Post-traumatic stress is a chronic psychological reaction to an event where a person experiences extreme fear or anxiety due to actual or perceived threat to life or bodily harm. It is usually thought of in other groups like combat veterans or crime victims. Trauma from medical experiences is less studied and the study team, a partnership between Northwestern and Rush Universities and led by Dr. Tiffany Taft and Dr. Stephen Hanauer, is the first to study PTS in IBD patients living in the United States. Between 25% and 30% of IBD patients report clinically significant symptoms of PTS which include nightmares, flashbacks, feeling on edge, mood changes and avoidance behaviors. Chronic PTS likely partially explains poor outcomes in some patients, including worse disease activity, more hospitalizations and higher healthcare utilization. It is likely many IBD patients are living with chronic PTS and go undiagnosed.

The DHF funded research on post-traumatic stress symptoms in patients with IBD, published in the Inflammatory Bowel Diseases Journal in June 2021 (https://academic.oup.com/ibdjournal/advance-article-abstract/doi/10.1093/ibd/izab152/6301664), is the first large-scale study of medical trauma due to experiences related to Crohn’s disease and ulcerative colitis. Almost 800 patients from the Crohn’s & Colitis Foundation IBD Partners database participated. This study will bring awareness to IBD physicians, nurses, and psychologists to screen patients for this condition more frequently.

The next steps are to identify preventive strategies and safe treatments for IBD-related PTS. Based on the findings of this DHF grant the study team has submitted a larger research project grant (R01) to the National Institutes of Health to test an established psychological treatment for PTS delivered via telemedicine in a large cohort of IBD patients. The results of the study, if funded, will validate a brief psychological intervention that can be widely disseminated to mental health practitioners who work with IBD patients and lay the foundation for future study of potential risk factors, predictors of PTS treatment response, and even PTS treatments that target the gut microbiome. Doctors Taft and Hanauer have partnered with leading experts on PTS treatment, medical trauma and the microbiome/metabolome in IBD for this initiative.