ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Am J Gastroenterol. 2017 Feb;112(2):241-258. doi: 10.1038/ajg.2016.537. Epub 2017 Jan 10.

Abstract

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.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Anxiety / diagnosis
  • Anxiety / therapy
  • Chickenpox / etiology
  • Chickenpox / prevention & control
  • Depression / diagnosis
  • Depression / therapy
  • Early Detection of Cancer
  • Female
  • Hepatitis, Viral, Human / etiology
  • Hepatitis, Viral, Human / prevention & control
  • Herpes Zoster / etiology
  • Herpes Zoster / prevention & control
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Inflammatory Bowel Diseases / drug therapy*
  • Influenza, Human / etiology
  • Influenza, Human / prevention & control
  • Male
  • Melanoma / diagnosis*
  • Meningococcal Infections / etiology
  • Meningococcal Infections / prevention & control
  • Osteoporosis / diagnosis*
  • Papillomavirus Infections / etiology
  • Papillomavirus Infections / prevention & control
  • Pneumococcal Infections / etiology
  • Pneumococcal Infections / prevention & control
  • Preventive Medicine / methods*
  • Primary Health Care*
  • Skin Neoplasms / diagnosis*
  • Smoking Cessation
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / prevention & control
  • Vaccines / therapeutic use*

Substances

  • Immunologic Factors
  • Immunosuppressive Agents
  • Vaccines