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. 2022 Sep 8;4(3):otac032.
doi: 10.1093/crocol/otac032. eCollection 2022 Jul.

Functional Medicine Approach to Patient Care Improves Sleep, Fatigue, and Quality of Life in Patients With Inflammatory Bowel Disease

Thomas M Strobel  1 , Christine Nguyen  1 , Taylor Riggs  1 , Sarah N Horst  1 , Amy Motley  1 , Spencer Upadhyaya  1 , Sarah Campbell  1 , Emily Spring  1 , Robin L Dalal  1 , Elizabeth Scoville  1 , Baldeep Pabla  1 , David A Schwartz  1 , Dawn B Beaulieu  1
Affiliations

Functional Medicine Approach to Patient Care Improves Sleep, Fatigue, and Quality of Life in Patients With Inflammatory Bowel Disease

Thomas M Strobel et al. Crohns Colitis 360. .

Abstract

Background: A Functional Medicine program was developed at an inflammatory bowel disease (IBD) center with the goal of integrating strategies to address modifiable lifestyle factors and to complete a 6-week elimination diet under the direction of a trained Functional Medicine dietitian and Functional Medicine providers.

Methods: From January 2019 to November 2019, patients with controlled, but persistent, symptoms from IBD were offered enrollment. Each of the 5 visits incorporated an educational session focused on nutrition followed by a session focusing on modifiable lifestyle factors. The patients were placed on a supervised 6-week elimination diet. At each visit, patients completed the SIBDQ (Short Inflammatory Bowel Disease Questionnaire), FSS (Fatigue Severity Scale), PSQI (The Pittsburgh Sleep Quality Index), and MSQ (Medical Symptoms Questionnaire). Statistical analysis was performed using the Wilcoxon matched pairs signed-rank test.

Results: Nineteen patients enrolled (2 men: 1 ulcerative colitis [UC], 1 Crohn's disease [CD]; 17 women: 3 UC, 14 CD). 15 patients completed all modules. There was improvement in all patient-reported outcomes (PROs) (FSS, P < .001; PSQI, P < .001; SIBDQ, P < .001; MSQ, P < .001). Every patient who completed the last session demonstrated weight loss.

Conclusions: The psychoemotional roots to immune disease states, particularly IBD, are complicated and often not addressed in traditional care. We are just beginning to understand the impact of nutrition, sleep, stress, movement, and relationships on IBD. In this cohort, utilizing Functional Medicine as an adjunct to traditional care resulted in improvement in all PROs.

Keywords: Crohn’s disease; Functional Medicine; inflammatory bowel disease; ulcerative colitis.

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Figures

Graphical Abstract
Graphical Abstract
Figure 1.
Figure 1.
Paired individual scores for select domains in the MSQ. Abbreviation: MSQ, Medical Symptoms Questionnaire. Improvements in each domain were significant with P < .01. Box and whisker plots demonstrate median, interquartile range, and extremes.
Figure 2.
Figure 2.
Improvements in MSQ and SIBDQ over 5 educational sessions. Abbreviations: MSQ, Medical Symptoms Questionnaire; SIBDQ, Short Inflammatory Bowel Disease Questionnaire. Box and whisker plot demonstrates median, interquartile range, and extremes.
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