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  1. Tanaka, Makoto PhD, RN
  2. Kawakami, Aki PhD, RN
  3. Iwao, Yasushi MD, PhD
  4. Fukushima, Tsuneo MD, PhD
  5. Yamamoto-Mitani, Noriko PhD, RN


The study objective was to investigate the nature and perceived effectiveness of strategies that patients with inflammatory bowel disease (IBD) use in response to worsening symptoms. Questionnaires to investigate the use and perceived effectiveness of 11 types of strategies for coping with possible flare-ups were mailed to 1,641 members of the Crohn's and Colitis Foundation of Japan. The responses were analyzed separately by disease type: ulcerative colitis (UC) and Crohn disease (CD). A total of 400 questionnaires were analyzed from 260 UC and 140 CD patients. The strategies used most by both patient groups were "change contents of meals" and "get more sleep." In addition, "skip some meals" was commonly used by CD patients. The most effective strategies were "use extra topical corticosteroids" (30 of the 56 subjects, 53.6%) among UC patients, and "skip some meals" (70 of the 114 subjects, 61.4%), and "take/add to the elemental diet" (53 of 89 subjects, 59.6%) among CD patients. The coping strategies used most by patients with IBD involved lifestyle modifications. However, the additional use of medications was regarded as the most effective, despite the small number of patients who used this strategy. Additional use of topical medications for UC patients and diet modifications for CD patients should be emphasized in self-management education for patients.