Five commonly used IBD tests and treatments that physicians and patients should question

As part of Choosing Wisely Canada, organizations encourage clinician and patient conversations by highlighting tests and treatment that may be potentially unnecessary — even harmful — to patients with Crohn’s disease or ulcerative colitis

Crohn’s and Colitis Canada and  the Canadian Association of Gastroenterology have listed five tests, treatments or procedures that are commonly ordered but not always necessary in the care of patients with Crohn’s disease and ulcerative colitis, the two main forms of inflammatory bowel disease (IBD).  The list was developed by the Canadian IBD Network for Research and Growth in Quality Improvement (CINGERGI) as part of the Choosing Wisely Canada campaign, and endorsed by Crohn’s and Colitis Canada and the Canadian Association of Gastroenterology. Choosing Wisely Canada is an initiative aimed at helping clinicians and patients engage in conversations about unnecessary tests, treatments and procedures, and make smart and effective choices to ensure high-quality care.
 
In developing the Choosing Wisely list for IBD, a working group comprised of CINERGI members, patients, radiologists and representatives from Crohn’s and Colitis Canada and the Canadian Association of Gastroenterology initially identified ten recommendations via an online voting platform. During a follow up face-to-face consensus meeting, the group narrowed down the original list to five key recommendations, which are:
 
  1. Don’t use steroids (e.g., prednisone) for maintenance therapy in IBD.
  2. Don’t use opioids long-term to manage abdominal pain in IBD.
  3. Don’t unnecessarily prolong the course of intravenous corticosteroids in patients with acute, severe ulcerative colitis (UC) in the absence of clinical response.
  4. Don’t initiate or escalate long-term medical therapies for the treatment of IBD based only on symptoms.
  5. Don’t use abdominal computed tomography (CT) scan to assess IBD in the acute setting unless there is suspicion of a complication (obstruction, perforation, abscess) or a non-IBD etiology for abdominal symptoms.
“It is vital that Crohn’s disease and ulcerative colitis patients feel that they can have informed discussions with their physicians about their care,” says Mina Mawani, President and CEO of Crohn’s and Colitis Canada.  “This list provides information and guidance around five key priority areas that patients should be aware of during discussions with their doctors, and they should feel empowered to raise questions if they feel it necessary.”
 
“Sometimes providing the best IBD care means knowing when to avoid certain tests or treatments.  And that’s why we started the Choosing Wisely IBD campaign,” adds Geoffrey Nguyen, chair of CINERGI and a practicing gastroenterologist at Sinai Health System. “We wanted to provide a list of tests and treatments that health providers and patients should think twice about because they may be ineffective, wasteful, or even harmful.  This list empowers our patients to engage in a dialogue with their providers when these tests are ordered for them.”

About Crohn's and Colitis Canada

Crohn’s and Colitis Canada is the only national, volunteer-based charity focused on finding the cures for Crohn’s disease and ulcerative colitis and improving the lives of children and adults affected by these diseases. We are one of the top two health charity funders of Crohn’s and colitis research in the world, investing over $100 million in research to date. We are transforming the lives of people affected by Crohn’s and colitis (the two main forms of inflammatory bowel disease) through research, patient programs, advocacy, and awareness.

For more information or to arrange an interview with a representative of Crohn’s and Colitis Canada, please contact:

Nic Canning
Smithcom Ltd., Account Manager
nic.canning@smithcom.ca
413-992-7187 

Rasheed Clarke
Crohn’s and Colitis Canada, Marketing and Communications Coordinator
rclarke@crohnsandcolitis.ca
416-920-5035 x 215

About Choosing Wisely Canada

In partnership with the Canadian Medical Association, Choosing Wisely Canada is a national health care campaign to help clinicians and patients engage in conversations about unnecessary tests and treatments and make smart and effective choices to ensure high-quality care. To learn more about Choosing Wisely Canada and to view the complete lists and additional detail about the recommendations and evidence supporting them, visit ChoosingWiselyCanada.org
 
About the Canadian Association of Gastroenterology

The Canadian Association of Gastroenterology (CAG) represents more than 1,100 members across Canada, including physicians, basic scientists, and affiliated health care providers who work in the field of gastroenterology. The CAG is a member-focused organization with a mission to support and engage in the study of the organs of the digestive tract in health and disease, as well as to promote and advance gastroenterology by providing leadership in patient care, research, teaching and continuing professional development.

For more information or to arrange an interview with a representative of the Canadian Association of Gastroenterology, please contact:

Paul Sinclair
Executive Director, Canadian Association of Gastroenterology
Tel: 905-829-2504 ext. 221
cagoffice@cag-acg.org               

About the Canadian Network for Research and Growth in Quality Improvement

The Canadian IBD Network for Research and Growth in Quality Improvement (CINERGI) is a research network of 14 inflammatory bowel disease (IBD) specialists representing 12 Canadian academic institutions spanning 7 provinces. Collectively, we have research expertise in epidemiology, clinical trials, health services research, economic analysis, and quality improvement. We are committed to a diverse array of initiatives to improve healthcare delivery in IBD.

For more information or to arrange an interview with a representative of CINERGI, please contact:

Geoffrey Nguyen
Chair, Canadian IBD Network for Research and Growth in Quality Improvement (CINGERGI)
Tel: 416-586-4800 ext. 2819
geoff.nguyen@utoronto.ca

  • Canada has among the highest incidence rates of Crohn's and colitis in the world.
  • 1 in 150 Canadians lives with Crohn’s or colitis.
  • Families new to Canada are developing these diseases for the first time.
  • Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
  • People are most commonly diagnosed before age 30.

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