Managing Pain and Suffering With Inflammatory Bowel Disease
The Mayo Clinic defines Inflammatory Bowel Disease (IBD) as “an umbrella term used to describe disorders that involve chronic inflammation of the digestive tract.” There is an estimated 1.3 million people in the U.S. suffering from Inflammatory Bowel Disease. The two primary types of IBD include Chron’s disease and Ulcerative Colitis.
Crohn’s is a lifelong condition that causes the gastrointestinal tract to become inflamed. Although it cannot be cured, symptoms can go into remission but then flair up without warning. It can affect any part of the GI tract including the mouth, esophagus, stomach, small intestine, and large intestine. Furthermore, inflammation and tissue damage is sporadic throughout the GI tract with no discernible pattern. There are several variations of Crohn’s disease, but the most common (Ileocolitis) affects the end of the small intestine.
In severe cases, Crohn’s can cause fissures (or tears) in the lining of the anus resulting in pain and bleeding. Additionally, according to several population based studies, fistula formation has been reported in 17%-50% of patients with Crohn’s disease. Doctors try to control symptoms with a combination of medication and dietary changes. In many cases, a colectomy is performed to remove a portion of the colon to help better control the disease.
Ulcerative Colitis is the most common Inflammatory Bowel Disease and is similar to Crohn’s in many ways. UC causes inflammation localized in the large intestine (colon) causing ulcers to form along the inner surface of the large intestine (colon and rectum). Unlike Crohn’s, ulceration typically begins in the anus and spreads throughout the colon uniformly. Patients may experience symptom flare ups, indicating new damage to the large intestine.
Symptoms can also inexplicably go into remission for weeks, months, even years. Like Crohn’s, doctors will try and alleviate the severity of symptoms with changes in diet coupled with medicine. If these treatments fail to produce results, a colectomy may become necessary.
There is no clear indication as to what may cause inflammatory bowel diseases, however scientists believe it is autoimmune in origin. Genetic predisposition and environmental factors may also play a role in developing an Inflammatory Bowel Disease.
Our bodies are equipped with a defense (immune) system that fights off harmful bacteria. White blood cells are programed to ignore healthy bacterium in our body and only attack foreign invaders like viruses, bacteria, fungi, and other microorganisms. Our body’s gastrointestinal tract contains harmless bacteria that aids in the digestive process.
However, suspected autoimmune disorders cause white blood cells to begin targeting healthy tissue in the gastrointestinal tract resulting in ulcers and inflammation.
Crohn and Ulcerative Colitis produce many of the same symptoms, which can come and go over time with varying severity. Some of the most frequently reported symptoms include:
Loss of appetite
Sudden urges to eliminate
Feeling of incomplete elimination
Inability to hold in stool
Puss in stool
Loss of menstruation
Developmental and growth delays (specifically in children)
Managing Suffering with Inflammatory Bowel Disease
Like many other invisible illnesses, medical specialists spend months (sometimes years) helping patients stabilize their condition. When it comes to inflammatory bowel diseases, this would include finding the right balance of medications (for disruptive ever-changing symptoms), diet, and lifestyle changes to reduce or control inflammation.
- Intensifying symptoms are raising a cause for concern,
- They hope to control inflammation and improve quality of life, or
- Cancerous tissue is discovered.
Life after Stabilization
Chronic pain is a frequent complaint among people living with an Inflammatory Bowel Disease. Like many invisible illnesses, there are only so many treatment options doctors can offer to help manage pain including shots, procedures, immunosuppressants, antibiotics, biotics, and other medications, one of the most common being opioid prescriptions.
Opioids are frequently used to treat pain for many invisible illnesses because they are cheap, widely available, fast acting and effective. Unfortunately, over time many patients find opioids become less effective in addressing their pain, and does not address the associated psychological suffering. One of the most common ways pain patients achieve prior levels of relief is to increase the medication dosage, or couple them with other substances to intensify the effects of the opioids.
Many patients who find their way to our triple diagnosis program find themselves caught at the intersection of chronic pain and opioids. They understand that the opioid medications are becoming problematic, or they are becoming dependent on the medications without gaining any pain relief.
A Healing Place – The Estates offers transformative solutions for chronic pain management. We help patients learn to manage suffering associated with IBD with a combination of psychoeducation and therapy while exploring holistic evidence-based pain management modalities.
We offer integrated concurrent treatment, meaning our team of specialists including therapists, clinicians and doctors will work in collaboration with you to find sustainable solutions for pain management. You will be introduced to a variety of non-pharmacological interventions to help you manage physical suffering including:
- Genomic testing that allows our doctors to see what medications are and are not being metabolized by your body
- Massage therapy
- Nutritional education and anti-inflammatory based diet
- Relaxation response training
- Restorative Yoga
- Aqua Exercise
Your team will also work with you to address any psychological disorders that may be complicating your pain management or addictive behaviors that have developed or worsened over time.
To learn more about program options at A Healing Place – The Estates, click here.
Managing Psychological and Emotional Suffering
Another major hurdle to living with chronic illness are psychological and mental health disorders. In fact, a recent study showed that over 30% of individuals suffering with Inflammatory Bowel Disease were diagnosed with anxiety and/or depression.
It’s not surprising. One day you are healthy, engaged in school, work, sports, and hobbies without a care in the world. Then, for no apparent reason you begin to feel concerning symptoms that ultimately lead to a diagnosis with potentially lifelong implications. This diagnosis forces many to change the way they live their life, from the food they eat to the activities they enjoy; everything becomes a challenge.
When patients enter our program, we help them discover the connection between psychological pain symptoms, and physical perception of pain. This perception of pain can become more severe during anxious or depressive episodes. This is why it is so important to develop healthy coping strategies and emotional regulation techniques.
We have several therapeutic modalities to help improve our patient’s mental health. These include:
- Biofeedback Training with emWave2 Handheld Device by HeartMath
- Enhanced Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Psychiatric Consultation
- Music / Acoustical Therapy
- Mindfulness Interventions
- Motivational Interviewing
- Self-Hypnotic MP3s
Related article: 12 Things NOT to Say to Someone Living with Chronic Illness
Managing Social Suffering
Being diagnosed with a chronic illness can be one of the most difficult times of your life. However, friends and family often rally t to help ease and process the shock of being diagnosed with a lifelong illness. They offer support with transportation for appointments, pick up prescriptions, and offer a shoulder to cry on when it all becomes overwhelming.
Unfortunately, the resiliency of caregivers often dwindles over time. Friends pull away as it becomes more difficult to attend social functions (let alone get through the day!) Family members become worn down and become less available to offer emotional support, and in some cases. Some may even begin to resent the difficulties that come with supporting a loved one living with a chronic illness.
When support structures break down, pain patients must work to reestablish healthy communication strategies with their support network. This can help prevent burnout and ensure that everyone is being heard and getting their needs met. We help patients become more resilient with a few strategic interventions that include:
- Group therapy
- Intensive family workshops
- Social needs assessment
- Support groups
Managing Spiritual Suffering
Patients entering our program often feel as if they have lost a piece of themselves to their chronic illness. They feel as though they have lost their purpose, sense of direction, and even believe their higher power has abandoned them.
One of our treatment goals is to help patients connect spiritually. Some will reconnect with an identified religion and strengthen a bond that has diminished over time. Others who do not identify with religions explore spiritual dimensions with nature, energy, and human connectedness. It is our mission to help you find a sense of hope and inspiration no matter where you are on your spiritual journey. We do this in a few different ways:
We do this in a few different ways:
- Spiritual Direction with Shannon Savage-Howie, Spiritual Director
- The Four Agreements
- Mindfulness and meditation