Alan Moss, MD, on Defining Disease Severity in IBD

Dr Moss discusses his presentation from AIBD 2022 on defining severity of inflammatory bowel disease, including differences in patient and physician perceptions.

Alan Moss, MD, is professor of Medicine and director of the Crohn's & Colitis Program at Boston University School of Medicine in Boston, Massachusetts.

TRANSCRIPT:

Good morning. I'm Alan Moss. I am a professor of medicine at Boston University School of Medicine and at Boston Medical Center, and I'm here at AIBD 2022 in Orlando.

This morning I was discussing measuring disease severity in inflammatory bowel disease. And during this talk there were three areas I covered at a high level. The first was recognizing the difference between acute severity in terms of symptoms and signs and more chronic severity in terms of bowel damage and the impact of IBD on a patient's quality of life. The second area was to talk about the gap between patient's perception of disease severity, and physician's perception of their patient's disease severity. We recognize that there does appear to be a difference in what we perceive as important for severity, and what patients perceive as important for their quality of life.

A good example would be fecal urgency. It's not something we often ask about in the clinic, but when patients are asked, at least two thirds perceive fecal urgency to be really important in terms of their quality of life and how it impacts their day-to-day activity.

The third topic I covered was some practical tools to use in the clinic for clinicians to quantify disease severity. Examples would be symptom scores for ulcerative colitis, symptom scores for deciding on remission or not remission for Crohn's disease, and then finally, some tools to use when patients are hospitalized in who needs rescue therapy for ulcerative colitis, and who is a high risk of proceeding to colectomy. And that would hopefully provide the audience with some simple tools they can use in their practice to quantify severity, quantify prognosis, and then ultimately give patients the best care, and the best care at the right time for their disease course.