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Dr. Siegel

An IBD specialist can have a big impact on your treatment plan

Being comfortable talking to your doctor can help you learn about and manage your inflammatory bowel disease (IBD) more effectively.

Dr. Siegel, Gastroenterologist, Crohn's and UC Expert

Dr. Corey Siegel is a gastroenterologist and the Director of the Inflammatory Bowel Disease Center at Dartmouth-Hitchcock Medical Center. He’s helped treat people living with Crohn’s disease or ulcerative colitis (UC) for over 10 years.

To learn about how inflammation affects your symptoms and how to work with your doctor to manage your condition, watch these videos and use our Doctor Discussion Guide.

Ins and Outs of Inflammation

Transcript

With Dr. Siegel as your guide, learn where your symptoms come from and what they may be trying to tell you.

INS & OUTS OF INFLAMMATION

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Ins and outs of inflammation

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INS & OUTS OF INFLAMMATION

DR. SIEGEL DTC:
Living with Crohn’s disease or ulcerative colitis may mean living with symptoms at some point. I want to help you understand where your symptoms come from and what they’re trying to tell you. Knowing the role that inflammation plays in your symptoms can help when checking up with your doctor. Together, you and your doctor can work towards controlling the inflammation with a goal of achieving and maintaining remission.

Ins and outs of inflammation is explained in three sections. One: The source of your symptoms. Two: What can trigger your symptoms. And three: What active inflammation can lead to.

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The source of your symptoms

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THE SOURCE OF YOUR SYMPTOMS

DR. SIEGEL:
Both Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases, also known as IBD. As the name suggests, these conditions stem from inflammation, which is the source of your symptoms. If you have Crohn’s disease or ulcerative colitis, you may go through periods when your disease is quiet and you experience few or no symptoms at all. However, these periods will likely alternate with times when the disease is active and you do experience symptoms. Those symptoms are the result of inflammation becoming active again. That’s why, even if you are taking medication, occasional symptoms need to be discussed with your doctor at all of your doctor check-ups. Your symptoms may be a sign of active disease and potentially damaging inflammation. The symptoms in both Crohn’s disease and ulcerative colitis can be unpredictable. They may come on suddenly, without warning. They may change in severity, or change altogether. You may go through long periods of remission with few or no symptoms and then, of course, have periods of flare-ups. It’s because of this unpredictability that it’s important to regularly check in on how you’re feeling and what symptoms you may be experiencing, and consistently check up with your doctor to get his or her expert opinion and insight. It might be useful to keep a symptom log on your phone’s notes or somewhere easily accessible, like a daily journal. This way, you can track your symptoms, no matter how minor, and be able to communicate about them later to your gastroenterologist.

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What can trigger your symptoms

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WHAT CAN TRIGGER YOUR SYMPTOMS

DR. SIEGEL:
In both Crohn’s disease and ulcerative colitis, inflammation may be present even when you are not experiencing symptoms. Regardless, it’s important you try to avoid triggers that could bring about or worsen your symptoms. But remember, symptoms may also return and occur even without a specific trigger.
So, what exactly is a trigger?
If you are living with inflammation associated with Crohn’s disease or ulcerative colitis, triggers are certain outside factors that could aggravate your symptoms. Triggers are different for different people. That's why it's important to check up with your doctor, work together to understand how triggers can influence your symptoms, and develop a plan to help avoid your triggers.

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Stress

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STRESS

DR. SIEGEL:
Stress may not be a direct trigger for Crohn’s disease or ulcerative colitis, but it certainly can make you feel worse. And while you’ll never be able to rid your life of stressful situations, it is possible to change your reaction to them so that your stressors don’t cause further distress to your digestive tract.

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Missed medications and incorrect dosing

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MISSED MEDICATIONS & INCORRECT DOSING

If you are taking medication on a regular basis for Crohn’s disease or ulcerative colitis, it’s important you take your medication exactly as prescribed by your doctor, even if you are not currently experiencing symptoms. Missing doses can lead to a worsening of symptoms.

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Smoking

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SMOKING

DR. SIEGEL:
Cigarette smoking affects Crohn’s disease and ulcerative colitis differently. For those living with Crohn’s, smoking not only raises the risk of actually developing Crohn’s disease, but it can trigger flares. For those living with ulcerative colitis, smoking withdrawal can actually cause the return of symptoms. However, if you do currently smoke, please ask your doctor for advice on how you can stop.

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Nonsteroidal anti-inflammatory and antibiotic drugs

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NONSTEROIDAL ANTI-INFLAMMATORY AND ANTIBIOTIC DRUGS

DR. SIEGEL:
Some commonly used medications may lead to flares. Nonsteroidal anti-inflammatory drugs or (NSAIDs) such as aspirin, naproxen, and ibuprofen are possible triggers for flares. Antibiotics also change the balance of bacteria in your intestine and therefore could cause inflammation.

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Food

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FOOD

DR. SIEGEL:
Eating any particular food does not cause Crohn’s disease or ulcerative colitis. However, diet can certainly impact your symptoms and food triggers can vary from person to person. It’s best to avoid greasy and fried foods. For some people, foods high in fiber, such as fruits and vegetables and whole grains, can be problematic. Alcohol can also be associated with flareups. If a particular food causes problems, talk to your doctor or dietitian before eliminating it from your diet. If a food does not bother you, then it’s probably OK to eat.

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What active inflammation could lead to

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WHAT ACTIVE INFLAMMATION COULD LEAD TO

DR. SIEGEL:
If you are treating your Crohn’s disease or ulcerative colitis, even occasional symptoms are signs that your disease may not be under control and you may have damaging inflammation. If the inflammation continues over time, it is possible that some of these potential complications could occur.

Checking in with yourself and consistently checking up with your doctor may help in your overall disease management.

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With Dr. Siegel as your guide, learn where your symptoms come from and what they may be trying to tell you.

Roadmap to Remission

Transcript

Dr. Siegel helps take you through the challenges and milestones you’ll have during your treatment journey.

ROADMAP TO REMISSION

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Roadmap to remission

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ROADMAP TO REMISSION

DR. SIEGEL:
It can be difficult to determine the next steps in treating your Crohn’s disease or ulcerative colitis. But as a gastroenterologist, I enjoy checking up with my patients and helping them develop a roadmap that can help get them on their way to remission. In this chapter of your check-in, I’d like to offer some tips on how you and your doctor can work together to effectively manage damaging inflammation and help treat your symptoms.

Roadmap to remission is split up into two sections. One: Treatment goals. And two: Treatment options.

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Treatment goals

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TREATMENT GOALS

DR. SIEGEL:
When you were first diagnosed with Crohn’s disease or ulcerative colitis, perhaps you imagined a future compromised by ongoing symptoms. And maybe even now you still think there’s no getting around, or avoiding, having any symptoms be part of your life. As you continue your check-in, I hope to change that belief by providing you with the information you need to check up with your doctor and together, create an effective treatment plan that meets your expectations. Whether you have Crohn’s disease or ulcerative colitis, you shouldn't have to just cope with ongoing symptoms. Experts believe that the goals for treatment are to achieve and maintain remission.

When you are open and honest with your doctors, these goals may be within reach. It’s also important to make sure you’re seeing the right doctor. If you are looking for a doctor or thinking about changing doctors, here are a few points you should be considering: Ideally, your gastroenterologist should specialize in Crohn’s disease or ulcerative colitis and:

Set goals for your treatment
Ask for specific details about your symptoms during your appointments
Have more than one plan of action
Be willing to take time to listen to your concerns at every appointment, and
Be available to address your concerns between appointments

Your doctor or gastroenterologist should be asking you for details about your symptoms. Each patient is different and so are his or her symptoms. Your doctor should recognize that sometimes various symptoms are difficult to talk about; however, if they don’t appear to recognize this, you will have to be proactive.

You should be telling your doctor or gastroenterologist the details of your symptoms. Do not hold back and do not assume that just because your doctor is an expert and sees a lot of patients with Crohn’s disease or ulcerative colitis that he or she is aware of what you are personally going through. Remember, when it comes to your health, your treatment goals should be set high.

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Treatment options

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TREATMENT OPTIONS

DR. SIEGEL:
While there are no medications that cure Crohn’s disease or ulcerative colitis, there are treatments that may help you manage your symptoms. In this check-in, I’ve outlined a few for you.

When you check up with your doctor or gastroenterologist, he or she may suggest one or more of these treatment options, if they believe they are right for you.

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Aminosalicylates, or 5-ASAs

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AMINOSALICYLATES (OR 5 ASAs)

DR. SIEGEL:
Work to decrease inflammation in the lining of the digestive tract

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Corticosteroids

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CORTICOSTEROIDS

DR. SIEGEL:
Help reduce inflammation by suppressing the immune system

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Immune modifiers, or immunomodulators

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IMMUNE MODIFIERS (OR IMMUNOMODULATORS)

DR. SIEGEL:
Suppress the body’s immune response so that it cannot cause ongoing inflammation

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Biologic therapies (or biologics)

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BIOLOGIC THERAPIES (OR BIOLOGICS)

DR. SIEGEL:
This class of drugs suppresses the immune system to reduce inflammation by targeting a specific pathway

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Surgery

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SURGERY

DR. SIEGEL:
Even though a person may be taking medication, in some instances, people with Crohn’s disease or ulcerative colitis may benefit from surgery

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Over-the-counter medications

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OVER-THE-COUNTER MEDICATIONS

DR. SIEGEL:
Such as antidiarrheals, pain relievers, and nutritional supplements are occasionally used as supplemental therapies along with your regular prescription medications

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Antibiotics

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ANTIBIOTICS

DR. SIEGEL:
Such as metronidazole, ciprofloxacin, and other antibiotics may be used when infections occur or to treat other symptoms related to Inflammatory Bowel Disease, also known as IBD.

If you are taking any of these medications or following any of these courses of action and are still experiencing even occasional symptoms, you may have damaging inflammation and it may be a sign that you and your doctor need to discuss a different treatment plan. It is also very important to keep in mind that what works at one point during your treatment may not be effective during another stage.

It’s important to check up consistently with your doctor so he or she can assess which course of therapy is best suited for you—keeping in mind that a combination of therapies may be the optimal treatment plan.

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Dr. Siegel helps take you through the challenges and milestones you’ll have during your treatment journey.

Honesty is the best policy when speaking with your doctor

Your gastroenterologist should make you feel comfortable about being open when talking with them. To ensure you get the best care, find a doctor that listens to your questions, responds to your concerns, and works with you towards your treatment goals.

Ready for more in-depth information? Learn more in tools & support.

Restroom Access Card | Mobile and Printed

Get a Restroom Access Card* and helpful info

Have a discreet way to ask for access to restricted restrooms if you have symptoms. And get updates, resources and more sent to your inbox.

*Eligibility restricted to patients diagnosed with Crohn’s disease or ulcerative colitis. Available as a card and mobile wallet version for your phone.

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