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Crohn’s disease and ulcerative colitis are the two main forms of Inflammatory Bowel Disease (IBD). They are chronic diseases that cause serious and lasting physical obstacles including pain, diarrhea, nausea, and vomiting.

While we often discuss IBD’s physical symptoms, we may spend less time talking about the anxiety people face while managing these symptoms. Research suggests patients require exceptional coping skills to manage Crohn’s or colitis. Magnifying this is the fact that people are often diagnosed in their late teens or early twenties, a time that many enter post-secondary education. Facing all the challenges that come with your first semester while living with a chronic illness can be terrifying. 

Dr. Dean Tripp from the Departments of Psychology, Anesthesiology, and Urology at Queen's University underscores the complexity of the pain associated with chronic illness and the unique challenges students with IBD face. For some, pain is consistent and nagging; for others it’s consistent but manageable; and some have to manage unexpected and periodic spikes in pain.

Regardless of the pain category a person with Crohn’s or colitis experiences, Dr. Tripp calls out a couple of things to watch for related to anxiety.

1. Catastrophizing – anticipation or constantly ruminating the worst scenario about future pains, feeling fear of not making it through class before needing to head to the washroom, or a sense of helplessness that there is little you can do to manage, can cause some to catastrophize which intensifies anxiety.
2. Hypersensitivity – pain hypersensitivity is promoted through high anxiety. Unfortunately for individuals with IBD, anxiety can only magnify sensitivities in the gut.

Dr. Tripp underscores some ways to be proactive and help manage such anxiety:

1. Talk to your professors – explain your situation prior to the start of the semester. Their understanding can help to reduce anxiety levels, especially if you need to leave class.
2. Scenario plan – know where the washrooms are related to your classrooms. Map them out beforehand to reduce future stress.
3. Listen to your body – if there are certain foods or beverages that upset you, avoid them. Drinking alcohol and eating out are part of the ritual for many post-secondary students. For many people with IBD, a night of drinking or spicy foods can cause days of uncomfortable symptoms. University/college is a time to experiment, but we all need to know our limits.

Dr. Jennifer Jones, Associate Professor of Medicine and Team Lead of the Nova Scotia Collaborative Inflammatory Bowel Diseases Program at Dalhousie University, echoes Dr. Tripp’s advice. First year university is a time when young adults flee the nest. It’s a critical time in one’s life and complications can have a profound impact on the ability to pursue life goals. Dr. Jones is interested in improving outcomes for young people with IBD and outlines a number of coping mechanisms students can use to overcome anxiety, and to live, study, and socialize better with IBD.

1. Develop a social support network – let your friends know your limits and work around them.
2. Reach out to others like you for peer mentorship – seek others in the same situation so you can talk things through and share coping mechanisms.  
3. Get access to programs of care – seek out the Office for Students with Disabilities or a similar departments or organization that can direct you to appropriate resources.

The best action recommended for students is to take charge. Try not to let the disease define you. Be knowledgeable. Be an advocate. Don’t be afraid to access health care when needed.

Dr. Robert Maunder is a Professor at the University of Toronto’s Department of Psychiatry, and the Deputy Psychiatrist-in-Chief and Head of Research at the Sinai Health System Department of Psychiatry in Toronto. He says the most consistent challenge faced by students living with a chronic disease like Crohn’s or colitis is adjusting to the basic idea of living with an illness for the rest of their lives and the many impacts that can cause across all areas of life, including personal relationships. He advises students to:

1. Trust yourself – you are the expert when it comes to knowing what your body is capable of at any given time. Respect that the illness is present and accept that you may have to make some adjustments to accommodate to it, even if doing so causes difficulties or unhappiness in the short term. It’ll make you stronger in the long term. 
2. Move at your own pace – Living with Crohn’s or Colitis can add challenges to friendships or relationships, there are no perfect answers. What works for you may not work for someone else, and vice-versa. Trying to solve these issues while living with IBD is just another challenge. Discussing these challenges with peers in similar situations, perhaps through a student group for students living with Crohn’s or colitis, can be helpful. 
3. Live your life – IBD can cause uncertainty and make it difficult to predict what will happen in the next hour, or the next day. Don’t respond to this by avoiding plans. A better solution is to coach your friends, and explain to them that if you don’t follow through with plans, it’s not because you didn’t want to. 

Crohn’s and Colitis Canada wants to support students. With AbbVie IBD Scholarships, the national charity offers annual scholarships to students from colleges and universities across the country. Recipients all live with the challenges of IBD and not only strive to sustain an optimal level of wellness, but also seek to inspire others to do the same. Each year these recipients share advice for new students. Click here to watch their tip videos.

For anyone with IBD looking to talk with someone who understands, Crohn’s and Colitis Canada offers a confidential, online, peer-to-peer mentoring program. To learn more, visit gutsypeersupport.ca.