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2006 Abstracts: Crohn’s Disease : A patient’s perspective
Back to 2006 Program and Abstracts
Crohn’s Disease : A patient’s perspective
Massarat Zutshi1, Tracy Hull1, Jeffery Hammel2; 1Colorectal Surgery A-30, Cleveland Clinic, Cleveland, OH; 2Department of Biostatistics, Cleveland Clinic Foundation, Cleveland , OH

Aim As healthcare providers for Crohn’s disease we assume that we have a good understanding of the disease progression and its symptoms. The aim of this study was to gather information about what patients with Crohn’s disease think are relevant to their symptoms and what helps them cope with this lifelong benign disease. Methods A questionnaire was sent to all patients with a diagnosis of Crohn’s disease seen in the Digestive Disease Center in the last 5 years. An analysis of the first 307 questionnaires recived is given below. Results: (See table for 3 main factors in each variable) 63% respondents were female. 1/3 were between the ages of 35- 50 years. 64% were married. 1/3 had a graduate degree, 22% were unemployed. 48% patients still smoked, a majority less than one pack a day. 67% said that their symptoms affected work and 1/4 changed jobs due to this. Foods worsened symptoms in 60% with a decrease in symptoms while on a low fibre foods and white meats. Life style changes worsened symptoms in 66 %. More than half used Remicade with 1/3 stating that it was helpful. 9% had never used steroids. Alcohol increased symptoms in 1/3. Factors that did not cause a significant change were children at any age, pregnancy, menopause and HRT. A change in the caregiver was not a significant stressor. Surgery caused half the patients to improve for many years although 1/3 felt a lowered self-esteem postoperatively. Conclusion Patients with Crohn’s disease should be managed in a more comprehensive manner to provide optimal care. Thus a team approach that includes a dietician and counselor should be considered as an integral part of this team. This will allow patients to have enhanced skills to cope with changes in their symptoms whether they are due to the disease itself or changes in their routine.
Results of top 3 factors that affect symptoms in each variable

Variable (improve/worsen)

No.1 Factor

No.2 Factor

No.3 Factor

Work stress (worsen)

Deadlines

Boss

Environment

Foods (worsen)

Oily/Spicy

Nuts

Citrus fruits

Lifestyle change (worsen)

Home

Work

Partner

Medicines (improve)

Antidiarrheals

Pain medication

Vitamins

Weather(worsen)

Heat and humidity

Cold

Humidity

Surgery (concerns)

Fear of surgery

Surgical stress

Being off medication

Stoma (concerns)

Clothes

Physical activity

Appearance


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