Thread by @halesj126

@MondayNightIBD 1a.
Welcome to an extra spooky #MNIBD #Back2Basics
🎃👻🎃👻🎃👻🎃👻🎃👻🎃

@JosephHabibi_MD and I will be discussing common myths in #IBD and doing our best to debunk them. Topics include:

🎃 Diet and supplement myths
🎃 Pregnancy and fertility myths
🎃 More surprise myths🔮

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD 1b.
Shout out 📣 to all of the amazing #IBD #PatientAdvocates who helped make this happen:

@aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena 1c.
See if you can find all of the spooky #IBD words in our #MondayNightIBD word search 👇

🎃👻🎃👻🎃👻🎃👻🎃👻

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD 2.
Diet & supplement myths:

❌Pts need to avoid certain foods to stay in remission

✅👨👩 w #IBD can eat a varied diet, avoiding foods that trigger symptoms (esp when🔥)
✅Avoidant restrictive food intake disorder (ARFID) and malnutrition are ⬆️ in IBD
✅RD consult can help

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid 3.
❌ #IBD = avoid fiber:

✅Strictures or bowel obstruction👉 avoid insoluble fibers
✅Fiber appears to have a protective effect against developing IBD in epidemiological studies
✅Have your fiber in a form you can tolerate (smoothie, pureed, cooked)

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid 4.
❌#IBD = avoid gluten

✅If there is coexisting celiac disease, gluten should be avoided
✅<1-2% of patients w IBD also have celiac
pubmed.ncbi.nlm.nih.gov/29762265/ @GeraldHoltmann @Prof_NickTalley

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley 5a.
❌Supplement or changing diet can cure #IBD

✅Exclusive enteral nutrition (EEN) induces clinical &🔦remission in pediatric 👦👧 CD
✅Many diets improve symptoms in #IBD and some may help w 🔥 but do not “cure” IBD or eliminate the need for meds in mod-severe disease

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley 5b.
Examples of diets 🥕🫑🍅🍇🍊 studied in IBD:
🎃 Crohn's disease exclusion diet (CDED)
🎃 Specific carbohydrate diet (SCD)
🎃 Partial enteral nutrition (PEN)
🎃 Mediterranean diet (MD)

See👇 for data on SCD and MD in CD

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox 5c.
🔑 features that are common to all of these diets:
✅ Avoid ultra + processed foods & added sugars (foods that come in a box/plastic bag/can)

Processed foods:
➡️Ass. w ⬆️ risk of #IBD
➡️ 👩‍🦱👨‍🦰 w #IBD with diet ⬇️ fiber ➕ ⬆️ fructose have ⬆️ pro-🔥🔥 gut dysbiosis

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox 5d:
✅ CD exclusion diet (CDED) + partial enteral nutrition (PEN) compared to exclusive enteral nutrition (EEN) in mild pediatric CD:
🎃 Better tolerated
🎃 Superior sustained remission at 12 w
🎃 ⬇️ CRP at 12 w (see 👇)

See also: pubmed.ncbi.nlm.nih.gov/30736095/

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd For more info on #IBD and diet:

Check out this #MNIBDWebinar 📽️ Brunch with
@DCharabaty + @almaldonxx

https://twitter.com/MondayNightIBD/status/1422238959380451335?s=20&t=6Iwf3GDqeEDUCosbH4BUvQ

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx 6.
🤰 & fertility myths:

❌Pts w #IBD can’t or shouldn't have👶

✅Fertility rates in IBD = general population
✅⬆️voluntary childlessness in pts w IBD (discuss these reasons 👇 with your patients)
✅Understand IBD factors that affect fertility👇

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD 7.
❌Stopping #IBD 💊💉 during 🤰👉healthy👶

✅Biologics & thiopurines: NO increase in neg outcomes in 👶 per🎹registry (@UmaMahadevanIBD) BUT
🚨 STOP MTX, AVOID small molecules (JAKi or Ozanimod)
✅🔥during🤰 ass. w⬆️fetal loss & preterm birth
❓Best time to get pregnant?👇

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD @UmaMahadevanIBD @IBDimmunology 8.
❌Patients with #IBD will give it to their children

✅⬆️⬆️risk factor for IBD is ➕FH, but it is multifactorial
✅1 parent 👩‍👦with CD⬆️ 5-10%
✅1 parent 👨‍👧with UC⬆️2-4%
✅2 parents👨‍👨‍👧with IBD ⬆️ ~30-40%

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD For more info on #IBD and 🤰:

Check out this #MNIBDWebinar 📽️ Brunch with
@DCharabaty + @ibdgijami

https://twitter.com/MondayNightIBD/status/1508549922986999808?s=20&t=6Iwf3GDqeEDUCosbH4BUvQ

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD @ibdgijami 9a.
👻Extra myths:

❌Patients with ostomies can’t🏊‍♀️🏃or🤰

✅You can swim!
✅You can run!
✅Most physical activity is okay!
✅Yes, you can have a healthy pregnancy!

✅More 👇

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD @ibdgijami 9b.
For more info on the #PatientExperience living with an #ostomy:

Check out this #MondayNightIBD 🧵 with @GutlessGlamour

https://twitter.com/MondayNightIBD/status/1444337591369834499?s=20&t=p_Pxz6vsIetA9j1QrhNj4g

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD @ibdgijami 10a.
❌You can have UC and CD at the same time

✅ CD can affect the colon only👉called Crohn’s colitis
⚠️CD can affect the rectum (not all proctitis = UC)
⚠️Peri-appendiceal patch in UC is not “patchy CD”
⚠️backwash ileitis in severe UC is not ileocolonic CD

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD @ibdgijami 10b.
❌You can have UC and CD at the same time

✅ 10% of pts w IBD have indeterminate colitis (features of both UC and CD)
✅ Patient first dx w UC can later develop features characteristic of CD (fistula, SB disease) & dx changes from UC to CD

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD @ibdgijami 11.
❌Controlled #IBD doesn’t need #MentalHealth support

✅ IBD affects physical, emotional, social, psychological, sexual & financial ⚕️ health
✅IBD👉higher risk of depression & anxiety & should be offered appropriate professional mental support
😷talk to your pts about this!

@MondayNightIBD @JosephHabibi_MD @dunleavy_katie @RomyChamoun @SanjeevaniTomar @DSTEINGIMD @BeniwalPatelMD @aboutIBD @nataliesparacio @mustbthemusic @Empoweringpts9 @DrTiffTaft @GutlessGlamour @IBDPassport @ownyourcrohns @bottomlineibd @GIdietitian @snehadave98 @LoriPlung @Youcantmakethi4 @shaina_sekhri @LambergMorgan @goodmra1 @KrugCleveland @john_damianosMD @AustinChiangMD @DrsMeena @ibddoctor @HorstIBDDoc @kehutchins77 @BilalMohammadMD @IBD_Afzali @LizzieAbyMD @doctornikkid @GeraldHoltmann @Prof_NickTalley @LinChangMD @SChandanMD @umfoodoc @KateAltaWilcox @SalinaFaidhalla @dr_fcalderaibd @DCharabaty @almaldonxx @JeremyAdlerMD @DrDLerner @PLLU @MLutzMD @ibdgijami 12.
❌Can’t enjoy Halloween with IBD

✅Of course, you can! Check 👇

What other myths do you want to be debunked for clinicians & for people living with #IBD?

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