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General Health Maintenance Fact Sheet
It is important to continue to maintain your health after being diagnosed with Inflammatory Bowel Disease.
The following vaccinations, testing and screening tools are encouraged:
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Vaccinations: Certain medications used for IBD can make you more susceptible to infections.
Because vaccinations can help prevent certain infections, it is extremely important to stay up to date.
Adults with IBD should generally follow the same vaccination schedule as the general population.
The one exception is for individuals on Immunomodulators and anti-TNF therapy, who should avoid
any live virus vaccines. Because there is a chance all patients with IBD may eventually be on these
medications, the best time to get vaccinated is when you are newly diagnosed.
Oral Health: Canker sores, also known as aphthous ulcers, are one of the most common
extraintestinal symptoms of IBD. These can be caused by the IBD itself or because of nutritional
deficiencies. Though these ulcers are not serious, they can be very painful. Mouth rinses or other
topical treatments may help relieve the discomfort. Routine dental care with your dentist should
also be done.
Tuberculosis Screening: Screening needs to be done before any kind of immunosuppressive
treatment is started. Because these medications can affect the outcome of the test, the best time to
get tested is when you are newly diagnosed.
Periodic Blood Testing: The frequency and types of blood test we will be asking you to do will
depend on the medications you are taking and any other medical conditions you may have. Before
many of the medications can be started, a baseline set of tests will need to be completed. This helps
us determine any medication-associated abnormalities or benefits.
Colonoscopies: These are essential in the management of IBD. They are used to determine the
severity and extent of the disease, monitor the effectiveness of therapy, check for postoperative
recurrence, and screen for colorectal cancer. Everyone with IBD in the colon should have a
colonoscopy starting 8 years after the first symptoms and then every 1 to 2 years thereafter to
monitor for colon cancer.
Tobacco Cessation: Smoking will make your Crohn’s disease worse and will make all IBD medications
less effective. If you are a smoker and you have Crohn’s disease or ulcerative colitis, the best thing
you can do for yourself is stop. This will lessen your cancer risk and improve your lung and heart
health.
Osteoporosis monitoring: Osteoporosis is the loss of bone minerals such as calcium. It can lead to
broken bones, typically in the hips and spine. Osteoporosis can be a significant medical problem for
individuals with IBD. This is because of chronic inflammation, side effects of medicines used for IBD
(steroids in particular), low ability to absorb calcium and vitamin D, and lack of exercise during acute
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flares. The best way to prevent osteoporosis is to minimize steroid use, supplement with calcium
and vitamin D, weight bearing exercise, such as walking, and the use of bisphosphonates for those
being treated with steroids. A bone density scan, also known as a DEXA (dual energy x-ray
absorptiometry) scan is done to measure bone loss. We will also do a blood test to check your
vitamin D level.
Blood pressure screening: Some medications used to treat IBD, specifically corticosteroids and
cyclosporine, cause individuals to be at an increased risk of secondary hypertension (high blood
pressure). Periodic blood pressure checks are important. In most instances, when the medications
are stopped the blood pressure returns to normal for these individuals.
Depression: Patients with IBD care prone to depression. This can be attributed to various factors
including the chronic relapsing nature of the disease and some of the medications used as treatment.
It has been said depression affects between 15 and 35% of patients. Screenings and appropriate
medical treatments are necessary
Ophthalmologic Screening: Corticosteroid use may increase the risk of glaucoma as well as cause
some temporary vision changes. Also, some extraintestinal symptoms of IBD involve the eye
Cancer Screening: Individuals with IBD should follow the current recommendations for regular
screenings for breast and prostate cancer. Women who are on immunomodulator therapy are at an
increased risk for abnormal (precancerous findings) on pap smears. This is related to being at an
increased risk for HPV. Annual pap smears are recommended. Men and women on
immunomodulator therapy are at an increased risk for basal cell and squamous cell skin cancers.
There is no increased risk for melanoma. Using sunblock and wearing protective clothing, such as a
hat, will help lower the risk, especially in the summer and any time you will be out in the sun. An
annual visual exam of skin by a dermatologist is recommended after long term immunosuppressant
use.
Health Care Maintenance Chart
YEAR
Tuberculosis Testing
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TB Skin Test
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QuantiFERON Blood Test
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Chest X-ray
Vaccinations
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Hepatitis A
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Hepatitis B
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HPV
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Influenza
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Meningococcal Meningitis
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MMR*
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Pneumococcal Pneumonia
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Td/TdaP
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Varicella*
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Zoster*
Cancer Screenings
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Cervical Cancer / Pap Smear
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Breast Cancer / Mammogram
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Prostate Cancer / PSA
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Colon Cancer / Colonoscopy
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Skin Cancer / Dermatology Consult
Other Screenings
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Blood Pressure
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Ophthalmologic
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Osteoporosis / DEXA Scan
Laboratory Exams
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Complete Blood Cell Count
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Liver Function Tests
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Creatinine
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Vitamin B12
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Folate
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Iron
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Vitamin D 25-OH
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Lipids
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Glucose
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Other
Counseling
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Immunosupression Counseling
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Calcium/Vitamin D Counseling
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Smoking Cessation Counseling
* Live virus vaccine