Holistic care in inflammatory bowel disease: is it in REACH?

Abstract

There is a growing body of evidence supporting the value of multidisciplinary teams in delivering comprehensive, holistic care for individuals with inflammatory bowel disease (IBD). Members of this team often include gastroenterologists, psychologists, nurses, dieticians, and other specialists and allied healthcare professionals, each of whom have a significant role in the treatment of IBD and its associated complications. Common symptoms that impact quality of life include persistent abdominal pain, fatigue, urgency, sleep disturbances, and mood disorders. Holistic care models are particularly well-suited to address these challenges, offering targeted symptom-based interventions. Further, holistic care models can modify broader health behaviors that can influence disease activity, such as nutrition, smoking cessation, and stress management. The implementation of holistic care can take various forms, ranging from fully integrated medical homes embedded within IBD centers to partially integrated or community-based programs. Antidepressant medications can help to restore the gut–brain axis, thereby improving mental health and physical symptoms concurrently, and we provide practical guidance in their dosing, side-effect profiles, and appropriate combination therapies. Additionally, digital health technologies have provided diagnostic and therapeutic insights into advancing IBD care, enhancing the delivery of longitudinal, patient-centered care. To improve long-term outcomes and enhance quality of life for individuals with IBD, clinicians and healthcare systems must prioritize the development and integration of holistic, multidisciplinary care models into routine practice.