Discover and read the best of Twitter Threads about #crohns

Most recents (24)

@MondayNightIBD @AaronBlocker_ 1/2 #IBDPoll1️⃣:
📊If you are/were a caregiver for an adolescent/young adult (AYA) with #IBD or are an AYA who transitioned from #PedsGI to adult GI for your #IBD care, how was that transition?

Pls share your #PatientExperience with #MondayNightIBD!!
@MondayNightIBD @AaronBlocker_ 2/2 #IBDPoll2️⃣ #MondayNightIBD

Adolescent & young adults (& caregivers) who transtioned from #PedsGI to adult GI for #IBD care:

🚧 What did you find most difficult in the transition?
#Crohns #UlcerativeColitis
@MondayNightIBD @AaronBlocker_ Just to share my personal story, I found my biggest barrier was navigating the different care coordination style amidst a major life transition that coincided with my #PedsGI to adult GI transition! 1/5
Read 11 tweets
@MondayNightIBD @DCharabaty @abbvie @TakedaPharma @GKochharMD @GauravsyalMD @IBD_FloMD @SaraElOualiMD @BenClickMD @HolubarStefan @SchwartzbergMD @BettenworthDb @SchairerIBDMD @JPAchkarMD 32 w SB #Crohns x15yrs, ICR + jejunal✂️for sympt strictures 3 yrs ago. Presents w SBO, CT: jejunal🔥->IV steroids+ started IFX 10mg/kg.
4mos later: Wt loss, abdo pain, melena. Hgb 6,CRP nl, IFX 10. CT: SBO, jejunal thickening, ⬇️🔥. Not better on IV steroids x48hrs.
What's next?
@MondayNightIBD @DCharabaty @abbvie @TakedaPharma @GKochharMD @GauravsyalMD @IBD_FloMD @SaraElOualiMD @BenClickMD @HolubarStefan @SchwartzbergMD @BettenworthDb @SchairerIBDMD @JPAchkarMD Thread 1/4 NL CRP,⬇️🔥 on CT 🚫 response to IV steroids🟰fibrotic stricture. CT angiography neg.. Enteroscopy not attempted d/t dilated SB.  ALSO phenotype change: melena and weight loss raised 🚩🚩. So ✂️ and found to have jejunal adenoCA, 🚫nodes or metz.
@MondayNightIBD @DCharabaty @abbvie @TakedaPharma @GKochharMD @GauravsyalMD @IBD_FloMD @SaraElOualiMD @BenClickMD @HolubarStefan @SchwartzbergMD @BettenworthDb @SchairerIBDMD @JPAchkarMD Thread 2/4 Key points: Need to consider SB ACA in CD pt with change in phenotype. Crohn's about 10Xs gen pop for SB ACA.  RFs: ♂️, young age at Dx, long disease duration, multiple resections, diverted bowel, immunosuppressive use. All of which our patient had.
Read 5 tweets
🔥Crohn’s Perianal Fistula - #MondayNightIBD w all🌟faculty 🔥 CME 👉 🔸Supported by an edu grant from @TakedaPharma 🔸…
2/#MondayNightIBD #Crohns #PerianalFistula #MedTwitter #GITwitter

✅Answer #IBDPolls👇
🗓 Mark your calendar - Live Q&A @ 8p ET/5p PT
📲Tweet your❓to be addressed Monday!

📸 Faculty disclosures & important CME info👇 Image
Read 11 tweets
Join⚕️@DCharabaty @AmyLightnerMD #DrMarlaDubinsky+ Brandon Pomish 4 #Crohns #PerianalFistula

🗓️#CPF #MNIBDWebinar Sat 2/11
🎯MultiD Mgmt
🎯Stem Cell Therapy

🔸Supported by an edu grant @TakedaPharma ImageImage
2/#PreConvo #IBDPoll 1️⃣
#MNIBDWebinar #Crohns #PerianalFistula #CPF


🟢The addition of which of the following to an anti-TNF agent is associated with a higher rate of #Crohns #PerianalFistula CPF healing vs the anti-TNF agent alone?
Read 7 tweets
@BassiMehak @MarcelYibirin @MondayNightIBD @kzhuangmd @agoldowskymd @IBD_FloMD @IBD_Afzali @babudayyeh @BolandBrigid @amjohnsonMD @PopovVioleta @RobertoSimonsMD @LauraChiuMD @PDulaiMD @HealthyLivingGI @oridamas @kehutchins77 @ven_satyam @MichelleKimMD @Chris_Velez_MD @traceyg_md @khalili_MD @ingrid_hickman @EdwardLoftus2 @ReemSharaiha @gutdoc18 @ThereziaR @CherylharrisRD @DBadurdeen @KellyHathornMD @GIdietitian 9/ Wt loss #Medications.
✔️ ➕➕ for wt loss.
✔️ Safe in DM2 in IBD; may improve IBD activity
💥SE- nausea, 🤮, 💩🚽. Monitor closely
💥Orlistat- 🚫in IBD pts, esp with active small CD +/- chr malabsp syndrome
💥Phentermine-topiramate, Bupropion-naltrexone-⏬ efficacy Image
Read 5 tweets
It is with sadness that I share with you all today that I will be closing my specialized family medicine practice in November.

I have been offered a #surgicalabortion role in BC!
Surgical abortion opportunities like this are limited (sometimes more so for family docs) and I knew that I had to take the leap. The Ottawa #OBGYN team was so dedicated to my surgical abortion learning and I want to maintain those skills.

I have training I want to use.
My clinic will continue to accept some referrals as outlined by faxes sent to clinics in the surrounding area. Patients can still self-refer for #contraception, #pap smears, and #abortion care.
Read 11 tweets
@MondayNightIBD @DCharabaty @abbvie @JanssenUS @TakedaPharma 1/ #IBDPoll1️⃣ 30M non-smoker w stricturing #Crohns ileocolitis dx 1 year ago is now s/p ileocecal resection due to refractory symptoms despite adalimumab.

What would you recommend post-surgery? #MondayNightIBD

🔦= C-scope
🔥= Active disease
Metronid= Metronidazole
@MondayNightIBD @DCharabaty @abbvie @JanssenUS @TakedaPharma 2/ #IBDPoll2️⃣ The pt was started on IFX 4 weeks post-op, but now presents @ 8 weeks post op w #Diarrhea 6-8 loose BM/day, no abdo pain, no blood. Stool Cdiff & Cx negative. FCP, CRP nml,

What’s next ? #MondayNightIBD
@MondayNightIBD @DCharabaty @abbvie @JanssenUS @TakedaPharma 3/ #IBDPoll3️⃣ Pt is dx w #BAD w 7C4 level 80ng/mL, & started cholestyramine. Now presents w abdo pain, MRE multiple SB #Strictures ➡️Sx complicated by leaks & more✂️. Now w foul smelling diarrhea, Wt loss, dry mouth, orthostasis. CLN & Stool studies nml.
What’s next?
Read 5 tweets
@MondayNightIBD 1/📢#GITwitter"There are two main mistakes in treating #IBD pts - the undertreatment and the overtreatment"-Prof #Rutgeerts!

Let’s talk about surgery & post-op surveillance in #crohns

@GroverDheera and I will #MakeItSimple in prep for #MondayNightIBD w @BattatMD4IBD @DCharabaty Image
@MondayNightIBD @GroverDheera @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek 2/ #MondayNightIBD
Journey of #Crohns disease:
🎢 Relapses & remission
🔥 Inflamm can leads to fibrostenosis, fistula and abscess
🚧 25% have complications at dx
✂️ 26% require surgery despite biologics Image
@MondayNightIBD @GroverDheera @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek @BettenworthDb @MaiaKayalMD @IBD_FloMD @APandT @debby_keller @ibdseb @IBDJournals @ezzatali64 @PracUpGastro @TwittyWhitty22 3/ Today’s focus is on surgery for #Crohns ileal #stricture

🌟 Indications: obstructive symptoms, stricture associated with abscess, suspicion of malignant stricture
🪄 Surgery🚫curative : #Crohns often recurs above IC anastomosis

#MondayNightIBD #Back2Basics
Read 6 tweets
#2 B-COMPLEX/MULTI VITAMIN. Buy a liposomal or other form that increases bio-availability. Take 1 capsule w/Breakfast and Lunch. If you have stomach upset, try sublingual (under tongue) EZ Melt B-Complex in AM & Multi w/iron for Dinner.…
#3 OMEGA 3s. Fish Oil, Krill Oil, Algae Oil are all good sources of Omega 3. Be careful the EPA/DHA ratio. EPA helps with inflammation/DHA helps with cognition. You need both! Opt for a 1:1 or 2:1 ratio of DHA to EPA (2:1 ratio eg. 800 DHA/400EPA)…
Read 93 tweets
Today marks 20 yrs of #remission from #Crohns. For some #IBD patients, remission feels like an elusive thing. I get it, I’ve had my share of time in the #ICU. I’m extremely fortunate that #Remicade has worked this long. Many people must switch meds to find a lasting solution. 1/n
The last 20 yrs haven’t come w/o complications. A sustained high quality of life was worth the trade offs that come with #biologics. I lived with recurrent infections and a #cancer diagnosis. Was it challenging? Yes. Was it better than living with flares? Absolutely. 2/n
There isn’t a day that I don’t think of those that weren’t as lucky. Alex Davidson, Ty Redler, Lacey Conners and Lindsey D’Ercole were younger than me and have since passed from IBD complications. In spite of some survivor’s guilt, I do my best to keep their memory alive.💜 3/n
Read 8 tweets
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 1/ I'm Tina from 🇺🇸 co-founder of Team @ibdesis. We are proud to lead #PatientExperience on @MondayNightIBD to discuss specific aspects of #SouthAsianIBD experience. We hope to improve care & reduce disparities in our community around the 🌍 thru @southasianIBD. #MondayNightIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 2/ Even though my dad suffered from #Crohns, when I presented with #IBS #constipation, #GERD, joint pains & eye issues as a child, no one made the connection or escalated it to a gastroenterologist. #MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 3/ When my dad passed from #CRC, my family went into poverty & couldn't afford health insurance. Though I was symptomatic as a child, I didn't have a #colonoscopy until 22 when I got my 1st job. That's when I received my very delayed #IBD diagnosis. #MondayNightIBD #SouthAsianIBD
Read 11 tweets
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 1/ When I transitioned to adult care at 17, I felt like I was stuck in a constant loop of tapering off prednisolone, flaring, and then ending up in hospital on IV steroids only to end up on another course of steroids for my #IBD.
#MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 2/ After speaking w/ a friend who knew someone w #Crohns, I decided to try #CAM. I didn't know what else to do. The promise of a "cure" & feeling defeated by the constant steroid cycle I was prescribed drove me to seek out another option. #MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 3/ Family had planned an 🇮🇳 trip. The journey to an ayurvedic clinic took hrs & we waited ~6 hours only to spend 5-10 mins w/ the #ayurveda specialist. Nothing was asked about my history w/ #Crohns; I was sent away w/ tablets wrapped in newspaper. #MondayNightIBD #SouthAsianIBD
Read 5 tweets
@MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 📣 #IBD patients & caregivers:

#IBDPoll 1️⃣

📊Thinking abt your IBD needs, what's been the biggest hurdle to your care?
📝 In the replies, elaborate. What’s helped your care?

Please share your #PatientExperience w #MondayNightIBD 👇🏽

@MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita #MondayNightIBD #PatientExperience
#IBDPoll 2️⃣

🧐Thinking about your culture’s expectations

📊 Have you tried Complementary and Alternative (CAM) Therapies (ex: ayurveda, homeopathy)?

What drove you to try these therapies? Please share your experience.

SE=side effects
@MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita Thank you @MondayNightIBD for shining a spotlight on 🌏 #SouthAsianIBD pt experience!

I'm Madhura from 🇮🇳, co-founder Team @ibdesis. We are proud to lead #PatientExperience on #MondayNightIBD!

We hope to improve care for our community around the 🌍 through @SouthAsianIBD.
Read 22 tweets
@MondayNightIBD @DCharabaty @JanssenUS @pfizer @TakedaPharma 2/ 📸 Faculty disclosures & CME certification ℹ 👇
#CME certificate 🏅 → ℹ️ Image
@MondayNightIBD @DCharabaty @JanssenUS @pfizer @TakedaPharma 3/ 👌let's 🚴

In addition to 💉, pts w #IBD should undergo regular #PreventiveHealth #HCM:
📌Cancer Screening 🦀
📌Bone Health assessment 🦴
📌Mental Health 🥺
📌Treatment specific Testing 💉💊
📌Smoking cessation 🚬

#ICYMI vaccines #MNIBDTweetorial 📎 @🔚 of 🧵 Image
@MondayNightIBD @DCharabaty @JanssenUS @pfizer @TakedaPharma 4/ 🧩Who is IS? #IBD pts on or had within last 3 months:
🚩 Prednisone > 20mg/day >2wks
🚩 AZA >2.5 mg/kg/day
🚩 6MP >1.5 mg/kg/day
🚩 MTX >0.4 mg/kg/week
🚩 Cyclosporine
🚩 Tacrolimus
🚩 Tofacitinib, ozanimod

🚩 Significant protein-calorie malnutrition
Read 22 tweets
@MondayNightIBD @DCharabaty @janssen @pfizer @TakedaPharma 2/ 📸 Faculty disclosures & CME certification ℹ
Want a #CME certificate? → ℹ️
#MondayNightIBD Image
@MondayNightIBD @DCharabaty @janssen @pfizer @TakedaPharma 3/ 😭 most pts are NOT getting safe 💉 like flu, pneumonia & HepB.
🤷‍♀️ Why?
🚫Many GIs won't/can't give 💉
❓Many PCPs don't know what to give
📞 Better communication is needed

Who do you think should make vaccine recs & where should pts w/ #IBD get 💉?
@MondayNightIBD @DCharabaty @janssen @pfizer @TakedaPharma 4/ pts w #IBD , esp if on ⚠️immunosuppressants (IS), at ⬆risk of (preventable) infections, so #vaccination is 🗝️
Infection in IBD = ⬆hospitalization ⬆ 🏥 stays ⬆costs & ⬆mortality.

Despite their benefits, vaccination rates remain LOW.

#MondayNightIBD Image
Read 19 tweets
In our project, we want to find a definitive cure for #IBD 🏥 using an innovative strategy🧬🔬 We explain this in our latest infographic and in this tweetorial. Get on board! 👇🏻 Image
We are researching #IBD because it affects millions of people worldwide, especially young adults 👦🏻👧🏻 Moreover, we target two of the most frequent IBD subtypes: #Crohns disease and ulcerative #colitis 👇🏻
We focus on the main issue of #IBD: inflammation 🔥 In this condition, the patient’s immune system attacks their #intestine as if it were an external agent. Image
Read 9 tweets
@MondayNightIBD @SobiaMujtabaMD @JasonHouMD @DCharabaty 1/ 65 y/o M new dx #Crohns ileitis after he presented w abdo pain,diarrhea, wt loss, anemia. CLN: deep linear ulcers in TI. He has an active lifestyle,stable CAD. Symptoms recur when prednisone<15 mg. What is the LEAST effective strategy to keep this pt in remission? #Back2Basics
@MondayNightIBD @SobiaMujtabaMD @JasonHouMD @DCharabaty 2/ #IBD is not only a disease of the young !

♦️ Typical dx age 20-39, w a second smaller peak >50

♦️ Recently ⬆️ prevalence in elderly> age 60, due to:

🔺Aging of adults w #IBD

🔺⬆️elderly onset IBD > age 60 #EOIBD:
🔹⬆️awareness & dx
🔹Environment/ microbiome changes
@MondayNightIBD @SobiaMujtabaMD @JasonHouMD @DCharabaty 3/ Clinical Features of #IBD in #elderly 🔎?

📌Milder disease course, Fewer #Crohns complications, but

⬆️rates of hospitalizations
⬆️rates of colectomy in EO UC

📌❓Due to disease severity vs poor #IBD control d/t underuse of effective Rx
Read 14 tweets
@MondayNightIBD @ibdnaik @SobiaMujtabaMD @ibdleuven @DCharabaty 1/29 yo M, smoker, presents with RLQ abscess w fistula to the TI; he undergoes abscess drainage & then ileocecal✂️w primary ileocolonic anastomosis. Path c/w #Crohns, margins free of disease. You see him for f/up 2 weeks post-op, What's the next ? #MondayNightIBD #Back2Basics
@MondayNightIBD @ibdnaik @SobiaMujtabaMD @ibdleuven @DCharabaty 2/ Let’s talk #Crohn’s intestinal complications
CD can present w stricturing/perforating complications
50-60% CD will develop strictures, fistulas or abscesses over time
70% require surgical✂️by 15yrs of dx
Surgery not curative, most pts will have endo recurrence 1 yr post-IC✂️
@MondayNightIBD @ibdnaik @SobiaMujtabaMD @ibdleuven @DCharabaty 3/ Natural course of CD recurrence post- IC ✂️

📌Histologic e/o CD within 3 wks post-op !!

📌70-90% pts w endo recurrence at 1 year

📌30-60% pts w clinical recurrence by 3 & 5 yrs

📌50% will need ✂️by 5 yrs

Read 12 tweets
@MondayNightIBD @SobiaMujtabaMD @SchwartzbergMD @DCharabaty 1/ 27 yo F, crohns colitis on AZA, presents w 2wk perianal pain. One week ago a “boil” developed adjacent to the anus, painful to touch and draining cloudy fluid. PE: Perianal fistulous opening tender & draining pus on palpation. What is the next best step ? #B2B
@MondayNightIBD @SobiaMujtabaMD @SchwartzbergMD @DCharabaty 2/Recap #Crohns:
📌Transmural inflammation involving any part of GIT
📌B for Phenotypes: inflammatory/stricturing/penetrating
📌L for location: UGI,SB,Colon
📌Penetrating Behaviors:
Intra-abdominal abscesses(IAA)

recall this #B2B MTL classification table👇🏼 Image
@MondayNightIBD @SobiaMujtabaMD @SchwartzbergMD @DCharabaty 3/♦️p->Perianal ds in CD
♦️Can occur w any B&L
♦️May be initial manif in ~10%
♦️Can be isolated(no luminal dis)
♦️Affect up to 1/3 of CD pts
♦️Incidence cld be ⬇️w⬆️use of biologics @sang_hyoung @EdwardLoftus2

♦️One of most challenging manif for pts+MDs
Read 8 tweets
Have tears in my eyes writing this. I didn’t realise verdict had come and the man involved had now died. I did not live in his shoes. All of us bowel patients have different stories + experiences. But this is so desperately sad. So really achingly sad 1/…
When I had my stoma op in Aug 2014, it came having put it off for years and years. I lived with poor health from #Crohns for far longer than I should or could have. I was scared. I feared coping with it. I was worried what people and potential partners would think. I delayed 2/
I worked & built a strong career despite my health battles. My amazing consultant and I both agreed he’d let me choose when the time was right. But warned also I may have that time chosen for me if I got very sick or my bowel ruptured. So I delayed. Out of fear. Putting it off 3/
Read 11 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
🗣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
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

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