Behavioral Health Barriers for People with Inflammatory Bowel Disease

Nearly 1.6 million Americans live with inflammatory bowel disease (IBD). But each journey is unique.

IBD is a set of chronic conditions. These include ulcerative colitis and Crohn’s disease and cause inflammation of the gut.

These conditions may cause physical symptoms such as:

  • Abdominal pain.
  • Fatigue.
  • Severe diarrhea.
  • Weight loss.

Individuals with IBD also have higher rates of emotional symptoms, such as:

  • Anxiety.
  • Depression.
  • Negative self-esteem and body image.
  • Social isolation.

The UPMC Inflammatory Bowel Disease (IBD) Center consists of a multidisciplinary team of experts. These experts offer thorough, personal IBD care.

They include digestive health doctors, nurse practitioners, and therapists. They also include nurses, nutritionists, psychiatrists, and social workers.

The psychiatry and social work team members work together to address behavioral health concerns. They do this through psychosocial support, counseling, and coping strategies. They also offer in-depth testing and help you manage medicine.

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Behavioral Health Concerns in Patients with IBD

“Patients with IBD may experience stress, anxiety, and depression due to their condition,” says Helen Hunt, LSW, social worker for UPMC Total Care-IBD. “The unpredictability of flare-ups, the demands of ongoing medical care, and the possibility of life-altering surgeries all add to the emotional strain experienced by individuals with IBD.”

IBD can impact many different parts of your life. Physical symptoms can cause frequent bathroom visits, dietary restrictions, and fatigue. This can result in a desire to avoid social activities.

Missing work or school due to symptoms or treatment can also strain finances. This can cause even more stress.

The emotional challenges of IBD can lead to:

  • Changes in appetite and weight.
  • Struggles with sticking to treatment.
  • Trouble sleeping.

Your gut health can also affect your behavioral health. This is because of the brain-gut connection.

“The brain-gut connection describes the two-way communication between the brain and the gastrointestinal system. This occurs through connections among the brain, the nervous system within the gastrointestinal tract, the immune system, and the endocrine system,” says Patrick Buckley, MD, integrated psychiatrist for UPMC Total Care-IBD.

The gut sends signals to the brain. The brain then interprets them. When this system is working properly, you don’t even know it’s happening most of the time.

But this system can stop working properly if you have IBD. IBD can change the way the brain responds to these signals. This results in a greater awareness of sensations in the intestines.

This can lead to distress. It may also worsen gut pain and other IBD symptoms.

Addressing any behavioral health challenges as quickly as possible is important. It makes thorough care for those with IBD easier to reach.

Behavioral Health Treatment Options at the UPMC IBD Center

Experts at the UPMC IBD Center have several tools for addressing IBD-related behavioral health concerns:

  • Medications: Psychiatric medications like antidepressants can alleviate symptoms of depression and anxiety. They can also make sleeping easier.
  • Mindfulness: Simple, guided meditation can help reduce stress. It can also relieve anxiety, depression, and other behavioral health conditions.
  • Support groups: Support groups offer a safe space for IBD patients to share their stories. They also make learning from others and speaking up for their needs easier.
  • Talk therapy: Talk therapy helps with coping strategies and improved self-esteem. It also makes communication stronger.

“One or a combination of these treatment options, in addition to nutritional and exercise guidance, may help alleviate stress, anxiety, and other emotional symptoms caused by IBD,” says Tara Sherry-Torres, LSW, social worker for UPMC Total Care-IBD. “Every patient is different and will require a specific care plan that addresses their needs.”

Considering behavioral health at every stage of the care journey ensures coordinated care at the UPMC IBD Center. Therapists are available to check in with patients about any concerns they may have.

“Both of the team’s therapists meet with patients for individual therapy in addition to working with patients during team visits. Patients are also able to reach out between team visits for support as needed,” Helen says.

“Additionally, a psychiatrist can meet individually with patients for diagnostic consultations, treatment planning, and medication management as needed,” Dr. Buckley notes.

A Multidisciplinary Approach to Care

Experts at the UPMC IBD Center take a multidisciplinary approach to IBD care. This means they work to offer holistic treatment. This treatment addresses the full spectrum of physical and emotional IBD symptoms.

“We take pride in working as a team to integrate current health concerns and past health history into treatment planning with our patients,” Tara says. “We can also work directly with patients to help them address any cognitive or behavioral barriers they may be facing in making progress on their treatment goals. We’re here to help each patient in every step of their journey.”

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About Digestive Disorders

UPMC Digestive Health Care cares for a wide range of gastrointestinal (GI) conditions and diseases, from diagnosis to treatment. Whether your digestive condition is common or complicated, our experts can help. Upon referral from your physician, we coordinate your testing and treatment. If you have a complicated condition, we can refer you to one of UPMC’s digestive health centers of excellence. Find a GI doctor near you.