Discover and read the best of Twitter Threads about #mondaynightibd

Most recents (24)

@MondayNightIBD @JosephHabibi_MD @VictorChedidMD @ManuelBragaMD @doctornikkid @agoldowskymd @DougSimonetto @dr_chhabrag @DrMalSimons @TolgaGidenerMD @HowardTLeeMD 1/🏳️‍🌈🏳️‍⚧️#LGBTQ+ includes many diverse groups.

🔖Helpful reference from @FenwayHealth: lgbtqiahealtheducation.org/publication/lg…

🔑Caveats:
👥Definitions vary across communities
💬Terms change frequently
⭐️If unsure, ask what terms someone would like you to use.
@MondayNightIBD @JosephHabibi_MD @VictorChedidMD @ManuelBragaMD @doctornikkid @agoldowskymd @DougSimonetto @dr_chhabrag @DrMalSimons @TolgaGidenerMD @HowardTLeeMD @FenwayHealth 2/Ask all patients verbally or on registration form:
✅Pts expect to be asked
✅Pts think it's important for HCP to know
✅Gender identity & sexual orientation affect care

⚠️Don't assume pronouns from appearances

@theNASEM👉
nap.nationalacademies.org/catalog/26424/…

#Genderbread👇 Image
@MondayNightIBD @JosephHabibi_MD @VictorChedidMD @ManuelBragaMD @doctornikkid @agoldowskymd @DougSimonetto @dr_chhabrag @DrMalSimons @TolgaGidenerMD @HowardTLeeMD @FenwayHealth @theNASEM 3/#LGBTQ+ health #disparities

Access
-13% LGB+ ppl uninsured
-25% trans ppl had insurance deny gender-affirming care in last yr

Discrimination
-33% trans ppl had neg experience/harassment/refusal in healthcare in last yr
-LGBTQ+ ppl delay/avoid care b/c fear of discrimination Image
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@MondayNightIBD @DCharabaty 1/12
📣#GITwitter #IBDTwitter

Welcome back to #MondayNightIBD #Back2Basics w @dunleavy_katie @john_damianosMD

🎯How do you approach a pt w #IBD in remission who has new or persistent #GI symptoms?

Check out our review📜
practicalgastro.com/2022/05/18/rec…

#NeuroGI #GastroPsych #DGBI
@MondayNightIBD @DCharabaty @john_damianosMD 2/12 #MondayNightIBD #B2B

👩🏼‍⚕️have been studying “IBS-type symptoms” in #IBD for 30 yrs. But there is more work to be done to help characterize cohort & dz mechanism!

It’s important bc:
👨‍👩‍👧‍👦Affects pts QoL, mental health, sleep
🥼Causes ⬆️HC utilization, ⬆️MD visits & 💊narcotics Image
@MondayNightIBD @DCharabaty @john_damianosMD @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak 3/12 #MondayNightIBD Persistent/New GI Sx in #IBD
1⃣R/o active🔥/#IBD complication (abscess, stricture):🔦, 🩻, CRP, FCP, ⚠️R/o infx like C. Difficile!

2⃣🤔Consequences of✂️: adhesion, bile acid diarrhea

3⃣🤔 #DGBI
🚩25% pts w #IBD in endo remission have #IBS @LancetGastroHep Image
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@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?
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@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
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@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 3/ Social determinants of health #SDOH
👉Conditions in places where people live, learn, work, & play shaped by 💰wealth, power, & resources that affect a wide range of health risks/outcomes
📌SDOH can lead to unfair & avoidable differences in health status w/in pops #disparities Image
@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 4/ #SDOH impact health outcomes
📌Unemployed >6yrs👉2x⬆️mortality
📌Chicago area👉16yrs⬇️ life expectancy
📌Social isolation👉2x⬆️ risk of CAD
📌Unsafe childhood👉5x⬆️risk mental health disorder
📌Dual M/M ins👉24%-67% ⬆️readmission
📌Language services👉60% ⬆️risk ED utilization Image
@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 5/ How do #SDOH impact pts w/ #IBD?

📌 Low socioeconomic status (SES) in pts w/ IBD 👉
⬆️ICU admissions
⬆️hospitalizations 🏥
⬆️mortality risk
⬆️use of steroids >2,000mg/yr
⬆️outpatient visits
⬆️narcotic/psych med use

#MondayNightIBD
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@MondayNightIBD @DCharabaty @pfizer @JanssenUS @TakedaPharma @BonumCe 3/ 👋@MondayNightIBD crew
#MentalHealth in #IBD:
⬆️Anxiety & depression
✅Patients experience medical trauma & Post-traumatic stress symptoms (PTSS)

👉Treat-to-target approach inc.⬇️disability & ⬆️QoL
⚠️Yet #MentalHealth is often overlooked in #IBD
#MondayNightIBD #GastroPsych Image
@MondayNightIBD @DCharabaty @pfizer @JanssenUS @TakedaPharma @BonumCe 4/ 📌#Depression in #IBD
👉 21% of #IBD pts vs 13% healthy pts

⬆️ 90-day readmissions
⬆️ Surgeries
⬆️ Unnecessary CT-scans/CLN
⬆️ ED visits
⬆️ Annual cost ~$18k

🚨Bi-directional effect
⚡️Poor #MentalHealth 🔁 Poor self-mgmt
⚡️⬆️ inflammation 🔁 ⬆️ depression
#MondayNightIBD Image
@MondayNightIBD @DCharabaty @pfizer @JanssenUS @TakedaPharma @BonumCe 5/ #Anxiety in #IBD
👉 19% of #IBD pts vs 10% healthy pts

🚨Bi-directional effect🚨
⬆️Anxiety = risk factor for IBD & IBD = risk factor for anxiety
⬆️Inflammation 🔁 ⬆️Anxiety
#MondayNightIBD #GastroPsych Image
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@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
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@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 1/People told me 'nothing's wrong, everything will be fine,’ like it was in my head. When I developed full-body psoriasis from Cimzia, someone from my culture told me to dab whole milk over the skin as a home remedy. Guess what - it didn't work! #MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 2/ I also deal with the unsolicited advice of eating “healthier” and people trying to tell me what to eat or how to gain weight, preferably by eating more roti/wholemeal carbs as if they know my body's ability to tolerate food better than me... #SouthAsianIBD #MondayNightIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 3/ Whenever an #ostomy was mentioned, my parents + I saw them in a negative light, I wish there was more support & positivity was provided on this during my paeds care so that it wouldn't have been a last resort for me. #MondayNightIBD #SouthAsianIBD
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@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 1/ I'm Surakhsha from🇬🇧, co-founder Team @ibdesis. We are proud to lead #PatientExperience on @MondayNightIBD to discuss specific aspects of #SouthAsianIBD experience. We hope to improve care for our community around the 🌍 #MondayNightIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 2/ Pre #Crohns dx was a hard fight to get any HCP to listen to me/my mum. The first GPs I saw were #SouthAsian, maybe they had no understanding of #IBD as it wasn't 'common' back then or seen in British Indians or #SouthAsians ... #MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 3/ I was fobbed off with indigestion medication, even when I was rapidly losing weight. It wasn't until the family GP (who wasn’t SA) saw me + immediately referred me to the paeds unit at the local hospital as an urgent matter. #MondayNightIBD #SouthAsianIBD
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@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @vkckiranpullela @TheMaveilousGut @dunung_ruchita Although I had the support of some friends & family, the taboo & lack of knowledge about #IBD meant not many knew how to support me. I found it difficult to educate loved ones & am thankful for more resources that are available now. #MondayNightIBD #SouthAsianIBD (1/ )
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @vkckiranpullela @TheMaveilousGut @dunung_ruchita At the same time, I've also met people who couldn't understand how someone my age (17-23) could have such a #disability. The invisibility of #IBD added to this. As a result, my struggles with #IBD were downplayed, minimized & ignored. #MondayNightIBD #SouthAsianIBD (2/ )
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @vkckiranpullela @TheMaveilousGut @dunung_ruchita Given the stigma around #digestive dx & #disability in #SouthAsian community, I felt like I had to make my condition as invisible as possible. These internalized social norms meant I also downplayed my UC to make others more comfortable. #MondayNightIBD #SouthAsianIBD (3/)
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@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
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@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 1/ I'm Sharan from 🇬🇧, co-founder Team @ibdesis. We are proud to lead #PatientExperience on @mondaynightibd to discuss specific aspects of #SouthAsianIBD experience. We hope to improve care for our community around the 🌍. #MondayNightIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 2/ My initial diagnosis came after months of going back & forth w my GP who was reluctant to refer to a specialist because they were certain that my symptoms couldn't be due to #IBD. In their own words, "#SouthAsians don't get IBD" #MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 3/ This delay led to extreme weight loss and worsening of symptoms to the point where I was unable to get myself out of bed. I was admitted into hospital with my weight down to 28kgs, from 38kgs just months before.
#MondayNightIBD #SouthAsianIBD
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@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @TheMaveilousGut @dunung_ruchita 1/ Even when I was not on biologics, buying medicines was a financial burden. As I was never
in remission, I got fed up & stopped medicines altogether. Instead I explored #ayurveda which
was relatively cheaper.
#MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @TheMaveilousGut @dunung_ruchita 2/ I knew even at that time that ayurveda won't "cure" me. But seemed to help initially & it made
me believe that #ayurveda might work, while being easy on my pocket. Also had perianal
#fistula repaired through #KsharSutra. But didn't last long
#MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @TheMaveilousGut @dunung_ruchita 3/ Stopping my medicines proved to be a very costly mistake. I had the biggest flare up of my life. I still struggle with the effects of that flare up even today.

#MondayNightIBD #SouthAsianIBD
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@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @TheMaveilousGut @dunung_ruchita 1/ From onset of Sx, it took >3 yrs to be Dx w #Crohns. Initially, I consulted GPs as they were
easily accessible & family believed that #GI specialists would recommend surgery over 💊 Took
over 10 🥼before I was diagnosed correctly.
#MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @TheMaveilousGut @dunung_ruchita 2/ Even today, I do not have access to #IBD specialist close home & travel 500 kms for my #IBD care. This is the reality for many #SouthAsian pts who do not have easy access to care #MondayNightIBD #SouthAsianIBD
@rebelliousgut @MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @TheMaveilousGut @dunung_ruchita 3/ For a large part of my #IBD journey, I was on 5ASAs, Azathioprine & steroids. The most painful aspect was #perianal dx which was not controlled by these meds. But unaffordability of biologics meant I relied on steroids for over a year
#MondayNightIBD #SouthAsianIBD
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@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 👇🏽

👨‍👩‍👧‍👦=Family
👩🏼‍🤝‍👩🏽=Friends
🥼=Specialist
@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.
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