Crohn's and colitis: New research offers insights into caring for young people

Crohn's disease, ulcerative colitis, and IBD-unclassified colitis belong to a group of conditions known as inflammatory bowel disease (IBD). IBD is a chronic, heterogeneous, condition characterised by periods of relapsing and remitting and it occurs primarily as a consequence of inflammation within the lumen of the bowel (Ashton et al, 2018). Unlike some other chronic conditions, IBD is characterised by unpredictability and flare-ups (Nicholas et al, 2007; Roberts et al, 2019). The symptoms include diarrhoea, abdominal pain, weight loss, blood in the stools, and fatigue (Ashton et al, 2018); those symptoms are intrusive and can impact on many aspects of life (Stapersma et al, 2019; Kim et al, 2019).

In our recent work (Qualter et al, 2020), we found that young people who experience severe symptoms of IBD were more likely to be depressed, anxious, and lonely compared to those with less severe symptoms. Our analyses showed that having more severe symptoms affected how embarrassed young people were about their condition, which influenced how they felt about their friendships, and impacted their mental health. The stigma surrounding symptoms was a barrier to creating and maintaining good quality friendships: the unpredictable nature of the symptoms and the stringent treatment and management regimens made for embarrassing social experiences and restricted social interaction, which resulted in poorer mental health. At a point in one's life where peer social relationships really matter (Foulkes and Blakemore, 2016), having unpredictable and embarrassing symptoms that are socially limiting can leave a person exposed within close friendships, and vulnerable in new social interactions.