IMAGINE a World with no IBD

Data about patients’ lifestyles, along with biological samples, will reveal more about intestinal microbiology, which informs individualized care and better treatment.
Data about patients’ lifestyles, along with biological samples, will reveal more about intestinal microbiology, which informs individualized care and better treatment.

Digestive issues are among the most common of all health complaints, with two in three Canadians experiencing gastrointestinal symptoms to at least some degree. Approximately 20 per cent of patients seen in primary health care have a chronic gastrointestinal disorder, such as acid reflux, Irritable Bowel Syndrome (IBS), or constipation, leading to very high referral rates to gastrointestinal specialists.

On the severe end of the spectrum is Inflammatory Bowel Disease (IBD), an umbrella term that encompasses Crohn’s disease and ulcerative colitis. Together, these two immune-mediated chronic diseases of the gastrointestinal tract affect an average of 1 in 140 Canadians and, as recent data reveals, an astonishing 1 in 83 Nova Scotians.

“We don’t yet know exactly what causes IBD, what triggers flare-ups, or how to predict how long a patient’s remission will last,” said Dr. Jennifer Jones. “These are important questions we need to answer to help patients keep their disease under control.”

If IBD is not well-managed with medication, diet and stress management techniques, patients may experience excruciating pain as well as an increase in loose, frequent, urgent bowel movements. Some patients develop complications such as strictures, fistulas, perforations, obstructions or abscesses in the bowel that require surgery.

The Canada-wide study, IMAGINE (Inflammation, Microbiome & Alimentation: Gastro-Intestinal & Neuropsychiatric Effects), is gathering data from some 8,000 patients to uncover those all-important answers.

Dr. Jones is co-leading the Nova Scotia arm with Dr. Anthony Otley, a pediatric gastroenterologist at the IWK Health Centre.

The Canadian Institutes of Health Research’s Strategy for Patient-Oriented Research (CIHR SPOR) is funding the five-year, 17-centre study to the tune of $24 million.

“We will enroll about 500 patients here at NSHA—most with IBD and some with IBS as well,” said research assistant, Slava Khovratovich. “Participants will fill out detailed annual surveys about their diet, medication use, symptoms, stress in their lives and so on, and we will collect blood, urine and stool samples from them, for four years.”

This wealth of anonymized patient data will be linked to provincial health databases and analyzed to reveal how patients’ genetics, diet, treatment regimen, emotions, intestinal microbiology and other factors influence the frequency of flare-ups and severity of symptoms. It will also explore how flare-ups and symptoms affect patients’ mental health, social and occupational functioning, and other key aspects of their lives.

“This is one of the largest, most comprehensive cohort studies of IBD and IBS ever conducted in the world,” said Dr. Jones. “We will learn so much that will guide us in providing more effective, individualized care, treatment, advice and support to our patients.”