IBD and the medications we take for it can put us at a higher risk of experiencing other health conditions. It’s important to know the preventive measures you can take.
Those of us with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, must take measures to keep our intestines healthy and the rest of our bodies healthy. Some of the medications we take to treat our IBD are immunosuppressants, which can raise our chances of developing certain infections and cancers.
That’s why it’s important that we follow recommended screening guidelines to help prevent infection and detect any abnormalities that could be precursors to cancer. These preventive vaccinations and procedures are generally covered by insurance and are minimally invasive.
People with IBD tend to be at a greater risk of developing influenza compared with those without IBD and at greater risk of requiring hospitalization. To help lower these risks, people with IBD can receive a flu shot yearly. Experts recommend that people who take immunosuppressant medications avoid live vaccinations and receive the inactivated version, as a live vaccine could actually give a person with a weakened immune system the flu. Before receiving a shot, always make sure your medical professional or pharmacist knows about the medications you take and your medical conditions.
People with IBD who take immunosuppressant medications can also receive pneumococcal vaccinations to help prevent them from getting pneumonia or developing complications from it, like respiratory failure, which could result in hospitalization or death. Typically, experts recommend this vaccination series for healthy people ages 65 or older, but they recommend it for people of earlier ages with certain medical conditions. This is a two-shot series that you only need once in your lifetime.
Shingles is a reactivation of the virus that causes chicken pox, and it can lead to long lasting nerve pain. Just as in the general population, experts recommend that people with IBD ages 50 and older receive the preventive two-shot shingles vaccination, which only needs to be done once in your lifetime.
Compared with the general population, people with IBD do not have increased rates of complications from COVID-19, such as pneumonia or hospitalization. As a result, for most people with IBD, the recommendations for vaccination against COVID-19 are the same as for the general population, which means primary vaccination and periodic booster shots, as the CDC recommends.
Experts advise people to wear protection against the sun when outside — especially those with IBD who take immunosuppressive medications like biologics and azathioprine, as these medications have been linked to a higher risk of developing skin cancer. Besides taking precautions such as wearing sunscreen and sun-protective clothing, it is important to contact a dermatologist around the time of your IBD diagnosis. Your dermatologist will then advise whether yearly skin checks are necessary for you or whether your screening interval may be more or less often.
Doctors recommend the human papillomavirus (HPV) vaccination series for all people, regardless of gender, between the ages of 11 and 26, and sometimes up to age 45 if the person is likely to continue having sex without a condom or another barrier method. The HPV vaccination helps prevent certain types of HPV infections. HPV can lead to the development of genital warts and cellular abnormalities, which can lead to precancerous lesions and cancers in the cervix, vulva, vagina, penis, anus, and oropharynx.
In addition to getting an HPV vaccination, it is important for women with IBD taking immunosuppressant medications to have yearly pap smears. This is because our suppressed immune systems may not allow the body to clear the HPV, increasing the risk of developing cervical cancer.
Steroid use can weaken bones, putting people with IBD at risk of low bone density, which puts us at risk for bone fractures. Additionally, nutrient malabsorption can lead to low vitamin D levels, which also can lead to low bone density.
However, weight-bearing exercises and strength exercises can help us build and maintain bone density, which is important for preventing dangerous bone fractures in the future. Additionally, if we need to consume more calcium (1,000 to 1200 milligrams/day) or vitamin D (800 to 1,000 IU/day) in our diets, it is important to add supplements.
It is important for women ages 65 and above or any person who has taken steroids for 3 months or longer, regardless of their age or gender, to undergo a DEXA scan to detect low bone density. A DEXA scan is simply a special X-ray of your bones. It is a quick, painless procedure. If the scan shows low bone density, your doctor will probably want the scan repeated in 2 years and may treat your low bone density with medication. If the DEXA scan is typical and you don’t have any new risk factors, it should be repeated in 5 to 10 years.
People with longstanding IBD that involves at least 30% of the colon may often be at a higher risk of developing colorectal cancer. Screening interval recommendations vary, but it is generally recommended to start screening for colorectal cancer after 8 years of greater than 30% colonic inflammation and then have regular screenings via colonoscopy after that. Depending on the individual situation, these could occur yearly, more often, or less often. By screening for colorectal cancer early, it is possible to remove precancerous polyps during the colonoscopy or potentially perform surgery to prevent the development of advanced colorectal cancer.
It’s extremely important to continue following up closely with your gastroenterology team, as they will guide you through the preventive guidelines as your situation changes over the years. It is also important to treat your IBD, as untreated IBD can lead to complications like infection and cancer. It may feel like the appointments are endless when you have IBD, but it is completely worth it to stay on top of your health and prevent the development of other serious conditions.
Medically reviewed on November 28, 2022
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