Expert Q&A

A: Going through a flare is physically and emotionally difficult. Also, symptoms associated with the flare can worsen or contribute to symptoms of depression. It is recommended that all symptoms be discussed with his IBD specialist. While there may be adjustments in his medication regimen, he may also benefit from a consultation with a GI mental health provider to aid with managing the complexities of IBD. They will assess for severity of mood symptoms and help create a treatment plan to aid in improving mood, fatigue and overall functioning. To locate a mental health provider, encourage your son to speak with his IBD provider as that provider may have someone on the team or have a local resource. He can also use this directory: www.romeGIpsych.org. hide answer

A: Stress can have a significant impact on our mind and body. Work is one aspect of life that can contribute to stress for various reasons. In people with chronic GI conditions stressors related to work can come from the actual job demands, while also GI-specific stressors such as physical symptoms, access to bathrooms, navigating medical appointments and more. If aspects of IBD are impacting you at work, it is likely time to identify who at work can assist with navigating your rights as someone in the work force with a chronic illness. Depending on your needs and work environment, you may be able to provide very basic information about your needs and the impact of your health on your work. You can share what you feel comfortable sharing. You may benefit from working with your medical provider and employer to complete FMLA (Family and Medical Leave Act) or ADA (Americans with Disabilities Act) paperwork to receive reasonable accommodations. Having these accommodations in place can assist with stress management by reducing some of the burden if you need a day off for the management of your health. You can find important information about your rights as a person with IBD here: https://www.crohnscolitisfoundation.org/sites/default/files/legacy/assets/pdfs/employment-and-inflammatory.pdf hide answer

A: There can be many anxiety provoking things that happen around back to school time for kids (schedules, lockers, new friends, school changes, etc). So, first it is important to normalize this for kids with and without chronic illness. For those with IBD, there may be some additional stressors that I would encourage you to explore with your daughter. Dr. Brad Jerson is a pediatric GI psychologist who just published a great article recently about school considerations that can impact those with GI conditions (https://www.healio.com/news/gastroenterology/20220823/back-to-school-with-digestive-disorders-parentschool-partnership-key-to-patient-support). Some of the factors to consider include bathroom access, dietary sensitivities, navigating your health with your peers and more. All of this can progress from worry to anxiety to panic if unaddressed. It is a great idea to chat with your pediatrician, and consider talking with a GI psychologist (if you are near one) or a general mental health provider who can assist with anxiety management. hide answer

A: I would say that the anxiety of having a roommate for the first time is common for most college students. Normalizing this for him may be a good place to start. It would them be helpful to work on language that he can become more comfortable with around talking to his roommate (and friends) to help them understand how IBD can impact his life. While discussing bathroom issues can feel uncomfortable, once he gets the conversation about his needs out there, it will likely help to reduce the anxiety. He doesn’t have to be graphic or overly detailed but help give some context to why he may spend some extra time in the bathroom, need to use the bathroom urgently, need time for rest or eat differently. It typically takes a lot more energy to avoid these types of conversations over time than it will to have the initial conversations and hopefully have them be well received. He may also see that his roommate can be supportive and assist him when and if he needs that. hide answer

A: Thank you for being curious and aware of these changes in your daughter. A new diagnosis of a chronic disease can lead to many life changes, new normal and at times, fear about the future. Watching for signs of anxiety and depression are important. It does sound like your daughter is experiencing some symptoms of depression. I would recommend speaking with her gastroenterologist about whether there is a GI psychologist or GI-specialized mental health professional for her to consult with. If not, you can check www.ROMEGIPsych.org or look for a mental health provider who specializes in working with teens, chronic illness, depression and anxiety via www.psychologytoday.com or another via the Crohn’s and Colitis Foundation resources. hide answer