The non-drug management of patients with chronic gastrointestinal disease

Abstract

The work embodied in this thesis explores various aspects of health for patients with chronic gastrointestinal disease. By analysing additional factors to the primary disease component, such as inflammatory bowel disease, it is hoped that the overall health of such patients may be improved. Dietary fibre in health is reviewed in the modern era of microbial science, and in the context of low mean daily fibre intake among patients with Crohns disease of 13.9g/day. In addition, a rise in BMI over a ten year period is demonstrated among patients with Crohns disease. This rise in abnormal metabolic health appears independent of biologic drugs now commonly prescribed. Furthermore, we demonstrate a low radiation dose CT protocol using model based iterative reconstruction, to reduce effects of radiation exposure associated with high BMI, to be an effective first-line imaging modality without image compromise. To mitigate effects of medication sideeffects using non-drug therapies, we show, using video capsule endoscopy (VCE), that Bifidobacterium 195 mitigated effects of Aspirin-induced small bowel damage. Finally, using VCE, we demonstrate median gastric and small bowel transit times of 22 minutes, interquartile range (IQR) 10-48 minutes, and 198.5 minutes, IQR 157- 240.5 minutes respectively.