2013 advances in inflammatory bowel diseases hollywood, florida december 12, 2013
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2013 Advances in Inflammatory Bowel DiseasesHollywood, Florida December 12, 2013Carol S. Brotherton, PhD, MSN, RNGeorge Mason University, Fairfax, Virginia 1
Nurse-Led Investigation of the Relationship Between Dietary Fiber and Crohn's Disease Symptoms
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Nothing to Disclose
Disclosures
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My background… Family and community experiences (beginning in 1977)
Some people with Crohn’s disease can control their symptoms through therapeutic use of dietary fiber
Clinical nursing in gastroenterology/outpatient surgery settings (1992 - 2007)1.Benefits of dietary fiber are not taught in conventional Crohn’s disease care
2.Patients can be taught about the benefits of fiber and observe improvements similar to that of individuals in the community
NIH-funded researcher (2008 – present)Research program focused on lifestyle factors that affect CD symptoms
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Contraindications…
◦Recent surgery◦Obstructive strictures ◦Open fistulas◦Short bowel syndrome◦Wheat allergy/gluten intolerance/celiac
disease
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What I taught…
◦Epidemiology evidence◦Fiber effects in the GI tract◦Fiber heterogeneity◦Anecdotal evidence◦Label reading
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What we did…
• Design: 4-week, 2-group, single-blind, randomized, controlled
• Purpose: to investigate the effects of fiber-related dietary instructions specifying wheat bran consumption on GI symptoms and HQoL in individuals diagnosed with CD
Dependent
Variables
Independent
Variable
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No group differences at baseline
What we found…
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What we found… Partial Harvey Bradshaw Index (pHBI)Lower Scores=Diminished Symptoms
Groups Bran treatment Control
Repeated Measures ANOVA P = 0.008
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Inflammatory Bowel Disease Questionnaire (IBDQ)Higher Scores=Better Quality of Life
What we found…
Repeated Measures ANOVA P = 0.028
Groups
Bran treatment Control
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Conclusions… Limitations
Implications
Future Research
• Small sample size• Limited generalizability• Limited power for objective measures
Disconnect between research and practice Patients with Crohn’s disease may benefit from receiving information from nurses about the effects of dietary fiber in the gastrointestinal tract
• Test intervention in a larger, more diverse sample• Choose outcomes and measures that are not affected by biologic drugs (effect of fiber on microbiota?)
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Thank you!Questions? Email: cbrothe2@gmu.edu
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