2 minute read
Meet the researcher
from Connect Magazine
Your membership helps us explore Crohn’s and Colitis in new ways. Clinical Research Fellow Nilofer Husnoo at Sheffield Teaching Hospitals is examining the best treatment options for Crohn’s Disease
In a third of patients with Crohn’s Disease, the condition affects the join between the small and large bowel. People are often given powerful medicines to control their symptoms and evidence shows that almost everyone who has disease in this part of their bowel ends up having an operation. However, usually surgery is only carried out after all possible medicines have been tried and have not worked.
Getting the timing right
All treatment options have risks and the disease can come back even after treatment. However, recent research has shown that an early operation before starting some medicines may make the disease less likely to come back. It may also reduce the need to take medication.
With this in mind, the Early Bowel Resection for Terminal Ileal Crohn’s Disease (E-Bric) study will look at the timing of surgical options. Clinical Research Fellow Nilofer Husnoo says: “Despite evidence suggesting that doing an operation sooner might have some benefits for patients, surgery is generally seen as a last resort.”
The benefits of surgery
The researchers will interview patients about how they choose treatments and what influences their decisions.
They will then study how patients weigh up pros and cons to decide whether to continue treating their Crohn’s Disease with medicines or if they’d rather have an operation.
“There have been lots of studies exploring how different medications impact quality of life for the patient, but there’s a lack of similar research into surgical outcomes,” says Nilofer.
“At the moment, patients and doctors seem to prefer medicines to surgery. There are no clear reasons for this, so the research aims to find out why.
“Earlier surgery could mean patients go for longer periods before needing more operations or it could mean they don’t need treatment post-surgery. If there’s a real benefit to having an early operation and patients aren’t getting it, that means they’re not getting the best possible care that they could have.”
Next steps
The research team, led by Nilofer and Professor Steven Brown, will gather patients’ views to find out what makes them opt for either medicines or an operation. They will also explore with patients when they think surgery should happen. Researchers will then test how patients weigh up pros and cons when making a choice about their treatment.
They will also speak to patients who have had surgery on this part of the bowel about their experiences to explore whether they regret the timing of their operation.
“This sort of work has never been done before,” says Nilofer. “There’s an opportunity for patients to understand their options better and it may affect how we look after people. This project will also help us set up larger studies to answer the question of which is better: early surgery or medication.” crohnsandcolitis.org.uk/
