It appears to be spread by respiratory droplets, generally when you inhale droplets from a cough or sneeze from a nearby person (usually within 6 feet). Do #IBD patients have increased risk for this respiratory virus?
By analogy to influenza, another respiratory virus spread by droplets that we know more about, #IBD patients have about a 50% increased risk of influenza. This risk goes up by about 20% more if you are on steroids.
Read 8 tweets
A New Year, New Therapies! An #IBD #medtwitter #tweetorial

As a late ring into the New Year, let’s explore Novel #IBD Agents coming to practice!

Our Aims:
1️⃣ Understand the Nomenclature
2️⃣ Revise Currently Available Drugs
3️⃣ Discuss Mechanisms & Adverse Events of Novel Agents
First, do we even know what are we treating ⁉️

Studies 🔬 within each one of these four key elements have unveiled pathways involved in #IBD pathogenesis.

Some of which are amendable for potential therapeutic intervention…
In summary...

It takes a genetically susceptible host 🧬 to be exposed to a specific environmental agent 🦠 that, through a weakened intestinal barrier ⚔️, will lead to an exaggerated Immune activation🔥, responsible for the phenotypes we see in clinical practice!
Read 25 tweets
Here's my latest* update to my vetted collection of Twitter Disability and Chronic Illness hashtags. Please share it!

Thank you :-) Graffiti background. Foreground in black letters on a  white background to the left reads “Twitter Disability and Chronic Illness Hashtags”<br />
This collection is current as of 01.30.20, previous Twitter update 09.11.19.

There's a PDF version coming up this weekend, to be posted to my Kofi profile. I'll add the link toward the end when it goes up, after the questions, where you can also sign up for email updates.
This version has added

- community suggestions,
- mental health hashtags,
- Medical crowdfunding hashtags,
- and a section for cancer-related hashtags.
Read 84 tweets
Please help! I have a brain tumor/IIH & such severe intestinal damage that I can't DIGEST food w/out enteral food RX @$198/mo, even w/pharma discount.
My now 78-year-old mom is my caregiver.
We get $72/mo for food + trying to save home. 😭
#Lyme #IBD #help
In 2011, I was bitten by a tick. I wasn't treated for 11 mos, despite traveling to the MAYO clinic (which I still owe $9000!)
I contracted E. Chaffeensis, Rickettsia, & #Lyme.
By then, the bacteria had invaded spinal cord & brain. I've had 8 spinal taps to alleviate the pain. 😪
During 1 of my many hospitalizations, I caught Vanc-resistant C. Difficile. I fought it for 3.5 yrs but had to have 2 FM transplants to save my intestines & life.
Now, bc of the damage to my intestines, I can't digest/ absorb food w/out RX
@ $198/mo, even w/a manuf. discount. 💔
Read 10 tweets
The UCP does NOT understand how devastating removing brand name biologics from the list of covered drugs could be. Let me…
Biological drugs are very expensive. They are genetically engineered antibodies that target specific molecules in our bodies that contribute to a disease process (like cancer, inflammation). They do not always just block the molecule from engaging it’s receptor.
Sometimes they have other actions (like inducing apoptosis/cell death) or activating receptors, or signaling other cells to eat the molecule/cell that the antibody binds to. That means that depending on how the antibody was originally designed, the therapeutic effect is different
Read 10 tweets
@EricTopol serves up a treasure trove of data and links to credible scientific research reports that are MUST READ
re: the current sad state of American physicians

🙏Why Doctors Should Organize…
#PatientCare #Healthcare
@drjudymelinek @choo_ek
Doctor-patient relationship is crucial and I wonder if a patient is aware of the hospital’s policy (not the doctor) for a visit time allotment (in minutes).

Building More Trust Between Doctors and Patients… @HarvardBiz #empathy #trust #PatientCare #IBD
“Administrative tasks have become so burdensome ....only thirteen per cent (13%) of a physician’s day, on average, is spent on doctor-patient interaction” Dr. Topol… #PatientCare #AI #Health #Healthcare #IBD #IBS #Hospital #Corpgov #Safety #MedEd #Doctors
Read 10 tweets
I have a brain tumor/IIH & such severe intestinal damage that I can't digest food w/out enteral food RX.
It's $198/mo even w/a pharma scholarship.
My now 77-year-old mom is my caregiver & she can't afford it.
We get $64/mo for food + trying to save home. Please help!
In 2011, I was bitten by a tick. I contracted E. Chaffeensis, Rickettsia, & Lyme. I wasn't treated for 11 mos. The bacteria went to my spinal cord/brain.
Please help us 💔
#Lyme #IBD #Fibromyalgia #Spoonies
During 1 of my numerous hospitalizations, I caught Vanc-resistant C. Difficile for 3.5 yrs & had to have 2 FM transplants.
I can't digest/ absorb food w/out EnteraGam.
It's norm. $1600/mo but I get a pharma discount, making it $198/mo. My 77-year-old mom still can't afford it.
Read 8 tweets
I was bitten by a #tick in 2011 & it's turned my worle upside down!
I was a practicing trial atty & am now on a walker.
I contracted E. Chaffeensis, Rickettsia of unknown et., & #Lyme.
I wasn't treated for 11 mos. By then, the tick bacteria had invaded my spinal fluid/brain.
Read 12 tweets
76 yr old Mom needs help…
Please help us! 😭
Can't afford next mos.' RX @$198/mo necessary to digest/absorb food.
My now 77-year-old Mom is my caregiver. We get $64/mo for food (long gone) + trying to save home.
#Lyme #SaveOurCare
Even $5 or $10 will help + RTs are free. 🙏
I was bitten by a #tick in 2011 & it utterly destroyed my life.
I contracted E. Chaffeensis, Rickettsia, & what was later found to be #Lyme.
I wasn't treated for 11 mos. By then, the bacteria had invaded my spinal cord + brain.
#LymeDisease #healthcare #tick #foodstamps
Read 16 tweets

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