Introduction
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Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), plays an important role in the pathogenesis of environmental and lifestyle factors . Lifestyle changes and environmental factors may play a role in the prevention and treatment of IBD. International Organization for the Study of Inflammatory Bowel DiseaseRecently at Lancet Gastroenterol Hepatol issued a consensus statement with a series of recommendations for patient management of IBD, come and see!
√smoking
Smoking increases the risk of CD, and quitting smoking increases the risk of UC. Children, adolescents, and young adults should be encouraged to never smoke to reduce the risk of IBD, as well as other long-term health benefits.
Smoking can worsen the natural history of CD, and smoking cessation can improve the prognosis of CD smoking patients. All smokers with CD should be strongly encouraged to quit.
Continued smoking does not improve the natural history of UC. Although smoking cessation may be associated with a higher risk of colectomy, patients with UC should be encouraged to quit because of the long-term adjunctive health benefits. √e-cigarettesData on the impact of e-cigarettes on IBD disease activity and outcomes Rarely, further research is needed to determine whether e-cigarettes can be a less harmful alternative to traditional smoking. √Stress, Emotional and Mental Health
Ask about anxiety, depression at diagnosis and at the time of new or worsening symptoms and psychosocial stressors diagnosis or symptom profile.
Patients with IBD and a mental health disorder should be referred to a mental health professional for assistance in diagnosis and treatment.
Further research is needed to investigate the efficacy of psychiatric medication and behavioral therapy in IBD patients with psychiatric disorders, and how these treatments affect the course of IBD. √Diet
IBD patients who begin elimination diet therapy should prioritize dietary strategies that are well-documented at the time. Monitor not only symptomatic improvement, but also objective resolution of inflammation.
IBD patients treated with an exclusion diet should be carefully monitored for evidence of nutritional deficiencies. √DrinkingIBD patients do not need to avoid alcohol to affect disease activity. But excessive drinking has adverse effects on other health outcomes. √NutritionPatients with IBD should be assessed for malnutrition, obesity, and sarcopenia by a professional dietitian as part of routine care. √Physical activityNo evidence that physical activity is associated with poor outcomes in IBD patients . Physicians should ask patients with IBD about their physical activity levels, identify and address barriers to physical activity, and advise patients to increase activity as tolerated. √Non-steroidal anti-inflammatory drugs (NSAIDs)
Patients with confirmed IBD should avoid prolonged or frequent use of high doses NSAIDs.
For short-term pain relief, nondrug therapy, acetaminophen, COX-2 inhibitors, or low-dose NSAIDs can be used.
Aspirin is safe for cardioprotective use in IBD patients. √ContraceptionCombined with the patient’s IBD characteristics, concomitant comorbidities, and risk factors for venous thromboembolism, the appropriate method should be determined jointly with the obstetrician and gynecologist. contraceptive method. Progestin-only or low-dose estrogen-containing approaches may be preferred in patients at high risk for venous thromboembolism. √Children’s primary preventionPatients who are consulting on how to prevent their children from developing IBD may be advised to consider breastfeeding when possible, with caution Give your child antibiotics and protect your child from tobacco exposure.
References: Ananthakrishnan AN, Kaplan G G, Bernstein C N, et al. Lifestyle, behaviour, and environmental modification for the management of patients with inflammatory bowel diseases: an International Organization for Study of Inflammatory Bowel Diseases consensus[J]. The Lancet Gastroenterology & Hepatology, 2022.