Support for You

There are several things you can do to help lower your risk of developing colon cancer. It is very important that you talk to your IBD specialist or health care provider about scheduling appointments to undergo colon cancer screening, including colonoscopies to check for polyps or pre-cancerous changes in the lining of the intestine. Lifestyle choices can also be modified to help decrease your risk. These include:

• maintaining a healthier diet that avoids foods or drinks high in fructose (sugar), fat, red and processed meats;

• exercising regularly;

• maintaining a healthy weight;

• quitting smoking;

• drinking alcohol in moderation (no more than 1 - 2 drinks per day).  

For more information about cancer and IBD, visit our Complications section. 

Sleep problems are common in IBD. They tend to occur more frequently during flares but can also occur during remission. Problems with sleep can affect quality of life and the ability to cope with IBD pain, fatigue, and other symptoms. Sleep problems can also make IBD worse by affecting the immune system. There are medications that can help promote sleep, but these may have side effects. Non-medication options include exercise, sleep education, cognitive behaviour and mindfulness therapy, and coping strategies:

• Do not try to force yourself to fall asleep. This can actually make insomnia worse
• Focus on doing relaxing activities at least one hour before bed
• Try to go to sleep and wake up at the same time each night. Sleeping in late because you could not fall asleep the night before can lead to more insomnia
• Do not take naps during the day
• Try to exercise each day
• Avoid caffeine before bedtime
• Avoid working or watching TV in bed
• Keep your room dim at night
• Keep a sleep journal to see if there are any trends or patterns in your sleep
• Consider seeing a sleep specialist

To learn more about managing symptoms click here. 

Anemia is a deficiency of red blood cells or hemoglobin in the blood. One major symptom of anemia is fatigue. Other symptoms include a pale appearance and reduced ability to exercise. About 14% to 19% of people with IBD have anemia, and 20% to 54% are low in iron. Most cases of anemia in IBD are due to iron deficiency. Inflammation, intestinal blood loss, reduced iron absorption, and altered iron metabolism can contribute to anemia. Another cause is low vitamin B12.

Learn more about anemia and ways to manage it in our Complication section.

One liver condition associated with IBD is primary sclerosing cholangitis (PSC). This is a disease of the bile ducts that carry bile from your liver to your small intestine. Inflammation causes scars in the bile ducts, making them hard and narrow. PSC can cause liver failure, repeated infections, and tumours of the bile duct or liver. Only 5% of patients with ulcerative colitis will develop PSC; however, about 70% of patients with PSC have underlying IBD, usually ulcerative colitis.

Symptoms of PSC are common to IBD flares and include: fatigue, itching, fever, chills, night sweats, weight loss, yellow eyes or skin (jaundice), enlarged liver or spleen. PSC is often diagnosed on routine blood tests before symptoms appear. IBD patients should be screened for PSC every year with liver function tests, regardless of whether or not they have symptoms.

Speak to your health care provider or IBD specialist if you are concerned about PSC and to ensure that you are being regularly screened.

For more information on PSC, visit our Complications section. 

Adhesions are scar tissue that stick the intestine to the abdominal wall, to other loops of intestine, or to another organ. Adhesions can cause the intestine to twist, causing a blockage. About 90% of adhesions arise after abdominal surgery. They occur after many different types of abdominal surgery, not just those that are IBD-related.  Adhesions can also develop as a result of inflammation.

Visit our Complications section to learn more about adhesions and how they are treated. 

Osteoporosis is when there is an imbalance in the formation and resorption of bone. Osteoporosis causes your bones to become brittle. Another condition you might hear about is osteopenia, which is a type of pre-osteoporosis.

People with IBD are at higher risk of developing osteopenia and osteoporosis. There are a few reasons for this including medications, inflammation and nutritional deficiency. Medications like systemic corticosteroids can impair bone formation. Inflammation causes a chemical called cytokines to be released which in impact bone formation.

Nutritional deficiencies can occur with IBD, especially in calcium as well as vitamins D and K, which are important for bone formation.

Visit our Complications section to learn more about osteoporosis prevention and management. 

In Crohn’s disease, arthritis affects 15% to 20% of patients; in ulcerative colitis, it affects about 10%. The arthritis that occurs in IBD is different from rheumatoid arthritis. People with rheumatoid arthritis have arthritis that destroys the joints over time. People with arthritis associated with IBD have arthritis that does not destroy or degrade the joints. There are two types of arthritis that affect people with IBD: 1) Peripheral arthritis (affects the large joints, such as the hands, knees, and elbows) and 2) symmetrical polyarthritis (patients typically have arthritis in the small joints of their hands). When possible, your doctor should try to use medications that reduce inflammation of both your IBD and your arthritis.

To learn more about joint inflammation and arthritis visit our Complications section.

It is important to remember that IBD does not just affect your abdomen; it is a systemic disease that affects other organs, including the eye. There are numerous types of eye inflammation that can arise with IBD. Some types of eye inflammation can affect your vision significantly. There are various types of inflammation: Episcleritis, Scleritis, Keratopathy and Uveitis.

To learn more about each type and how to manage them, read more here.

Losing hair, or a thinning of hair, is not uncommon in people living with Crohn's or colitis. Reasons for hair loss in people with IBD are complex and not yet well understood.

Hair loss (mild alopecia) has been reported as a side effect of both methotrexate and azathioprine (e.g., Imuran), which are immunomodulator drugs that may be prescribed to patients with IBD and other autoimmune disorders such as arthritis.

A recent observational study found that patients with a history of taking 5-ASA (i.e., Mesalamine) and Anti-TNF medications (i.e., Infliximab/Remicade) were less likely to report a history of hair loss. More research is needed to better understand how medications are associated with hair loss in IBD.

Please do not make any changes to your treatment without first talking to your health care provider.  You may need to undergo some tests to help rule out other potential causes of your hair loss.

If you are concerned about hair loss, speak to your health care provider or IBD specialist for more information. 

Your health care provider will likely need to do some tests to help determine the cause of your hair loss. This can include blood tests and physical examinations. Depending on the cause of hair loss, there are several treatment options to stimulate hair growth. If hair loss is due to telogen effluvium, the first step will be to test for active disease (inflammation) and get your IBD under control.

Your IBD specialist may ask you to undergo an endoscopy/colonoscopy, and conduct blood and/or fecal tests to determine if you are experiencing active disease. Your health care provider may also check for nutritional deficiencies, including vitamin B12 and iron, and you may need to adjust your diet or take nutritional supplements.

If your hair loss is due to treatment side effects, your IBD specialist may consider changing your medication after further evaluation. If hair loss is due to a related autoimmune condition such as alopecia areata, you may be referred to a dermatologist and prescribed a corticosteroid as a topical agent or an injection to stimulate hair growth. Make sure you talk to your healthcare provider about the options, especially before you use any over the counter treatments.

In most people, hair loss is reversible and given time, your hair will start to regrow.