Preventive Care in Inflammatory Bowel Disease
Publication Date: February 1, 2017
Preventive health maintenance recommendations
Statement 1a: All adult patients with IBD should undergo annual vaccination against influenza. (Conditional (weak) “We suggest”, Very low)
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Statement 1b: Those on immunosuppressive therapies and their household contacts should receive the non-live trivalent inactivated influenza vaccine, but not the live inhaled influenza vaccine. (, )
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Statement 2: Adult patients with IBD receiving immunosuppressive therapy should receive pneumococcal vaccination with both the PCV13 and PPSV23, in accordance with national guidelines. (Conditional (weak) “We suggest”, Very low)
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Statement 3: Adults with IBD over the age of 50 should consider vaccination against herpes zoster, including certain subgroups of immunosuppressed patients. (Strong “We recommend”, Low)
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Statement 4: Adults with IBD should be assessed for prior exposure to varicella and vaccinated if naive before initiation of immunosuppressive therapy when possible. (Conditional (weak) “We suggest”, Very low)
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Statement 5: Patients with IBD who are immunosuppressed and traveling to endemic areas for yellow fever should consult with a travel medicine or infectious disease specialist prior to travel. (Conditional (weak) “We suggest”, Very low)
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Statement 6: Adolescents with IBD should receive meningococcal vaccination in accordance with routine vaccination recommendations. (Conditional (weak) “We suggest”, Very low)
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Statement 7: Household members of immunosuppressed patients can receive live vaccines with certain precautions. (Conditional (weak) “We suggest”, Very low)
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Statement 8: Adults with IBD should receive age-appropriate vaccinations before initiation of immune suppression when possible. (Conditional (weak) “We suggest”, Very low)
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Statement 9: Vaccination against Tdap, HAV, HBV, and HPV should be administered as per Advisory Committee on Immunization Practice guidelines. (Conditional (weak) “We suggest”, Very low)
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Statement 10: Women with IBD on immunosuppressive therapy should undergo annual cervical cancer screening. (Conditional (weak) “We suggest”, Very low)
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Statement 11: Screening for depression and anxiety is recommended in patients with IBD. (Conditional (weak) “We suggest”, Low)
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Statement 12a: Patients with IBD (both ulcerative colitis and CD) should undergo screening for melanoma independent of the use of biologic therapy. (Strong “We recommend”, Low)
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Statement 12b: IBD patients on immunomodulators (6-mercaptopurine or azathioprine) should undergo screening for NMSC while using these agents, particularly over the age of 50. (Strong “We recommend”, Low)
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Statement 13: Patients with conventional risk factors for abnormal bone mineral density with ulcerative colitis and CD should undergo screening for osteoporosis with bone mineral density testing at the time of diagnosis and periodically after diagnosis. (Conditional (weak) “We suggest”, Very low)
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Statement 14: Patients with CD who smoke should be counseled to quit. (Strong “We recommend”, Low)
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Title
Preventive Care in Inflammatory Bowel Disease
Authoring Organization
American College of Gastroenterology
Publication Month/Year
February 1, 2017
External Publication Status
Published
Country of Publication
US
Document Objectives
The purpose of this article is to review preventive care for the inflammatory bowel disease (IBD) patient.
Target Patient Population
Patients with Inflammatory bowel disease
Inclusion Criteria
Female, Male, Adolescent, Adult, Child, Older adult
Health Care Settings
Ambulatory, Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Prevention
Diseases/Conditions (MeSH)
D015212 - Inflammatory Bowel Diseases, D011315 - Preventive Medicine, D014611 - Vaccination
Keywords
vaccination, inflammatory bowel disease, chronic inflammatory disease (CID), preventive care
Source Citation
Farraye, Francis A MD, MSc, FACG; Melmed, Gil Y MD, MS, FACG; Lichtenstein, Gary R MD, FACG; Kane, Sunanda V MD, MSPH, FACG4 ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease, American Journal of Gastroenterology: February 2017 - Volume 112 - Issue 2 - p 241-258 doi: 10.1038/ajg.2016.537