Digestive Diseases and Sciences

, Volume 45, Issue 1, pp 26–31 | Cite as

REVIEW: Concerns of Patients with Inflammatory Bowel Disease

  • Josee Casati
  • Brenda B. Toner
  • Elizabeth C. De Rooy
  • Douglas A. Drossman
  • Robert G. Maunder
Article

Abstract

Idiopathic, chronic inflammatory bowel disease (IBD) refers to two diseases—ulcerative colitis (UC) and Crohn's disease (CD). Despite an abundant literature discussing the pathophysiology and treatment of these diseases, little if any empirical studies have focused on patients' subjective experiences with their diseases. The purpose of this paper was to identify and discuss the concerns of individuals with IBD and to suggest that the integration of concerns in clinical management is necessary for a comprehensive understanding of these chronic and debilitating diseases. In addition, case studies were included to highlight the concerns of people with IBD. Our review of the literature identified eight categories of concerns for individuals with IBD. They included loss of energy, loss of control, body image, isolation and fear, not reaching full potential, feeling dirty, and lack of information from the medical community. In conclusion, we argue that the efficacy of treatment for IBD would be greatly improved if psychosocial issues were to be integrated into treatment protocols.

inflammatory bowel disease ulcerative colitis Crohn's disease psychosocial factors worries and concerns 

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REFERENCES

  1. 1.
    Mallet SJ, Lennard-Jones JE, Bomgleu J, Gilon E: Living with the disease. Lancet 2:619-621, 1978PubMedGoogle Scholar
  2. 2.
    Rees J, Mayberry J, Calcraft B: What the patient wants to know about Crohn's disease. J Clin Gastroenterol 5:221-222, 1983PubMedGoogle Scholar
  3. 3.
    Martin A, Leone L, Castagliuolo I, Di Mario F, Naccarato R: What do patients want to know about their inflammatory bowel disease? Ital J Gastroenterol 24:477-480, 1992PubMedGoogle Scholar
  4. 4.
    Maunder RG, de Rooy EC, Toner BB, Greenberg GR, Steinhart HA, McLeod RS, Cohen Z: Health-related concerns of people who receive psychological support for inflammatory bowel disease. Can J Gastroenterol 11(8):681-685, 1997PubMedGoogle Scholar
  5. 5.
    de Rooy EC, Toner BB, Greenberg GR, Cohen Z, Baron D, Steinhart HA, McLeod R: Concerns of outpatients with in-flammatory bowel disease: Identification and impact (submitted)Google Scholar
  6. 6.
    Drossman DA, Patrick D, Mitchell M, Zagami E, Appelbaum M: Health-related quality of life in inflammatory bowel disease: Functional status and patient worries and concerns. Dig Dis Sci 34(9):1379-1386, 1989PubMedGoogle Scholar
  7. 7.
    Mitchell A, Guyant G, Singer J, Irvine EJ, Goodacre R, Tompkins C, Williams N, Wagner F: Quality of life in patients with inflammatory bowel disease. J Clin Gastroenterol 10(3):306-310, 1988PubMedGoogle Scholar
  8. 8.
    Godber D: Lay counselling and inflammatory bowel disease. Stress Med 5:211-212, 1989Google Scholar
  9. 9.
    Drossman DA, Leserman J, Li Z, Mitchell CM, Zagami EA, Patrick DL: The rating form of IBD patient concerns: A new measure of health status. Psychosom Med 53:701-712, 1991PubMedGoogle Scholar
  10. 10.
    Kirsner JB, Shorter R: Diseases of the Colon, Rectum, & Anal Canal. Baltimore, Williams & Wilkins, 1994Google Scholar
  11. 11.
    Dion KK, Dion KL: On the love of beauty and the beauty of love: Two psychologists study attraction. In The Social Psychologists: Research Adventures. GG Brannigan, MR Merrans (eds). New York, McGraw-Hill, 1995, pp 115-127Google Scholar
  12. 12.
    Lips HM: Sex and Gender: An Introduction. Mountain View, Mayfield. 1997Google Scholar
  13. 13.
    Gloeckner M, Starling J: Providing sexual information to ostomy patients. Dis Colon Rectum 2:575-579, 1982Google Scholar
  14. 14.
    Druss R, O'Connor J, Stern L: Psychologic response to colectomy II. Adjustment to a permanent colostomy. Arch Gen Psychiatry 20:419-427, 1969PubMedGoogle Scholar
  15. 15.
    Rolstad B, Wilson G, Rothenberger DA: Sexual concerns in the patient with an ileostomy. Dis Colon Rectum 26:170-171, 1983PubMedGoogle Scholar
  16. 16.
    Brown C, Jasper K: Consuming Passions. Toronto, Second Story Press, 1983Google Scholar
  17. 17.
    Whitehead WE, Schuster MM: Gastrointestinal Disorders: Behavioral and Physiological Basis for Treatment. Orlando, Academic Press, 1985Google Scholar
  18. 18.
    McIllmurray MB, Langman, MJS: Large bowel cancer: Causation and management. Gut 17:815-820, 1975Google Scholar
  19. 19.
    Colcher S: Family Structure, stress, and individual adjustment to ulcerative colitis. Dissertation. Abstr Int 44(10):3200B, 1984Google Scholar
  20. 20.
    Zigmund E, Wood B: Implications of contrasting patterns of divorce in families of children with gastrointestinal disorders. Fam Syst Med 4:385, 1986Google Scholar
  21. 21.
    Engstorm I: Mental health and psychological functioning in children and adolescents with inflammatory bowel disease: A comparison with children having other chronic illnesses and with healthy children. J Child Psychol 33:563-582, 1992Google Scholar
  22. 22.
    Gazzard B, Price H, Libby G, Dawson A: The social toll of Crohn's disease. Br Med J 2:1117-1119, 1978PubMedGoogle Scholar
  23. 23.
    Guyatt G, Mitchell A, Irvine E, Singer J, Williams N, Goodacre R, Tompkins C: A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterology 96:804-810, 1989PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • Josee Casati
    • 1
  • Brenda B. Toner
    • 1
  • Elizabeth C. De Rooy
    • 1
  • Douglas A. Drossman
    • 1
  • Robert G. Maunder
    • 1
  1. 1.Women's Mental Health Research Programme, Centre for Addiction and Mental Health (Clarke division)University of TorontoTorontoCanada

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