Preventive Care in Inflammatory Bowel Disease

Abstract

Francis A. Farraye, MD, MSc, FACG1, Gil Y. Melmed, MD, MS, FACG2, Gary R. Lichtenstein, MD, FACG3, and Sunanda V. Kane, MD, MSPH, FACG4

1Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA; 2Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA; 3Division of Gastroenterology, Hospital of the University of Pennsylvania, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA; 4Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA

Recent data suggest that inflammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identification, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identification of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary.

Am J Gastroenterol 2017;112:241-258
Received 22 January 2016 ; accepted 10 October 2016

Correspondence: Francis A. Farraye, MD, MSc, FACG, Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, 85 East Concord Street, Boston, Massachusetts 02118, USA . E-mail: francis.farraye@bmc.org