It’s estimated that there are over half a million people living with Inflammatory Bowel Disease in the UK¹. IBD is mainly used to describe ulcerative colitis and Crohn’s disease, two long-term conditions characterised by inflammation of the gut².

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Currently, there is unwarranted variation in the quality of IBD care across the UK, with waiting times for new patient appointments at gastroenterology clinics varying between one and 27 weeks³. A recent survey of 10,000 people living with IBD found that 26 per cent waited over a year for a diagnosis, and 41 per cent had visited accident and emergency at least once before being diagnosed⁴, which can prove costly for the NHS. At an estimated £900m annually⁵, lifetime medical costs associated with IBD care are comparable to diabetes and cancer care⁵.

Clearly, there’s a need for change on a national scale. The IBD community – including the IBD UK collaboration led by Crohn’s & Colitis UK – continues to achieve significant progress for people living with IBD, but tackling unwarranted variation requires further collaborative, national effort, with the support of government and NHS leaders.

As pandemic and economic pressures compound longstanding challenges to the NHS, addressing unwarranted variation in IBD care can feel daunting. But there are examples of best practice that demonstrate how even small changes can make a big difference to those living with IBD and the teams and services supporting them. “Levelling up care for people living with Inflammatory Bowel Disease (IBD)” a report initiated and funded by healthcare company Takeda UK, spotlights seven NHS best practice case studies across different parts of our IBD care pathway which other centres can learn from.

This includes the “AWARE-IBD” project from the IBD Centre at Sheffield Teaching Hospitals Foundation Trust, in partnership with Crohn’s & Colitis UK. Funded by The Health Foundation as part of the “Common Ambition” programme, the project aims to improve service experience by making explicit the question “What matters to you?” – empowering those with IBD and enabling them to feel in control of their care. It aims to establish a process within the trust whereby change is driven through collaboration with people with IBD, and using systematic, embedded data collection. This has led to engagement with “less heard voices”, the development of personalised care plans and a toolkit to help people express what is important for them to their clinical team.

This is one example of good practice – but between trusts, the requirements of services may vary. Services can work with patients to further understand what “good care” means for them, embedding their voice into service development.

As we look for solutions to improve outcomes and experiences for people living with IBD, tackling unwarranted variation is key. While each trust has a role to play, we can’t tackle it alone. There’s a clear need for a national IBD strategy, drawing on the expertise of both patients and healthcare professionals, with NHS and government backing, to ensure everyone living with IBD can receive quality care.

References:

¹Crohn’s & Colitis UK. New research shows over 1 in 123 people in UK living with Crohn’s or Colitis. March 2022. Available at: https://crohnsandcolitis.org.uk/news-stories/news-items/new-research-shows-over-1-in-123-people-in-uk-living-with-crohn-s-or-colitis Last accessed January 2023.

²NHS England. Inflammatory bowel disease. Available at: https://www.nhs.uk/conditions/inflammatory-bowel-disease/ Last accessed: January 2023.

³Oates B., Gastroenterology, Getting It Right First Time (GIRFT) Programme National Speciality Report. March 2021. Available at: https://gettingitrightfirsttime.co.uk/wp-content/uploads/2021/10/Gastroenterology-Oct21v.pdf Last accessed January 2023.

⁴IBD UK, “Crohn’s and Colitis Care in the UK: The Hidden Cost and a Vision for Change” April 2021. Last accessed January 2023. Available at: https://ibduk.org/reports/crohns-and-colitis-care-in-the-uk-the-hidden-cost-and-a-vision-for-change

⁵Crohn’s & Colitis UK, “New resources for Nurse and Healthcare Professionals”. February 2018. Available at: https://www.crohnsandcolitis.org.uk/news/new-resource-for-ibd-nurse-specialists Last accessed January 2023.

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Outbreak declared at local hospital

Seaforth Community Hospital Sign, Seaforth, ON. (Photo by Craig Power, © 2016).

By Bob Montgomery
January 30, 2023 5:41am

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A COVID-19 Outbreak has been declared on the Inpatient Unit at Seaforth Community Hospital.

Quality, Patient Safety & Infection Control Manager Erica Jensen explains what an outbreak means.

“An outbreak refers to two or more COVID positive cases. So one of our control measures in response to outbreaks is that we restrict the family and caregiver presence on the unit to essential need only, so that is for palliative patients,” Jensen stated.

Jensen adds, the restrictions will be in place until, in collaboration with the local health unit, they can determine that no ongoing transmission is occurring within the outbreak unit.

“Definitely call ahead if you’re wanting to visit someone at the Seaforth Hospital. I know that the staff there are working diligently to contact family and caregivers who do have loved ones in the hospital right now,” Jensen added.

Jensen also points out, as much as COVID cases have gone down recently, testing is still quite limited, so it’s difficult to know exactly what the situation is and COVID is still present, so the outbreak wasn’t a complete surprise. She advises people to continue to take precautions like washing their hands, wearing a mask in public places and get vaccinated.

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Apples are one of the oldest cultivated fruit, dating back at least 6,500 years, and have some of the greatest health benefits.  There is truth behind the old adage “An apple a day keeps the doctor away.”

They are high in soluble fibre, low calorie, low on the glycemic index, and contain beneficial vitamins like Vitamin C, quercetin, pectin and potassium. They are a good antioxidant (especially the peel) and are the number one fruit to help prevent diabetes, cancer and heart disease. They help lower cholesterol as the soluble fibre in apples binds with saturated fat (preventing it from entering the bloodstream). 

To aid weight loss, it is beneficial to eat an apple prior to a meal, as they curb your appetite. Apples encourage more saliva production, which protects your teeth. Some studies show mental health benefits of increased intellectual capabilities and a slowing down of mental aging and Parkinson’s (due to their antioxidant properties). The fibre and quercetin (a plant polyphenol) builds immunity to combat virus and bacteria, especially when one is stressed. The antioxidant properties help regulate ocular muscles and nerves, helping to preserve one’s eyesight.

Apples also speed up liver regeneration. The pectin in apples binds with heavy metals in the gut (aluminum and lead) and helps eliminate them. Heavy metal poisoning is one of the leading causes of Alzheimer’s disease.  Apples are also proven to reduce anxiety when eaten regularly. The soluble fibre pectin aids IBS symptoms and ulcerative colitis.

Apple cider vinegar (fermented apple juice) has become a health rage and has its own set of health benefits including aiding digestion and weight loss, lowering inflammation and boosting energy.

Consuming it before a meal is said to help reduce blood sugar spikes afterward. It also helps with the absorption of the following nutrients: protein, calcium, iron, carbohydrates, fats, Vitamins A,B,C and E and magnesium.  Apple cider vinegar is an antifungal, antibacterial and antiviral helps with absorption of calcium and other minerals. Even though it is acidic, once absorbed in the gut it is slightly alkaline.  As it is acidic before digestion, it shouldn’t sit on the teeth as it may soften enamel. It is best to drink apple cider vinegar through a straw or rinse your mouth out afterwards with water.

These are some (proven and unproven) folk remedies using apple cider vinegar. Here are several but not all: removes age spots, as a soak for arthritic hands and feet or for athlete’s foot, soften foot corns, prevents asthma, heals bruises, fights cancer, helps prevent cataracts, eliminates cold sores, soothes a sore throat, eliminates cramping, treats dandruff, lowers blood sugars, kills diarrhea causing bacteria, soothes eczema and itching due to rashes, bites or stings, eliminates fatigue, increases stomach acid for those with gallbladder issues (associated with low stomach acid), aids hay fever, reduces headaches, dissolves the glue that holds nits (head lice eggs) onto the hair, treats hiccups, lowers blood pressure, aids osteoporosis by aiding calcium absorption, stops nose bleeds, aids absorption of all vitamins and minerals, treats smelly feet and warts.   

As with any alternative remedy, it is important to talk to your naturopath and doctor beforehand to make sure there are no contra-indications with existing medicines, but there doesn’t seem to be any doubt that apples and apple cider vinegar contribute to healthy living.  There are also many beauty aids but space prevents me from covering them in this article.

I personally use apple cider vinegar in a wonderful salad dressing with our Lemon-Honey Elixir, crushed garlic, avocado oil and a pinch of dried mustard. 

Claire Nielsen is a health coach, author, public speaker and founder of www.elixirforlife.ca. The information provided in the above article is for educational purposes only and is not a substitute for professional health and medical advice. Please consult a doctor or healthcare provider if you’re seeking medical advice, diagnoses and/or treatment.

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