Loving your inflammatory bowel disease

Because it here.

Because there is no cure yet.

Because hating your IBD and your body hasn’t helped you.

Because you are not broken or deformed or diseased.

Because your IBD has grown your strength and resilience and compassion.

Because maybe IBD is your superpower.

Just today I had a discussion with a client of mine, who after many years of struggling with active Crohn’s disease was finally in remission. She thought she would feel amazing, but instead she was disappointed.

She did not feel that sense of freedom that she had imagined.

She spent her time worrying that her Crohn’s disease would flare again. And worse- she was sure she was going to “screw something up” and that the flare would be all her fault. She feared that she would eat the wrong thing or exert herself too much or that all the stress in her life would tip her back into a flare.

She was afraid and fear paralyzed her.

Fear and blame stopped her from doing the things that she knew helped to keep her well. She would forget to take her medication regularly- the very thought of her medication actually started to make her feel more anxious. She stopped eating a diet that made her feel good, because she was so sure she was going to mess it up that she might as well not even try.

Fear and blame are emotions that we sometimes think will help us achieve our health goals. We talk about “whipping ourselves into shape.” We beat ourselves up emotionally when we do human things like forget to take our medications because we think it will drive us to do better in the future. If we are scared enough that something terrible will happen, we think we will be driven to take control of our health.

But so many times, like my client above, fear and blame actually drive us to the opposite result. And even when they do help motivate us to move forward with our health priorities in the short run, fear is not a sustainable emotion. Our minds get tired of the discomfort associated with feeling afraid all the time and we lose momentum.

What if instead of using fear and blame, we used the emotion of LOVE to drive us to our healthcare goals?

Love doesn’t tire, it always feels good. What if we loved ourselves and our body so deeply that we did everything in our power to make healing inevitable? Even when the road was bumpy, the path was unclear or hurdle after hurdle stood in our way. When we love every part of ourselves, we are willing to commit to the work of figuring it all out.

Loving yourself, your body, your IBD to health is possible.

To find out more about my exclusive coaching program for women with IBD, contact me.

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The Power of Belief in IBD

In my medical specialty treating inflammatory bowel disease, the placebo effect has been a thorn in the side of doctors. I have called it the placebo “problem.”

In a clinical trial, when we are testing a new medication to see if it will be effective, we compare it to a “placebo” or fake medication (sometimes referred to as a “sugar pill”). The placebo effect occurs when patients receiving the placebo experience a benefit.

My colleagues and I look at the data published in clinical trials and see the clear improvement in patients getting both real drug and placebo as a problem. It makes it hard to interpret their results if many patients are getting better when they are not receiving the real drug. In trials for inflammatory bowel disease, placebo rates for symptom response have historically been between 20-40%. While accounting for the placebo effect is critical to know whether a drug is truly effective, I was ignoring an equally exciting and important part of what these studies show.

Over the past few years, I have begun to look at the placebo response with curiosity and excitement. If patients with Crohn’s disease and ulcerative colitis can objectively feel better by just believing that this is possible, than why are we not harnessing the power of the mind more and learning to do it better? We may not even have to “trick” ourselves into believing we are getting a real medication. Studies have shown that even when people know they are getting a placebo, they may still experience improvement in symptoms.

While there is clearly a very strong mind-body connection in IBD, I think we have to be careful when we recommend harnessing the power of the mind to manage disease. The placebo response as it relates to symptoms is high, but is much lower when we look at more objective markers of inflammation such as blood inflammatory markers (CRP, ESR), stool inflammatory markers (calprotectin) and healing of the tissues seen on colonoscopy. Doctors, including myself, become concerned that patients will take this to mean that they should work on mindset instead of taking traditional medications. We worry that our patients might then suffer long-term complications of undertreating their disease. A better approach is to capture as much benefit as possible using the right medications and the right mindset tools.

In medicine, we often tell patients that they are likely to have a 10-15% response rate to a certain drug. That is what we call the delta- or difference- between the response of the patients who received drug and those who received placebo in a clinical trial. So, for instance, if 20% of subjects receiving placebo responded to a medication and 35% responded to a drug, the drug’s overall efficacy (the difference) is 15%. When I quote these rates of response with medications, my patients often become discouraged at the low likelihood that they will get better. They may not even want to take a chance on a medication that might really work for them. However, when we combine the medication and placebo response, things look much better. The full effect is 35%, not 15%.

So what if I told you that there was something you could do that would make your current medicines twice as effective at reducing your symptoms? What if I also told you it had no traditional medication side effects (unless you count better relationships, increased productivity and less pain)?

I think of the addition of the placebo response to traditional therapy as a starting place. There are then ways that we can train the brain to be even more efficient. Coaching and mindset tools are designed to help us work on believing that getting better is not only possible but inevitable. Then out of that place of determination, we take the actions we need to help the body heal.

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